Long-term Effects of Dieting on Resting Metabolic Rate in Obese Outpatients

Wadden, Thomas A.; Foster, Gary D.; Letizia, Kathleen A.; Mullen, James L.

doi:10.1001/jama.1990.03450060053028

Cited by 112 publications

(60 citation statements)

References 37 publications

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“…7 However, controversy exists regarding the existence of a long-term metabolic adaptation (understood as a drop in REE larger than that predicted from changes in FFM) when energy balance is almost restored. 9,10,29 In our study, REE decreased between 6% and 9% more than that would have been predicted from changes in FFM on the 28 d period of VLCD. However, these signi®cant differences between observed and predicted REE no longer persisted at month 1 of Signi®cantly different from the observed REE, { P`0.05.…”

Section: Discussioncontrasting

confidence: 43%

A study of the prognostic respiratory markers of sustained weight loss in obese subjects after 28 days on VLCD

1997

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OBJECTIVE: To investigate parameters of energy metabolism during a 28 d VLCD to identify possible prognostic markers of weight change observed, subsequently, when the subjects were on a six-month hypocaloric diet. DESIGN: Longitudinal, clinical intervention study of a 2 MJ diet daily for 28 d and six month follow-up under a conventional, hypocaloric diet. SUBJECTS: Seven pre-menopausal women and one male all morbidly obese but otherwise healthy (age: 16±47 y, BMI 38.9±50.5 kg/m 2 ). MEASUREMENTS: Body weight, resting energy expenditure (REE), resting respiratory quotient (RQ) and the 5 h thermic effect of food (TEF) were assessed by indirect calorimetry at the beginning and at the end of a 28 d VLCD treatment. Body composition was measured on day 1 by hydrodensitometry and tetrapolar bioelectrical impedance (TBIA), on day 28 by TBIA and nitrogen balance (NB) and by TBIA on follow-up. RESULTS: The individual weight loss during VLCD (mean 9.9 AE 2.4 kg) was signi®cant (P`0.01) and correlated signi®cantly with energy de®cit (r 0.83, P 0.01). REE/FFM decreased 6.2% (FFM TBIA ) and 8.9% (FFM NB ), respectively. TEF 28 was unchanged from TEF 1 while fasting RQ declined during the intervention period but was back to baseline already within one month of follow-up even though the mean weight loss at six months had increased to 14.0 AE 5.6 kg. There was a signi®cant (P`0.05) positive correlation between RQ 28 and body-weight changes after one, three and six months of follow-up. The RQ 28 explained 60±72% of the inter-individual variation in weight change. CONCLUSION: The resting RQ measurement is recommended as a simple and inexpensive assessment at the end of a strict weight-loss regimen in order to identify those individuals who may need greater assistance in maintaining a weight-loss when placed on a subsequent, free-living hypocaloric diet.

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Section: Discussioncontrasting

confidence: 43%

A study of the prognostic respiratory markers of sustained weight loss in obese subjects after 28 days on VLCD

1997

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“…The two groups that underwent muscle biopsies consisted of 12 subjects in each of the upper and lower quintiles for weight loss and were similar in terms of age, initial weight, and other variables. Wadden et al (30) and others have demonstrated that RMR decreases in the first few weeks of this weight loss regimen but then returns toward normal despite continued weight loss. Given the invasive nature of this procedure, it was not possible to perform muscle biopsies before and after entry into the weight loss program.…”

Section: Discussionmentioning

confidence: 85%

Decreased Mitochondrial Proton Leak and Reduced Expression of Uncoupling Protein 3 in Skeletal Muscle of Obese Diet-Resistant Women

et al. 2002

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Weight loss in response to caloric restriction is variable. Because skeletal muscle mitochondrial proton leak may account for a large proportion of resting metabolic rate, we compared proton leak in diet-resistant and dietresponsive overweight women and compared the expression and gene characteristics of uncoupling protein (UCP)2 and UCP3. Of 1,129 overweight women who completed the University of Ottawa Weight Management Clinic program, 353 met compliance criteria and were free of medical conditions that could affect weight loss. Subjects were ranked according to percent body weight loss during the first 6 weeks of a 900-kcal meal replacement protocol. The highest and lowest quintiles of weight loss were defined as diet responsive and diet resistant, respectively. After body weight had been stable for at least 10 weeks, 12 of 70 subjects from each group consented to muscle biopsy and blood sampling for determinations of proton leak, UCP mRNA expression, and genetic studies. Despite similar baseline weight and age, weight loss was 43% greater, mitochondrial proton leak-dependent (state 4) respiration was 51% higher (P ‫؍‬ 0.0062), and expression of UCP3 mRNA abundance was 25% greater (P < 0.001) in diet-responsive than in diet-resistant subjects. There were no differences in UCP2 mRNA abundance. None of the known polymorphisms in UCP3 or its 5 flanking sequence were associated with weight loss or UCP3 mRNA abundance. Thus, proton leak and the expression of UCP3 correlate with weight loss success and may be candidates for pharmacological regulation of fat oxidation in obese diet-resistant subjects. Diabetes 51: 2459 -2466, 2002 A t the Weight Management Program at the University of Ottawa, we have documented a 10-fold variation in the rate of weight loss in 353 highly compliant women on a standard exercise program and standard 900-kcal meal replacement protocol. These women were ranked according to percent body weight loss, and highest and lowest quintiles were defined as diet responsive and diet resistant, respectively. Regression analyses demonstrated that the known variables regulating energy requirements, including initial weight, age, and plasma free triiodothyronine (T3) concentrations, accounted for only half of this variability (1), leading us to search for novel molecular determinants of weight loss success.Variable responses to overfeeding have been reported. Rodent studies have demonstrated that genetic factors not only regulate weight gain in response to high-fat highcalorie diets but also determine the susceptibility to obesity when energy intake is controlled (2). In response to the ingestion of hypercaloric diets, the majority of subjects gain less weight than anticipated, and a process of adaptive thermogenesis appears to play a role in the defense against obesity (3). Several studies have demonstrated marked interindividual variability in the susceptibility to weight gain in response to overfeeding (4), and identical twins show marked similarity in this regard, suggesting an important genetic cont...

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“…Previous studies have reported both metabolic adaptation to weight loss [14][15][16][17] and no metabolic adaptation [19][20][21][22][23], and factors such as ongoing weight loss and lack of accounting for body fat change as well as FFM change may help explain the variability in results [26]. However, in our study, TEE was lower than expected based on the changes in fat and FFM (at 12 months of CR by approximately 0.76 MJ/d (180 kcals/d), equivalent to 6.6% of baseline TEE) suggesting an adaptive response to the long-term CR that may contribute to the recognized risk of weight regain following weight loss in mildly overweight individuals such as those studied here [58].…”

Section: Discussionmentioning

confidence: 99%

“…Metabolic adaptation can be defined as a change in energy expenditure with weight gain or loss over and above that accounted for by the change in body fat free mass (FFM) and fat mass, and may potentially impact long-term weight loss success. Some studies have reported that metabolic adaptation occurs during weight loss and/or subsequently [11][12][13][14][15][16][17][18] while others have found no evidence for this phenomenon [19][20][21][22][23][24][25]. In part, the different results obtained may be due to different mathematical approaches to calculating metabolic adaptation, as well as the duration and severity of caloric restriction (CR) [26].…”

Section: Introductionmentioning

confidence: 99%

Long - Term Effects of Energy-Restricted Diets Differing in Glycemic Load on Metabolic Adaptation and Body Composition*

Das¹,

Gilhooly²,

Golden³

et al. 2008

TONUTRJ

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A randomized controlled trial of high glycemic load (HG) and low glycemic load (LG) diets with food provided for 6 months and self-administered for 6 additional months at 30% caloric restriction (CR) was performed in 29 overweight adults (mean±SD, age 35±5y; BMI 27.5±1.5 kg/ m 2 ). Total energy expenditure (TEE), resting metabolic rate (RMR), fat and fat free mass (FFM), were measured at 3, 6 and 12 months. Changes in TEE, but not changes in RMR, were greater than accounted for by the loss of FFM and fat mass (P=0.001-0.013) suggesting an adaptive response to long-term CR. There was no significant effect of diet group on change in RMR or TEE. However, in subjects who lost >5% body weight (n=26), the LG diet group had a higher percentage of weight loss as fat than the HG group (p<0.05), a finding that may have implications for dietary recommendations during weight reduction.

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Long-term Effects of Dieting on Resting Metabolic Rate in Obese Outpatients

Cited by 112 publications

References 37 publications

A study of the prognostic respiratory markers of sustained weight loss in obese subjects after 28 days on VLCD

A study of the prognostic respiratory markers of sustained weight loss in obese subjects after 28 days on VLCD

Decreased Mitochondrial Proton Leak and Reduced Expression of Uncoupling Protein 3 in Skeletal Muscle of Obese Diet-Resistant Women

Long - Term Effects of Energy-Restricted Diets Differing in Glycemic Load on Metabolic Adaptation and Body Composition*

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