Maintaining a clinical weight loss after intensive lifestyle intervention is the key to cardiometabolic health

Dandanell, Sune; Skovborg, Camilla; Præst, Charlotte Boslev; Kristensen, K; Nielsen, Malene Glerup; Lionett, Sofie; Jørgensen, Sofie Drevsholt; Vigelsø, Andreas; Dela, Flemming; Helge, Jørn Wulff

doi:10.1016/j.orcp.2016.09.009

Cited by 14 publications

(13 citation statements)

References 32 publications

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“…After completion of the ILI, a gradual weight regain begins, and after 1 year only about half of the participants maintain a clinical weight loss of >10% of body weight, and in subsequent years a further decrease is observed . The effects of the specific residential ILI under investigation in this study on weight loss and weight loss maintenance have recently been reported elsewhere and indicate that at least 25% maintain weight loss after 1.5 years .…”

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confidence: 60%

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Correlates and predictors of obesity‐specific quality of life of former participants of a residential intensive lifestyle intervention

Elbe

Elsborg

Dandanell

et al. 2018

Obesity Science & Practice

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SummaryIntroductionThe aim of this study was to investigate the relationship between weight loss during and after a unique type of weight loss intervention, namely, a residential intensive lifestyle intervention (ILI), and participants' obesity‐specific health‐related quality of life (HRQOL) several years after the intervention. In the residential ILI under investigation, participants attended a 10‐ to 12‐week long course away from their daily living environment, namely, at Ubberup Folk High School located in Denmark.MethodsA total of 79 former participants (31 male, mean age 36.6; SD = 12.7 years) who had participated in the intervention on average 5.3 (SD = 3.2) years ago were recruited for this study. They completed a questionnaire on weight‐related quality of life (IWQOL‐lite) and physical activity, as well as measurements of VO2max, blood pressure, Homeostatic Model Assessment for Insulin Resistance, waist circumference and hand grip strength.ResultsThe study results showed that weight change after the end of the intervention could predict HRQOL whereas how much weight they lost during the intervention could not. Furthermore, almost all of the investigated physiological factors were related to participants' current HRQOL. Waist circumference showed relationships with four of the five aspects of HRQOL.ConclusionFocusing on behavioural change, adhering to improved lifestyle and maintaining weight loss after the end of the intervention seem to be the key not only for cardio‐metabolic risk factors but also for sustainable HRQOL.

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confidence: 60%

“…Homeostatic model assessment of insulin resistance (HOMA‐IR) was calculated as described elsewhere . To determine metabolic syndrome status and insulin sensitivity concentrations of blood and plasma substrates, we measured the metabolites and hormones .…”

Section: Methodsmentioning

confidence: 99%

Correlates and predictors of obesity‐specific quality of life of former participants of a residential intensive lifestyle intervention

Elbe

Elsborg

Dandanell

et al. 2018

Obesity Science & Practice

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“…Body composition was measured using dual energy X‐ray absorptiometry (DXA; n = 21); water displacement (n = 6); deuterium dilution (n = 7); bioelectrical impedance (BIA; n = 5), and air displacement plethysmography (ADP; n = 4). In 27 studies, there was a passive follow‐up period where no contact with participants occurred, whereas 16 studies conducted an active WLM intervention . The median weight loss period was 13 (4‐52) weeks, and the median follow‐up period was 44 (18‐249) weeks.…”

Section: Resultsmentioning

confidence: 99%

Associations between the rate, amount, and composition of weight loss as predictors of spontaneous weight regain in adults achieving clinically significant weight loss: A systematic review and meta‐regression

et al. 2019

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Weight regain following weight loss is common although little is known regarding the associations between amount, rate, and composition of weight loss and weight regain. Forty-three studies (52 groups; n = 2379) with longitudinal body composition measurements were identified in which weight loss (≥5%) and subsequent weight regain (≥2%) occurred. Data were synthesized for changes in weight and body composition. Meta-regression models were used to investigate associations between amount, rate, and composition of weight loss and weight regain. Individuals lost 10.9% of their body weight over 13 weeks composed of 19.6% fat-free mass, followed by a regain of 5.4% body weight over 44 weeks composed of 21.6% fatfree mass. Associations between the amount (P < 0.001) and rate (P = 0.049) of weight loss and their interaction (P = 0.042) with weight regain were observed. Fatfree mass (P = 0.017) and fat mass (P < 0.001) loss both predicted weight regain although the effect of fat-free mass was attenuated following adjustment. The amount (P < 0.001), but not the rate of weight loss (P = 0.150), was associated with fat-free mass loss. The amount and rate of weight loss were significant and interacting factors associated with weight regain. Loss of fat-free mass and fat mass explained greater variance in weight regain than weight loss alone. KEYWORDS body composition, fat mass, fat-free mass, weight loss, weight regain 1 | INTRODUCTION Over half of the UK population are currently considered overweight or obese, and it is estimated that around 55% of individuals worldwide will be affected by obesity by 2050. 1 At any one time, approximately 40% of adults report that they are engaged in attempts to control their weight. 2 While these attempts show initial success, relapse is common, 3 and less than 20% of those losing 10% of their weight maintain the loss for a year or more. 4 It is likely that several factors during weight loss influence subsequent weight regain, however, although commonly measured in clinical weight loss studies, the extent to which the rate, amount, and composition (eg, fat-mass [FM] and fat-free mass [FFM]) of weight loss are associated with weight regain remains unclear. Studies of weight loss with follow-up periods in which weight regain occurs may be used as a model to identify predictive factors associated with weight regain. Factors such as a rapid rates and large amounts of weight loss have previously been associated with weight

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“…Eighty patients with obesity [means (SD)] (48/32 women/men; age, 36 (13) yr; body mass index (BMI), 38 (1) kg/m 2 ] were recruited from a population of 2,420 former participants of a lifestyle intervention at a residential private health school in Denmark (www.ubberup.dk). The enrollment process has been described in a prior paper based on the same subjects but with a focus on glucose metabolism and more general health effects of weight loss maintenance after lifestyle intervention (11). In short, subjects were contacted by letter sent to all former participants and by an advertisement on Facebook in a group for former participants.…”

Section: Participantsmentioning

confidence: 99%

“…Western blotting. Western blotting was performed as described previously (11,16,40). The primary antibodies used were anti-ATGL (10006409, Cayman), anti-HSL (4107S, Cell Signaling Technology), anti-FABPpm (GOT2, Ab93928, Abcam, Cambridge, UK), anti-FATP4 (ab200353, Abcam), anti-CD36 (AF1955, R&D Systems), anti-ADRP (Perilipin 2) (NB 110-4087, Novus Biological), anti-TIP47 (Perilipin 3) (R04251, Sigma Prestige Antibodies, St. Louis, MO), anti-OXPAT (Perilipin 5) (NB 110-60509, Novus Biologicals).…”

Section: Muscle Analysesmentioning

confidence: 99%

Influence of maximal fat oxidation on long-term weight loss maintenance in humans

Dandanell

Husted

Amdisen

et al. 2017

Journal of Applied Physiology

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Impaired maximal fat oxidation has been linked to obesity and weight regain after weight loss. The aim was to investigate the relationship between maximal fat oxidation (MFO) and long-term weight loss maintenance. Eighty subjects [means (SD): age, 36(13) yrs; BMI, 38(1) kg/m] were recruited from a total of 2,420 former participants of an 11- to 12-wk lifestyle intervention. Three groups were established based on percent weight loss at follow-up [5.3(3.3) yr]: clinical weight loss maintenance (CWL), >10% weight loss; moderate weight loss (MWL), 1-10% weight loss; and weight regain (WR). Body composition (dual X-ray absorptiometry) and fat oxidation (indirect calorimetry) during incremental exercise were measured at follow-up. Blood and a muscle biopsy were sampled. At follow-up, a U-shaped parabolic relationship between MFO and percent weight loss was observed ( = 0.448; < 0.001). Overall differences between CWL, MWL, and WR were observed in MFO (mean [95% confidence interval], in g/min, respectively: 0.46 [0.41-0.52]; 0.32 [0.27-0.38]; 0.45 [0.38-0.51]; = 0.002), maximal oxygen uptake (V̇o, in ml·min·FFM, respectively; 49 [46-51]; 43 [40-47]; 41 [39-44]; = 0.007), HAD-activity (in µmol·g·min, respectively: 123 [113-133]; 104 [91-118]; 97 [88-105]; < 0.001), muscle protein content of CD36 (in AU, respectively: 1.1 [1.0-1.2]; 0.9 [0.8-1.0]; 0.9 [0.8-0.9]; = 0.008) and FABPpm (in AU, respectively, 1.0 [0.8-1.2]; 0.7 [0.5-0.8]; 0.7 [0.5-0.9]; = 0.008), body fat (in %, respectively: 33 [29-38]; 42 [38-46]; 52 [49-55]; < 0.001), and plasma triglycerides (in mM, respectively: 0.8 [0.7-1.0]; 1.3 [0.9-1.7]; 1.6 [1.0-2.1]; = 0.013). CWL and WR both had higher MFO compared with MWL, but based on different mechanisms. CWL displayed higher V̇o and intramuscular capacity for fat oxidation, whereas abundance of lipids at whole-body level and in plasma was higher in WR. Impaired maximal fat oxidation has been linked to obesity and weight regain after weight loss. Noteworthy, maximal fat oxidation was equally high after clinical weight loss maintenance and weight regain compared with moderate weight loss. A high maximal fat oxidation after clinical weight loss maintenance was related to higher maximal oxygen updake, content of key proteins involved in transport of lipids across the plasma membrane and β-oxidation. In contrast, a high maximal fat oxidation after weight regain was related to higher availability of lipids, i.e., general adiposity and plasma concentration of triglycerides.

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Maintaining a clinical weight loss after intensive lifestyle intervention is the key to cardiometabolic health

Cited by 14 publications

References 32 publications

Correlates and predictors of obesity‐specific quality of life of former participants of a residential intensive lifestyle intervention

Correlates and predictors of obesity‐specific quality of life of former participants of a residential intensive lifestyle intervention

Associations between the rate, amount, and composition of weight loss as predictors of spontaneous weight regain in adults achieving clinically significant weight loss: A systematic review and meta‐regression

Influence of maximal fat oxidation on long-term weight loss maintenance in humans

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