Metabolic adaptation following massive weight loss is related to the degree of energy imbalance and changes in circulating leptin

Objective To measure changes in resting metabolic rate (RMR) and body composition in obese subjects following massive weight loss achieved via bariatric surgery or calorie restriction plus vigorous exercise. Methods Body composition and RMR were measured in 13 pairs of obese subjects retrospectively...

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Published inObesity (Silver Spring, Md.) Vol. 22; no. 12; pp. 2563 - 2569
Main Authors Knuth, Nicolas D., Johannsen, Darcy L., Tamboli, Robyn A., Marks‐Shulman, Pamela A., Huizenga, Robert, Chen, Kong Y., Abumrad, Naji N., Ravussin, Eric, Hall, Kevin D.
Format Journal Article
LanguageEnglish
Published United States Blackwell Publishing Ltd 01.12.2014
Subjects
Adult
Basal Metabolism
Body Composition - physiology
Body Mass Index
Body Weight
Energy Metabolism - physiology
Female
Gastric Bypass
Gastrointestinal surgery
Humans
Insulin resistance
Leptin - blood
Male
Middle Aged
Obesity
Obesity, Morbid - metabolism
Obesity, Morbid - surgery
Physical fitness
Weight control
Weight Loss - physiology
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Summary:Objective To measure changes in resting metabolic rate (RMR) and body composition in obese subjects following massive weight loss achieved via bariatric surgery or calorie restriction plus vigorous exercise. Methods Body composition and RMR were measured in 13 pairs of obese subjects retrospectively matched for sex, body mass index, weight, and age who underwent either Roux‐en‐Y gastric bypass surgery (RYGB) or participated in “The Biggest Loser” weight loss competition (BLC). Results Both groups had similar final weight loss (RYGB: 40.2 ± 12.7 kg, BLC: 48.8 ± 14.9 kg; P = 0.14); however, RYGB lost a larger proportion of their weight as fat‐free mass (FFM) (RYGB: 30 ± 12%, BLC: 16 ± 8% [P < 0.01]). In both groups, RMR decreased significantly more than expected based on measured body composition changes. The magnitude of this metabolic adaptation was correlated with the degree of energy imbalance (r = 0.55, P = 0.004) and the decrease in circulating leptin (r = 0.47, P = 0.02). Conclusions Calorie restriction along with vigorous exercise in BLC participants resulted in preservation of FFM and greater metabolic adaption compared to RYGB subjects despite comparable weight loss. Metabolic adaptation was related to the degree of energy imbalance and the changes in circulating leptin.
Bibliography:Author contribution
NDK, DLJ, ER, NNA, KYC, and KDH designed the research; NDK, DLJ, RAT, PAMS, NNA, and RH conducted the research; NDK and KDH analyzed data or performed statistical analysis; NDK, DLJ, ER, RH, RAT, and KDH wrote the paper; KDH had primary responsibility for final content.
These authors contributed equally to the research and manuscript.
This research was supported in part by the Intramural Research Program of the NIH, National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK) (NDK and KDH), the Pennington NORC Center Grant P30 DK072476 (to ER), NIDDK grants R01‐DK070860 (to NNA), DK20593 to the Vanderbilt Diabetes Research and Training Center, DK058404 to the Vanderbilt Digestive Disease Research Center, K01DK89005 (to DLJ), and the Vanderbilt CTSA grant 1 UL1 RR024975 from the NCRR.
The authors declared no conflict of interest.
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ISSN:1930-7381
1930-739X
1930-739X
DOI:10.1002/oby.20900