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

Knuth ND, Johannsen DL, Tamboli RA, Marks-Shulman PA, Huizenga R, Chen KY, Abumrad NN, Ravussin E, Hall KD
Obesity (Silver Spring). 2014 22 (12): 2563-9

PMID: 25236175 · PMCID: PMC4236233 · DOI:10.1002/oby.20900

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.

© 2014 The Obesity Society.

MeSH Terms (14)

Adult Basal Metabolism Body Composition Body Mass Index Body Weight Energy Metabolism Female Gastric Bypass Humans Leptin Male Middle Aged Obesity, Morbid Weight Loss

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