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Metabolic adaptation following massive weight loss is related to the degree of energy imbalance and changes in circulating leptin
Author(s) -
Knuth Nicolas D.,
Johannsen Darcy L.,
Tamboli Robyn A.,
MarksShulman Pamela A.,
Huizenga Robert,
Chen Kong Y.,
Abumrad Naji N.,
Ravussin Eric,
Hall Kevin D.
Publication year - 2014
Publication title -
obesity
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.438
H-Index - 199
eISSN - 1930-739X
pISSN - 1930-7381
DOI - 10.1002/oby.20900
Subject(s) - weight loss , leptin , medicine , basal metabolic rate , calorie restriction , obesity , calorie , metabolic adaptation , body mass index , endocrinology , energy expenditure , composition (language) , metabolism , linguistics , philosophy
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.