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Does metabolic compensation explain the majority of less-than-expected weight loss in obese adults during a short-term severe diet and exercise intervention?

Byrne, Nuala M., Wood, Rachel, Schutz, Yves, & Hills, Andrew P. (2012) Does metabolic compensation explain the majority of less-than-expected weight loss in obese adults during a short-term severe diet and exercise intervention? International Journal of Obesity.

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    Abstract

    Objective: We investigated to what extent changes in metabolic rate and composition of weight loss explained the less-than-expected weight loss in obese men and women during a diet-plus-exercise intervention.

    Design: 16 obese men and women (41 ± 9 years; BMI 39 ± 6 kg/m2) were investigated in energy balance before, after and twice during a 12-week VLED (565–650 kcal/day) plus exercise (aerobic plus resistance training) intervention. The relative energy deficit (EDef) from baseline requirements was severe (74-87%). Body composition was measured by deuterium dilution and DXA and resting metabolic rate (RMR) by indirect calorimetry. Fat mass (FM) and fat-free mass (FFM) were converted into energy equivalents using constants: 9.45 kcal/gFM and 1.13 kcal/gFFM. Predicted weight loss was calculated from the energy deficit using the '7700 kcal/kg rule'.

    Results: Changes in weight (-18.6 ± 5.0 kg), FM (-15.5 ± 4.3 kg), and FFM (-3.1 ± 1.9 kg) did not differ between genders. Measured weight loss was on average 67% of the predicted value, but ranged from 39 to 94%. Relative EDef was correlated with the decrease in RMR (R=0.70, P<0.01) and the decrease in RMR correlated with the difference between actual and expected weight loss (R=0.51, P<0.01). Changes in metabolic rate explained on average 67% of the less-than-expected weight loss, and variability in the proportion of weight lost as FM accounted for a further 5%. On average, after adjustment for changes in metabolic rate and body composition of weight lost, actual weight loss reached 90% of predicted values.

    Conclusion: Although weight loss was 33% lower than predicted at baseline from standard energy equivalents, the majority of this differential was explained by physiological variables. While lower-than-expected weight loss is often attributed to incomplete adherence to prescribed interventions, the influence of baseline calculation errors and metabolic down-regulation should not be discounted.

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    6 citations in Scopus
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    5 citations in Web of Science®

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    ID Code: 52896
    Item Type: Journal Article
    Additional Information: advance online publication
    Keywords: obesity, metabolic compensation , adaptive thermogenesis , resting metabolic rate, energy restriction, exercise , weight loss
    DOI: 10.1038/ijo.2012.109
    ISSN: 0307-0565
    Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > HUMAN MOVEMENT AND SPORTS SCIENCE (110600) > Exercise Physiology (110602)
    Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > NUTRITION AND DIETETICS (111100) > Nutritional Physiology (111103)
    Divisions: Current > QUT Faculties and Divisions > Faculty of Health
    Current > Institutes > Institute of Health and Biomedical Innovation
    Current > Schools > School of Exercise & Nutrition Sciences
    Copyright Owner: Copyright 2012 Macmillan Publishers Limited
    Copyright Statement: All rights reserved
    Deposited On: 03 Aug 2012 09:06
    Last Modified: 05 Feb 2013 09:57

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