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Obesity (Silver Spring, Md.) Aug 2016To measure long-term changes in resting metabolic rate (RMR) and body composition in participants of "The Biggest Loser" competition.
OBJECTIVE
To measure long-term changes in resting metabolic rate (RMR) and body composition in participants of "The Biggest Loser" competition.
METHODS
Body composition was measured by dual energy X-ray absorptiometry, and RMR was determined by indirect calorimetry at baseline, at the end of the 30-week competition and 6 years later. Metabolic adaptation was defined as the residual RMR after adjusting for changes in body composition and age.
RESULTS
Of the 16 "Biggest Loser" competitors originally investigated, 14 participated in this follow-up study. Weight loss at the end of the competition was (mean ± SD) 58.3 ± 24.9 kg (P < 0.0001), and RMR decreased by 610 ± 483 kcal/day (P = 0.0004). After 6 years, 41.0 ± 31.3 kg of the lost weight was regained (P = 0.0002), while RMR was 704 ± 427 kcal/day below baseline (P < 0.0001) and metabolic adaptation was -499 ± 207 kcal/day (P < 0.0001). Weight regain was not significantly correlated with metabolic adaptation at the competition's end (r = -0.1, P = 0.75), but those subjects maintaining greater weight loss at 6 years also experienced greater concurrent metabolic slowing (r = 0.59, P = 0.025).
CONCLUSIONS
Metabolic adaptation persists over time and is likely a proportional, but incomplete, response to contemporaneous efforts to reduce body weight.
Topics: Absorptiometry, Photon; Adult; Basal Metabolism; Body Composition; Body Mass Index; Body Weight; Female; Follow-Up Studies; Humans; Male; Middle Aged; Obesity, Morbid; Weight Loss
PubMed: 27136388
DOI: 10.1002/oby.21538 -
International Journal of Obesity (2005) Aug 2015Obesity is a major global health problem and predisposes individuals to several comorbidities that can affect life expectancy. Interventions based on lifestyle... (Review)
Review
Obesity is a major global health problem and predisposes individuals to several comorbidities that can affect life expectancy. Interventions based on lifestyle modification (for example, improved diet and exercise) are integral components in the management of obesity. However, although weight loss can be achieved through dietary restriction and/or increased physical activity, over the long term many individuals regain weight. The aim of this article is to review the research into the processes and mechanisms that underpin weight regain after weight loss and comment on future strategies to address them. Maintenance of body weight is regulated by the interaction of a number of processes, encompassing homoeostatic, environmental and behavioural factors. In homoeostatic regulation, the hypothalamus has a central role in integrating signals regarding food intake, energy balance and body weight, while an 'obesogenic' environment and behavioural patterns exert effects on the amount and type of food intake and physical activity. The roles of other environmental factors are also now being considered, including sleep debt and iatrogenic effects of medications, many of which warrant further investigation. Unfortunately, physiological adaptations to weight loss favour weight regain. These changes include perturbations in the levels of circulating appetite-related hormones and energy homoeostasis, in addition to alterations in nutrient metabolism and subjective appetite. To maintain weight loss, individuals must adhere to behaviours that counteract physiological adaptations and other factors favouring weight regain. It is difficult to overcome physiology with behaviour. Weight loss medications and surgery change the physiology of body weight regulation and are the best chance for long-term success. An increased understanding of the physiology of weight loss and regain will underpin the development of future strategies to support overweight and obese individuals in their efforts to achieve and maintain weight loss.
Topics: Adaptation, Physiological; Comorbidity; Diet, Reducing; Energy Intake; Energy Metabolism; Exercise; Homeostasis; Humans; Obesity; Social Environment; Weight Gain; Weight Loss
PubMed: 25896063
DOI: 10.1038/ijo.2015.59 -
Australian Family Physician Jun 2017Many women report gaining weight as they transition through menopause. For most, the weight gain is modest and can be reduced with a conscious effort to limit energy...
BACKGROUND
Many women report gaining weight as they transition through menopause. For most, the weight gain is modest and can be reduced with a conscious effort to limit energy intake and increase energy expenditure. However, many women who are already overweight and obese will gain more weight as they approach menopause.
OBJECTIVE
The aims of this paper are to explain the reasons for menopausal weight gain and to detail a method for achieving and sustaining a substantial weight loss.
DISCUSSION
Weight gain during menopause is predominantly due to a reduction in spontaneous activity. For women who are lean, advice about controlling energy intake and increasing physical activity may be all that is required to prevent weight gain. For women who are overweight and obese rapid weight loss is best achieved with the help of a very low energy diet. This must be followed by lifelong behaviour modification with or without the help of hunger-suppressing pharmacotherapy.
Topics: Body Weight Maintenance; Dietary Carbohydrates; Humans; Menopause; Obesity
PubMed: 28609591
DOI: No ID Found -
International Journal of Environmental... Oct 2022The best nutritional strategy to fight the rise in obesity remains a debated issue. The Mediterranean diet (MD) and the Very Low-Calorie Ketogenic diet (VLCKD) are... (Randomized Controlled Trial)
Randomized Controlled Trial
Mediterranean Diet versus Very Low-Calorie Ketogenic Diet: Effects of Reaching 5% Body Weight Loss on Body Composition in Subjects with Overweight and with Obesity-A Cohort Study.
The best nutritional strategy to fight the rise in obesity remains a debated issue. The Mediterranean diet (MD) and the Very Low-Calorie Ketogenic diet (VLCKD) are effective at helping people lose body weight (BW) and fat mass (FM) while preserving fat-free mass (FFM). This study aimed to evaluate the time these two diets took to reach a loss of 5% of the initial BW and how body composition was affected. We randomized 268 subjects with obesity or overweight in two arms, MD and VLCKD, for a maximum of 3 months or until they reached 5% BW loss. This result was achieved after one month of VLCKD and 3 months of MD. Both diets were effective in terms of BW ( < 0.0001) and FM loss ( < 0.0001), but the MD reached a higher reduction in both waist circumference ( = 0.0010) and FM ( = 0.0006) and a greater increase in total body water ( = 0.0017) and FFM ( = 0.0373) than VLCKD. The population was also stratified according to gender, age, and BMI. These two nutritional protocols are both effective in improving anthropometrical parameters and body composition, but they take different time spans to reach the goal. Therefore, professionals should evaluate which is the most suitable according to each patient's health status.
Topics: Humans; Body Composition; Cohort Studies; Diet, Ketogenic; Diet, Mediterranean; Obesity; Overweight; Weight Loss
PubMed: 36293616
DOI: 10.3390/ijerph192013040 -
Cell Metabolism Sep 2020Time-restricted feeding (TRF) regimens have grown in popularity; however, very few studies have examined their weight-loss efficacy. We conducted the first human trial... (Observational Study)
Observational Study
Time-restricted feeding (TRF) regimens have grown in popularity; however, very few studies have examined their weight-loss efficacy. We conducted the first human trial (Clinicaltrials.gov NCT03867773) to compare the effects of two popular forms of TRF (4 and 6 h) on body weight and cardiometabolic risk factors. Adults with obesity were randomized to 4-h TRF (eating only between 3 and 7 p.m.), 6-h TRF (eating only between 1 and 7 p.m.), or a control group (no meal timing restrictions). After 8 weeks, 4- and 6-h TRF produced comparable reductions in body weight (∼3%), insulin resistance, and oxidative stress, versus controls. Energy intake was reduced by ∼550 kcal/day in both TRF groups, without calorie counting. These findings suggest that 4- and 6-h TRF induce mild reductions in body weight over 8 weeks and show promise as interventions for weight loss. These diets may also improve some aspects of cardiometabolic health.
Topics: Adolescent; Adult; Aged; Body Weight; Cardiovascular Diseases; Fasting; Female; Humans; Middle Aged; Obesity; Risk Factors; Weight Loss; Young Adult
PubMed: 32673591
DOI: 10.1016/j.cmet.2020.06.018 -
Nutrients Jan 2021Globally, increasing rates of obesity are one of the most important health issues. The association between breakfast skipping and body weight is contradictory between... (Meta-Analysis)
Meta-Analysis
Globally, increasing rates of obesity are one of the most important health issues. The association between breakfast skipping and body weight is contradictory between cross-sectional and interventional studies. This systematic review and meta-analysis aims to summarize this association based on observational longitudinal studies. We included prospective studies on breakfast skipping and overweight/obesity or weight change in adults. The literature was searched until September 2020 in PubMed and Web of Science. Summary risk ratios (RRs) or β coefficients with a 95% confidence interval (CI), respectively, were estimated in pairwise meta-analyses by applying a random-effects model. In total, nine studies were included in the systematic review and five of them were included in the meta-analyses. The meta-analyses indicated an 11% increased RR for overweight/obesity when breakfast was skipped on ≥3 days per week compared to ≤2 days per week (95% CI: 1.04, 1.19, = two studies). The meta-analysis on body mass index (BMI) change displayed no difference between breakfast skipping and eating (β = -0.02; 95% CI: -0.05, 0.01; = two studies). This study provides minimal evidence that breakfast skipping might lead to weight gain and the onset of overweight and obesity.
Topics: Adult; Body Mass Index; Body Weight; Breakfast; Feeding Behavior; Female; Humans; Longitudinal Studies; Male; Obesity; Observational Studies as Topic; Odds Ratio; Overweight; Weight Gain; Young Adult
PubMed: 33477881
DOI: 10.3390/nu13010272 -
Obesity Reviews : An Official Journal... Feb 2015Despite the poor prognosis of dieting in obesity management, which often results in repeated attempts at weight loss and hence weight cycling, the prevalence of dieting... (Review)
Review
Despite the poor prognosis of dieting in obesity management, which often results in repeated attempts at weight loss and hence weight cycling, the prevalence of dieting has increased continuously in the past decades in parallel to the steadily increasing prevalence of obesity. However, dieting and weight cycling are not limited to those who are obese or overweight as substantial proportions of the various population groups with normal body weight also attempt to lose weight. These include young and older adults as well as children and adolescents who perceive themselves as too fat (due to media, parental and social pressures), athletes in weight-sensitive competitive sports (i.e. mandatory weight categories, gravitational and aesthetic sports) or among performers for whom a slim image is professionally an advantage. Of particular concern is the emergence of evidence that some of the potentially negative health consequences of repeated dieting and weight cycling are more readily seen in people of normal body weight rather than in those who are overweight or obese. In particular, several metabolic and cardiovascular risk factors associated with weight cycling in normal-weight individuals have been identified from cross-sectional and prospective studies as well as from studies of experimentally induced weight cycling. In addition, findings from studies of experimental weight cycling have reinforced the notion that fluctuations of cardiovascular risk variables (such as blood pressure, heart rate, sympathetic activity, blood glucose, lipids and insulin) with probable repeated overshoots above normal values during periods of weight regain put an additional stress on the cardiovascular system. As the prevalence of diet-induced weight cycling is increasing due to the opposing forces of an 'obesigenic' environment and the media pressure for a slim figure (that even targets children), dieting and weight cycling is likely to become an increasingly serious public health issue.
Topics: Adolescent; Adult; Body Image; Cardiovascular Diseases; Child; Humans; Hypertension; Nutrition Surveys; Obesity; Risk Assessment; Risk Factors; Weight Gain; Weight Loss
PubMed: 25614199
DOI: 10.1111/obr.12251 -
The Journal of Clinical Endocrinology... Feb 2015Various drugs affect body weight as a side effect. (Meta-Analysis)
Meta-Analysis Review
CONTEXT
Various drugs affect body weight as a side effect.
OBJECTIVE
We conducted this systematic review and meta-analysis to summarize the evidence about commonly prescribed drugs and their association with weight change.
DATA SOURCES
MEDLINE, DARE, and the Cochrane Database of Systematic Reviews were searched to identify published systematic reviews as a source for trials.
STUDY SELECTION
We included randomized trials that compared an a priori selected list of drugs to placebo and measured weight change.
DATA EXTRACTION
We extracted data in duplicate and assessed the methodological quality using the Cochrane risk of bias tool.
RESULTS
We included 257 randomized trials (54 different drugs; 84 696 patients enrolled). Weight gain was associated with the use of amitriptyline (1.8 kg), mirtazapine (1.5 kg), olanzapine (2.4 kg), quetiapine (1.1 kg), risperidone (0.8 kg), gabapentin (2.2 kg), tolbutamide (2.8 kg), pioglitazone (2.6 kg), glimepiride (2.1 kg), gliclazide (1.8 kg), glyburide (2.6 kg), glipizide (2.2 kg), sitagliptin (0.55 kg), and nateglinide (0.3 kg). Weight loss was associated with the use of metformin (1.1 kg), acarbose (0.4 kg), miglitol (0.7 kg), pramlintide (2.3 kg), liraglutide (1.7 kg), exenatide (1.2 kg), zonisamide (7.7 kg), topiramate (3.8 kg), bupropion (1.3 kg), and fluoxetine (1.3 kg). For many other remaining drugs (including antihypertensives and antihistamines), the weight change was either statistically nonsignificant or supported by very low-quality evidence.
CONCLUSIONS
Several drugs are associated with weight change of varying magnitude. Data are provided to guide the choice of drug when several options exist and institute preemptive weight loss strategies when obesogenic drugs are prescribed.
Topics: Antipsychotic Agents; Body Weight; Humans; Hypoglycemic Agents; Weight Gain; Weight Loss
PubMed: 25590213
DOI: 10.1210/jc.2014-3421 -
Endocrine Practice : Official Journal... Feb 2022Adiposity-based chronic disease (ABCD) requires life-long treatment and follow up. Obesity protects obesity through altered regulation of caloric intake and set point... (Review)
Review
Adiposity-based chronic disease (ABCD) requires life-long treatment and follow up. Obesity protects obesity through altered regulation of caloric intake and set point mechanisms, which help maintain a high equilibrium body weight. Lifestyle interventions and obesity medications do not permanently alter the set point, which often makes weight loss achieved using lifestyle changes short-lived and operates to drive weight regain once medications are discontinued. Bariatric surgery procedures can alter appetite and lower the "set point" for the equilibrium body weight via unknown mechanisms. However, few patients attain an ideal body weight following surgery, many regain weight, and all require long-term follow up for the disease. The excess adiposity associated with ABCD gives rise to complications that impair health and confer morbidity and mortality; however, the genetic risks and potential interactions between genes and the environment that give rise to complications cannot be eliminated. The equilibrium body weight around which set point mechanisms operate can be modified by the environment, which underscores the importance of a less obesogenic environment for the prevention and treatment of ABCD on a population basis. Whether ABCD will eventually be curable will depend on a clear understanding of the molecular mechanisms that determine the set point regulation of body weight and the ability to permanently modulate the set point to oscillate around a lean body mass. However, the conceptualization of ABCD as a chronic disease does present us with opportunities for primary, secondary, and tertiary prevention to avert disease progression. For tertiary care, the advent of new, more effective second-generation obesity medications will allow clinicians to treat to target via active management of body weight into a target range that will ameliorate specific complications.
Topics: Adiposity; Chronic Disease; Energy Intake; Humans; Obesity; Weight Loss
PubMed: 34823000
DOI: 10.1016/j.eprac.2021.11.082 -
Pharmacological Research Oct 2023There is no research on the comparative effects of nutraceuticals on weight loss in adults with overweight or obesity. This study aimed at quantifying and ranking the... (Meta-Analysis)
Meta-Analysis Review
Comparative effects of nutraceuticals on body weight in adults with overweight or obesity: A systematic review and network meta-analysis of 111 randomized clinical trials.
There is no research on the comparative effects of nutraceuticals on weight loss in adults with overweight or obesity. This study aimed at quantifying and ranking the effects of different nutraceuticals on weight loss. We searched PubMed, Scopus, and Web of Science to November 2022. We included randomized trials evaluating the comparative effects of two or more nutraceuticals, or compared a nutraceutical against a placebo for weight loss in adults with overweight or obesity. We conducted random-effects network meta-analysis with a Frequentist framework to estimate mean difference [MD] and 95% confidence interval [CI] of the effect of nutraceuticals on weight loss. One hundred and eleven RCTs with 6171 participants that investigated the effects of 18 nutraceuticals on body weight were eligible. In the main analysis incorporating all trials, there was high certainty of evidence for supplementation of spirulina (MD: -1.77 kg, 95% CI: -2.77, -0.78) and moderate certainty of evidence that supplementation of curcumin (MD: -0.82 kg, 95% CI: -1.33, -0.30), psyllium (MD: -3.70 kg, 95% CI: -5.18, -2.22), chitosan (MD: -1.70 kg, 95% CI: -2.62, -0.78), and Nigella sativa (MD: -2.09 kg, 95%CI: -2.92, -1.26) could result in a small improvement in body weight. Supplementations with green tea (MD: -1.25 kg, 95%CI: -1.68, -0.82) and glucomannan (MD: -1.36 kg, 95%CI: -2.17, -0.54) demonstrated small weight loss, also the certainty of evidence was rated low. Based on our findings, supplementations with nutraceuticals can result in a small weight loss in adults with overweight or obesity.
Topics: Adult; Humans; Overweight; Network Meta-Analysis; Randomized Controlled Trials as Topic; Body Weight; Obesity; Weight Loss; Dietary Supplements
PubMed: 37778464
DOI: 10.1016/j.phrs.2023.106944