Evaluation of Resting Energy Expenditure in Subjects with Severe Obesity and Its Evolution After Bariatric Surgery

Abstract Purpose One major determinant of weight loss is resting energy expenditure (REE). However, data regarding REE is scarce in patients with severe obesity (SO)—BMI>50kg/m2. Most studies used equation in order to estimate REE and not indirect calorimetry (IC) (gold standard). Additionally, there is no reliable data on the impact of bariatric surgery (BS) on REE. Objectives (a) To evaluate the REE in patients with SO; (b) to compare REE measured by IC (mREE) to that calculated by Mifflin St-Jeor equation (eREE); (c) to evaluate the impact of BS on REE and the relationship with evolution post-BS. Material and Methods Single-center observational study including consecutive patients with SO between January 2010 and December 2015, candidates for BS. mREE was determined at baseline, and 1 and 12 months post-BS by IC, using a Vmax metabolic monitor. Results Thirty-nine patients were included: mean age 46.5±11.77 years, 64.1%women. Preoperative mREE was 2320.38±750.81 kcal/day. One month post-BS, the mREE significantly decreased (1537.6 ± 117.46 kcal/day, p = 0.023) and remained unchanged at 12 months (1526.00 ± 123.35 kcal/day; p =0.682). Reduction in mREE after the BS was a predictor of reaching successful weight loss (nadir) and weight regain (5 years follow-up) (AUCROC of 0.841 (95%CI [0.655–0.909], p=0.032) and AUCROC of 0.855 (95% CI [0.639–0.901]), p= 0.027, respectively). eREE was not valid to identify these changes. Conclusion In patients with SO, a significant reduction of mREE occurs 1 month post-BS, unchanged at 12 months, representing the major conditioning of successful weight loss and maintenance post-BS. Graphical abstract

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The relationship between resting energy expenditure and thyroid hormones in response to short-term weight loss in severe obesity

PLoS ONE ◽

10.1371/journal.pone.0205293 ◽

2018 ◽

Vol 13 (10) ◽

pp. e0205293 ◽

Cited By ~ 5

Author(s):

Paolo Marzullo ◽

Alessandro Minocci ◽

Chiara Mele ◽

Rezene Fessehatsion ◽

Mariantonella Tagliaferri ◽

...

Keyword(s):

Weight Loss ◽

Energy Expenditure ◽

Thyroid Hormones ◽

Severe Obesity ◽

Resting Energy Expenditure ◽

Short Term ◽

The Relationship ◽

Resting Energy

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Impact of Protein Intake during Weight Loss on Preservation of Fat-Free Mass, Resting Energy Expenditure, and Physical Function in Overweight Postmenopausal Women: A Randomized Controlled Trial

Obesity Facts ◽

10.1159/000514427 ◽

2021 ◽

pp. 1-12

Author(s):

Isabell Englert ◽

Anja Bosy-Westphal ◽

Stephan C. Bischoff ◽

Kathrin Kohlenberg-Müller

Keyword(s):

Weight Loss ◽

Energy Expenditure ◽

Physical Function ◽

Postmenopausal Women ◽

Protein Intake ◽

Resting Energy Expenditure ◽

Fat Free Mass ◽

The Impact ◽

Resting Energy

Introduction: Weight loss in old age increases the risk of sarcopenia caused by the age-related reduction of fat-free mass (FFM). Due to the strong correlation between FFM and resting energy expenditure (REE), the maintenance of this must also be considered. Besides, the physical function (PF) must be maintained. Objective: The impact of protein intake on changes in FFM, REE, and PF during weight loss in overweight postmenopausal women was investigated. Methods: Fifty-four postmenopausal women (BMI 30.9 ± 3.4; age 59 ± 7 years) were randomized into 2 groups receiving energy-restricted diets with either 0.8 g (normal protein; NP) or 1.5 g protein/kg body weight (high protein; HP) for 12 weeks, followed by a 6-month follow-up phase with an ad libitum food intake. FFM, REE, and PF (strength, endurance, and balance) were measured at baseline, after weight loss, and after follow-up. Results: Forty-six women completed the weight loss intervention and 29 were followed up. The weight loss was –4.6 ± 3.6 kg (HP) and –5.2 ± 3.4 kg (NP; both p < 0.001) and the weight regain during follow-up was 1.3 ± 2.8 kg (HP; p = 0.03) and 0.4 ± 2.5 kg (NP; p = 0.39), with no differences between groups. Similar decreases in FFM (–0.9 ± 1.1 [HP] vs. –1.0 ± 1.3 kg [NP]) and REE (–862 ± 569 [HP] vs. –1,000 ± 561 kJ [NP]; both p < 0.001) were observed in both groups. During follow-up, no changes in FFM were detected in either group, whereas in the NP group the REE increased again (+138 ± 296; p = 0.02). The main determinants of FFM loss were the energy deficit and the speed of weight loss. In the NP group, the Short Physical Performance Battery score improved with weight loss (+0.6 ± 0.8; p < 0.001) and handgrip strength decreased (–1.7 ± 3.4 kg; p < 0.001), whereas no changes were observed in the HP group. Conclusions: An HP weight-loss diet without exercise had no impact on preservation of FFM and REE but may help to maintain muscle strength in postmenopausal women.

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Does Preoperative Resting Energy Expenditure Predict Weight Loss after Bariatric Surgery?

Surgery for Obesity and Related Diseases ◽

10.1016/j.soard.2015.08.070 ◽

2015 ◽

Vol 11 (6) ◽

pp. S62

Author(s):

Dimitrios Stefanidis ◽

Mitchell Lynn ◽

Timothy Kuwada ◽

Keith Gersin

Keyword(s):

Bariatric Surgery ◽

Weight Loss ◽

Energy Expenditure ◽

Resting Energy Expenditure ◽

Predict Weight Loss ◽

Resting Energy

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No consistent evidence of a disproportionately low resting energy expenditure in long-term successful weight-loss maintainers

American Journal of Clinical Nutrition ◽

10.1093/ajcn/nqy179 ◽

2018 ◽

Vol 108 (4) ◽

pp. 658-666 ◽

Cited By ~ 8

Author(s):

Danielle M Ostendorf ◽

Edward L Melanson ◽

Ann E Caldwell ◽

Seth A Creasy ◽

Zhaoxing Pan ◽

...

Keyword(s):

Weight Loss ◽

Energy Expenditure ◽

Body Mass ◽

Resting Energy Expenditure ◽

Weight Loss Maintenance ◽

Fat Free Mass ◽

Predictive Equations ◽

Successful Weight Loss ◽

Resting Energy

Abstract Background Evidence in humans is equivocal in regards to whether resting energy expenditure (REE) decreases to a greater extent than predicted for the loss of body mass with weight loss, and whether this disproportionate decrease in REE persists with weight-loss maintenance. Objectives We aimed to1) determine if a lower-than-predicted REE is present in a sample of successful weight-loss maintainers (WLMs) and 2) determine if amount of weight loss or duration of weight-loss maintenance are correlated with a lower-than-predicted REE in WLMs. Design Participants (18–65 y old) were recruited in 3 groups: WLMs (maintaining ≥13.6 kg weight loss for ≥1 y, n = 34), normal-weight controls [NCs, body mass index (BMI; in kg/m2) similar to current BMI of WLMs, n = 35], and controls with overweight/obesity (OCs, BMI similar to pre–weight-loss maximum BMI of WLMs, n = 33). REE was measured (REEm) with indirect calorimetry. Predicted REE (REEp) was determined via 1) a best-fit linear regression developed with the use of REEm, age, sex, fat-free mass, and fat mass from our control groups and 2) three standard predictive equations. Results REEm in WLMs was accurately predicted by equations developed from NCs and OCs (±1%) and by 3 standard predictive equations (±3%). In WLMs, individual differences between REEm and REEp ranged from −257 to +163 kcal/d. A lower REEm compared with REEp was correlated with amount of weight lost (r = 0.36, P < 0.05) but was not correlated with duration of weight-loss maintenance (r = 0.04, P = 0.81). Conclusions We found no consistent evidence of a significantly lower REE than predicted in a sample of long-term WLMs based on predictive equations developed from NCs and OCs as well as 3 standard predictive equations. Results suggest that sustained weight loss may not always result in a substantial, disproportionately low REE. This trial was registered at clinicaltrials.gov as NCT03422380.

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Is There a Contribution of Structural Brain Phenotypes to the Variance in Resting Energy Expenditure before and after Weight Loss in Overweight Females?

Nutrients ◽

10.3390/nu11112759 ◽

2019 ◽

Vol 11 (11) ◽

pp. 2759

Author(s):

Corinna Geisler ◽

Manfred J. Müller

Keyword(s):

Weight Loss ◽

Energy Expenditure ◽

Brain Metabolism ◽

Resting Energy Expenditure ◽

Main Determinant ◽

Before And After ◽

Age Range ◽

The Impact ◽

Structural Brain ◽

Resting Energy

Brain gray (GM) and white matter (WM) are associated with resting energy expenditure (REE). The impact of weight loss on GM and WM masses, as well as on their associations with REE and the ratio between body and brain metabolism, i.e., encephalic measure (EM)), are unknown. Longitudinal data of 69 female Caucasian subjects (age range 19–69 years) with detailed information on fat mass (FM), fat free mas (FFM), GM, WM and REE. Mean weight loss was 14.5 ± 11.9 kg with changes in FM (−12.9 ± 9.8 kg), FFM (−1.7 ± 4.8 kg) and REE (−159 ± 191 kcal/24 h) (all p < 0.05). With weight loss, there were no changes in GM and WM. Before and after weight loss, FFM was the main determinant of REE (r2 = 0.483 and 0.413; p < 0.05). After weight loss, GM added to the variances in REE (3.6%), REEadjFFM (6.1%) and the REE on FFM residuals (6.6%). In addition, before and after weight loss GM explained 25.0% and 10.0% of the variances in EM (p < 0.05). Weight loss had no effect on volumes of GM and WM. After weight loss, both, GM added to the variances of REE, REE on FFM residuals and EM.

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Increased Resting Energy Expenditure/Body Weight and Decreased Respiratory Quotient Correlate with Satisfactory Weight Loss After Sleeve Gastrectomy: a 6-Month Follow-Up

Obesity Surgery ◽

10.1007/s11695-019-04308-2 ◽

2020 ◽

Vol 30 (4) ◽

pp. 1410-1416 ◽

Cited By ~ 1

Author(s):

Kun Li ◽

Lei Zheng ◽

Jing Guo ◽

Wentao Shi ◽

Feng Zhao ◽

...

Keyword(s):

Weight Loss ◽

Body Weight ◽

Sleeve Gastrectomy ◽

Energy Expenditure ◽

Respiratory Quotient ◽

Resting Energy Expenditure ◽

Resting Energy

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The Relationship Between Resting Energy Expenditure and Weight Loss in Benign and Malignant Disease

Annals of Surgery ◽

10.1097/00000658-198603000-00003 ◽

1986 ◽

Vol 203 (3) ◽

pp. 240-245 ◽

Cited By ~ 57

Author(s):

DOUGLAS T. HANSELL ◽

JOHN W. L. DAVIES ◽

HENRY J. G. BURNS

Keyword(s):

Weight Loss ◽

Energy Expenditure ◽

Malignant Disease ◽

Resting Energy Expenditure ◽

The Relationship ◽

Resting Energy

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Place Work on a Scale: What Do We Know About the Association Between Employment Status and Weight Loss Outcomes After Bariatric Surgery?

Obesity Surgery ◽

10.1007/s11695-021-05388-9 ◽

2021 ◽

Author(s):

Marleen M. Romeijn ◽

Marlies Bongers ◽

Daniëlle D.B. Holthuijsen ◽

Loes Janssen ◽

François M.H. van Dielen ◽

...

Keyword(s):

Bariatric Surgery ◽

Weight Loss ◽

Employment Status ◽

Weight Regain ◽

Weight Loss Outcomes ◽

Working Status ◽

Successful Weight Loss ◽

Patients Experience ◽

The Impact

AbstractDespite the initial successful weight loss after bariatric surgery, a significant amount of patients experience weight loss failure and weight regain. Several factors are known to contribute to this, though the impact of employment status is unknown. The objective of this systematic review was to examine the impact of employment status on post-surgical weight loss outcomes. Eight studies were included with a follow-up ranging between 2 and 10 years. Employed patients seemed to present more weight loss (9.0–11.0% EWL, 1.3–1.6% BMI loss) compared to unemployed patients, but none of these numbers were statistically significant. Moreover, there were contrasting findings in terms of weight regain. This review may highlight the importance of working status after bariatric surgery and warrants further investigation on this topic. Graphical abstract

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Abstract P131: Changes In Bile Acid Subtypes And Improvements In Adiposity And Energy Metabolism In Response To Weight-loss Diets

Circulation ◽

10.1161/circ.143.suppl_1.p131 ◽

2021 ◽

Vol 143 (Suppl_1) ◽

Author(s):

Yoriko Heianza ◽

Tao Zhou ◽

Hua He ◽

Jennifer Rood ◽

Clary Clish ◽

...

Keyword(s):

Weight Loss ◽

Energy Metabolism ◽

Waist Circumference ◽

Energy Expenditure ◽

Resting Energy Expenditure ◽

Blood Levels ◽

Central Adiposity ◽

Body Adiposity ◽

Successful Weight Loss ◽

Resting Energy

Introduction: Bile acids (BAs) are synthesized in the liver from cholesterol, and gut microbiota transform the host-derived primary BAs into secondary BAs in the intestine. Emerging evidence suggests that different types of circulating BAs may play pivotal roles in regulating energy metabolism and body adiposity. Hypothesis: We comprehensively examined whether changes in different BA subtypes after consuming weight-loss diets were associated with improvements in energy metabolism and body adiposity among patients with obesity. Methods: This study included 551 overweight and obese adults who participated in a 2-year weight-loss dietary intervention, the POUNDS Lost trial. Blood levels of 14 types of BAs (primary and secondary unconjugated BAs and their taurine-/glycine-conjugates) were measured at baseline and 6 months after the intervention; changes in BAs from baseline to 6 months after the intervention were calculated. We evaluated changes in resting energy expenditure, weight, and waist circumference. Also, body composition was assessed by the dual-energy X-ray absorptiometry (DEXA) scans, and fat distribution was assessed by computed tomography (CT) scans. Results: At baseline, higher primary and secondary BAs were related to greater degrees of adiposity and energy expenditure. At 6 months after the intervention, greater decreases in primary BAs (cholic acid [CA] and chenodeoxycholic acid) and secondary BAs (deoxycholic acid [DCA] and lithocholic acid [LCA]) and their conjugated subtypes (except for glycolithocholic acid) were significantly associated with more decreases in weight and waist circumference at 6 months after the intervention (P values after controlling for the multiple testing, P FDR <0.05). Greater reductions in the primary BAs (both unconjugated and conjugated types) and secondary BAs (DCA and its taurine-/glycine-conjugated forms) were also significantly ( P FDR <0.05) associated with more decreases in resting energy expenditure at 6 months. We found that reductions in two BA subtypes, glycocholic acid (GCA) and glycoursodeoxycholic acid (GUDCA), were consistently and significantly associated with improvements in energy metabolism, general and central adiposity, as well as body fat composition and visceral adipose tissue mass. Further, the initial (6-month) changes in several primary and secondary BAs (including GCA and GUDCA) were significantly predictive of the long-term successful weight loss (weight loss of more than 5% loss from the initial weight) at 2 years. Conclusions: Weight-loss diet-induced changes in circulating various BAs may be involved in improving general and central adiposity and energy metabolism. Changes in specific BA subtypes would be potential targets for improving regional adiposity and achieving successful weight-loss among patients with obesity.

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