Early reduction of resting energy expenditure and successful weight loss after Roux-en-Y gastric bypass

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

Obesity Surgery ◽

10.1007/s11695-021-05578-5 ◽

2021 ◽

Author(s):

Enzamaria Fidilio ◽

Marta Comas ◽

Miguel Giribés ◽

Guillermo Cárdenas ◽

Ramón Vilallonga ◽

...

Keyword(s):

Bariatric Surgery ◽

Weight Loss ◽

Energy Expenditure ◽

Severe Obesity ◽

Resting Energy Expenditure ◽

Successful Weight Loss ◽

The Impact ◽

The Relationship ◽

Resting Energy

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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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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Effects of 30‐day diet cycling on weight loss and resting energy expenditure in women participating in the Curves® fitness program: a preliminary long‐term analysis

The FASEB Journal ◽

10.1096/fasebj.24.1_supplement.lb301 ◽

2010 ◽

Vol 24 (S1) ◽

Author(s):

S Simbo ◽

J Culbertson ◽

M Mardock ◽

M Byrd ◽

J Oliver ◽

...

Keyword(s):

Weight Loss ◽

Energy Expenditure ◽

Resting Energy Expenditure ◽

Fitness Program ◽

Term Analysis ◽

Resting Energy

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Effect of Weight Loss on Resting Energy Expenditure in Hypertensive and Normotensive Obese Women

Clinical and Experimental Hypertension ◽

10.3109/10641969809053221 ◽

1998 ◽

Vol 20 (4) ◽

pp. 403-416 ◽

Cited By ~ 3

Author(s):

Wayne H-H Sheu ◽

H-M Linda Chin ◽

H-Y Su ◽

C-Y Jeng

Keyword(s):

Weight Loss ◽

Energy Expenditure ◽

Resting Energy Expenditure ◽

Obese Women ◽

Resting Energy

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Weight and body composition changes affect resting energy expenditure predictive equations during a 12‐month weight‐loss intervention

Obesity ◽

10.1002/oby.23234 ◽

2021 ◽

Vol 29 (10) ◽

pp. 1596-1605

Author(s):

Jared H. Dahle ◽

Danielle M. Ostendorf ◽

Zhaoxing Pan ◽

Paul S. MacLean ◽

Daniel H. Bessesen ◽

...

Keyword(s):

Weight Loss ◽

Body Composition ◽

Energy Expenditure ◽

Resting Energy Expenditure ◽

Weight Loss Intervention ◽

Predictive Equations ◽

Composition Changes ◽

Resting Energy

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Changes in Resting Energy Expenditure following Gastric Bypass Surgery: Impact on Total Body Weight.

Proceedings of The Nutrition Society ◽

10.1017/s0029665120004450 ◽

2020 ◽

Vol 79 (OCE2) ◽

Author(s):

Fathimath Naseer ◽

Ruth Price ◽

Adele McElroy ◽

Carel Le Roux ◽

Tamsyn Redpath ◽

...

Keyword(s):

Weight Loss ◽

Gastric Bypass ◽

Body Weight ◽

Energy Expenditure ◽

Resting Energy Expenditure ◽

Total Body Weight ◽

Post Surgery ◽

Significant Difference ◽

Total Body ◽

Ree Group

AbstractBariatric surgery, including Gastric Bypass (GBP) Surgery, is the most efficient modality to manage severe obesity. Resting Energy Expenditure (REE) is an area of interest in the context of weight loss (WL) as it has been postulated to be an independent predictor of WL success following GBP. As such, the aim of this study is to investigate the impact of REE on WL following GBP. 31 GBP patients (77.4% females BMI 45.5 ± 7.0kg/m2 ; 47.3 ± 11.6y) and 32 weight-stable controls (46.9% females; BMI 27.0 ± 4.6kg/m2 ; 41.1 ± 13.5y) were assessed at one-month pre-surgery and at 3 and 12-months post-surgery. Fat mass (FM) and fat-free mass (FFM) were measured using dual energy X-ray absorptiometry (Lunar iDXA, GE Healthcare). REE was measured under standardised conditions using indirect calorimetry (ECAL, Metabolic Health Solutions). Statistical analyses were performed with SPSS v24.0, Armonk, NY. Multiple regression analysis showed that FM (P = 0.001), FFM (P < 0.0001) and gender (P = 0.012) significantly predicted the interindividual variability in REE. Total body weight (TBW) was removed from the model due to collinearity. Adjusted-REE values were then generated using the above predictor variables. Low-REE and high-REE groups were created using within-group adjusted-REE split. At both follow-ups (3- and 12-months post-surgery), patients had a greater reduction in TBW, FM, FFM, measured-REE and adjusted-REE values compared with controls (P < 0.0001). There was also no significant difference between measured and adjusted-REE values at all time-points (P > 0.05). Patients with high REEs at baseline lost more TBW than those in the low-REE group at 3-months post-surgery (-24.9 ± 6.5 kg vs. -16.6 ± 7.0 kg; P = 0.005) and 12-months post-surgery (-41.3 ± 12.5 kg vs. -25.8 ± 10.4.0 kg; P = 0.003). There was no significant difference in mean TBW changes for controls in the low-and high-REE groups at both follow-ups. Patients with high REEs at 3-months post-surgery did not lose more TBW than those in the low-REE group at 12-months post-surgery (-30.1 ± 12.8 kg vs. -38.6 ± 14.4 kg; P = 0.155). Similarly, there was no difference in mean TBW reduction between controls in the low- and high-REE groups (P = 0.115). Thus while patients with a high adjusted-REE value at baseline (> 9746.6kJ/day) lost more weight at 3- and 12-months post-GBP, it is plausible that from the third to the 12th month post-surgery, other key drivers of weight loss, particularly the reduction in energy intake are more important in predicting WL. Further research with a larger sample size is required to increase the chances of detecting a true effect.

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