On a low calorie diet, are there separate and discrete effects of negative energy balance and weight loss on blood pressure?

IntroductionThe success rate of weight loss maintenance is limited. Therefore, the purpose of this study is to investigate the maintenance of weight loss and immunometabolic health outcomes after diet-induced weight loss followed by 1-year treatment with a glucagon-like peptide-1 receptor agonist (liraglutide), physical exercise or the combination of both treatments as compared with placebo in individuals with obesity.Methods and analysisThis is an investigator-initiated, randomised, placebo-controlled, parallel group trial. We will enrol expectedly 200 women and men (age 18–65 years) with obesity (body mass index 32–43 kg/m2) to adhere to a very low-calorie diet (800 kcal/day) for 8 weeks in order to lose at least 5% of body weight. Subsequently, participants will be randomised in a 1:1:1:1 ratio to one of four study groups for 52 weeks: (1) placebo, (2) exercise 150 min/week+placebo, (3) liraglutide 3.0 mg/day and (4) exercise 150 min/week+liraglutide 3.0 mg/day. The primary endpoint is change in body weight from randomisation to end-of-treatment.Ethics and disseminationThe trial has been approved by the ethical committee of the Capital Region of Denmark and the Danish Medicines Agency. The trial will be conducted in agreement with the Declaration of Helsinki and monitored to follow the guidelines for good clinical practice. Results will be submitted for publication in international peer-reviewed scientific journals.Trial registration number2015-005585-32

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Use of Very Low-Calorie Diet in Preoperative Weight Loss: Efficacy and Safety

Obesity Research ◽

10.1002/j.1550-8528.1997.tb00581.x ◽

1997 ◽

Vol 5 (6) ◽

pp. 595-602 ◽

Cited By ~ 29

Author(s):

Tuula Pekkarinen ◽

Pertti Mustaioki

Keyword(s):

Weight Loss ◽

Preoperative Weight Loss ◽

Efficacy And Safety ◽

Very Low Calorie Diet ◽

Low Calorie ◽

Low Calorie Diet ◽

Calorie Diet ◽

Preoperative Weight

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Efficacy of a dietitian‐led very low calorie diet (VLCD) based model of care to facilitate weight loss for obese patients prior to elective, non‐bariatric surgery

Journal of Human Nutrition and Dietetics ◽

10.1111/jhn.12819 ◽

2020 ◽

Cited By ~ 1

Author(s):

S. B. Griffin ◽

L. J. Ross ◽

M. J. Burstow ◽

B. Desbrow ◽

M. A. Palmer

Keyword(s):

Bariatric Surgery ◽

Weight Loss ◽

Obese Patients ◽

Model Of Care ◽

Very Low Calorie Diet ◽

Low Calorie ◽

Low Calorie Diet ◽

Calorie Diet

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Metabolic adaptations during negative energy balance and their potential impact on appetite and food intake

Proceedings of The Nutrition Society ◽

10.1017/s0029665118002811 ◽

2019 ◽

Vol 78 (3) ◽

pp. 279-289 ◽

Cited By ~ 4

Author(s):

Nuno Casanova ◽

Kristine Beaulieu ◽

Graham Finlayson ◽

Mark Hopkins

Keyword(s):

Weight Loss ◽

Energy Balance ◽

Food Intake ◽

Negative Energy ◽

Fat Free Mass ◽

Negative Energy Balance ◽

Energy Deficit ◽

Behavioural Responses ◽

Compensatory Responses ◽

Metabolic Adaptations

This review examines the metabolic adaptations that occur in response to negative energy balance and their potential putative or functional impact on appetite and food intake. Sustained negative energy balance will result in weight loss, with body composition changes similar for different dietary interventions if total energy and protein intake are equated. During periods of underfeeding, compensatory metabolic and behavioural responses occur that attenuate the prescribed energy deficit. While losses of metabolically active tissue during energy deficit result in reduced energy expenditure, an additional down-regulation in expenditure has been noted that cannot be explained by changes in body tissue (e.g. adaptive thermogenesis). Sustained negative energy balance is also associated with an increase in orexigenic drive and changes in appetite-related peptides during weight loss that may act as cues for increased hunger and food intake. It has also been suggested that losses of fat-free mass (FFM) could also act as an orexigenic signal during weight loss, but more data are needed to support these findings and the signalling pathways linking FFM and energy intake remain unclear. Taken together, these metabolic and behavioural responses to weight loss point to a highly complex and dynamic energy balance system in which perturbations to individual components can cause co-ordinated and inter-related compensatory responses elsewhere. The strength of these compensatory responses is individually subtle, and early identification of this variability may help identify individuals that respond well or poorly to an intervention.

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