Peripheral metabolic responses to prolonged weight reduction that promote rapid, efficient regain in obesity-prone rats

2006 ◽  
Vol 290 (6) ◽  
pp. R1577-R1588 ◽  
Author(s):  
Paul S. MacLean ◽  
Janine A. Higgins ◽  
Matthew R. Jackman ◽  
Ginger C. Johnson ◽  
Brooke K. Fleming-Elder ◽  
...  
Keyword(s):  
Weight Loss ◽  
Body Weight ◽  
Weight Reduction ◽  
Weight Regain ◽  
Energy Gap ◽  
Neural Pathways ◽  
Low Fat ◽  
Cross Sectional ◽  
Low Fat Diet

Weight regain after weight loss is the most significant impediment to long-term weight reduction. We have developed a rodent paradigm that models the process of regain after weight loss, and we have employed both prospective and cross-sectional analyses to characterize the compensatory adaptations to weight reduction that may contribute to the propensity to regain lost weight. Obese rats were fed an energy-restricted (50–60% kcal) low-fat diet that reduced body weight by 14%. This reduced weight was maintained for up to 16 wk with limited provisions of the low-fat diet. Intake restriction was then removed, and the rats were followed for 56 days as they relapsed to the obese state. Prolonged weight reduction was accompanied by 1) a persistent energy gap resulting from an increased drive to eat and a reduced expenditure of energy, 2) a higher caloric efficiency of regain that may be linked with suppressed lipid utilization early in the relapse process, 3) preferential lipid accumulation in adipose tissue accompanied by adipocyte hyperplasia, and 4) humoral adiposity signals that underestimate the level of peripheral adiposity and likely influence the neural pathways controlling energy balance. Taken together, long-term weight reduction in this rodent paradigm is accompanied by a number of interrelated compensatory adjustments in the periphery that work together to promote rapid and efficient weight regain. These metabolic adjustments to weight reduction are discussed in the context of a homeostatic feedback system that controls body weight.

scholarly journals Biology's response to dieting: the impetus for weight regain

2011 ◽  
Vol 301 (3) ◽  
pp. R581-R600 ◽  
Author(s):  
Paul S. MacLean ◽  
Audrey Bergouignan ◽  
Marc-Andre Cornier ◽  
Matthew R. Jackman
Keyword(s):  
Weight Loss ◽  
Weight Reduction ◽  
Weight Regain ◽  
Energy Homeostasis ◽  
Biological Response ◽  
Recidivism Rate ◽  
Obese People ◽  
Low Fat Diet ◽  
Adiposity Signals

Dieting is the most common approach to losing weight for the majority of obese and overweight individuals. Restricting intake leads to weight loss in the short term, but, by itself, dieting has a relatively poor success rate for long-term weight reduction. Most obese people eventually regain the weight they have worked so hard to lose. Weight regain has emerged as one of the most significant obstacles for obesity therapeutics, undoubtedly perpetuating the epidemic of excess weight that now affects more than 60% of U.S. adults. In this review, we summarize the evidence of biology's role in the problem of weight regain. Biology's impact is first placed in context with other pressures known to affect body weight. Then, the biological adaptations to an energy-restricted, low-fat diet that are known to occur in the overweight and obese are reviewed, and an integrative picture of energy homeostasis after long-term weight reduction and during weight regain is presented. Finally, a novel model is proposed to explain the persistence of the “energy depletion” signal during the dynamic metabolic state of weight regain, when traditional adiposity signals no longer reflect stored energy in the periphery. The preponderance of evidence would suggest that the biological response to weight loss involves comprehensive, persistent, and redundant adaptations in energy homeostasis and that these adaptations underlie the high recidivism rate in obesity therapeutics. To be successful in the long term, our strategies for preventing weight regain may need to be just as comprehensive, persistent, and redundant, as the biological adaptations they are attempting to counter.

scholarly journals Long-term effects of a very-low-carbohydrate weight loss diet compared with an isocaloric low-fat diet after 12 mo

2009 ◽  
Vol 90 (1) ◽  
pp. 23-32 ◽  
Author(s):  
Grant D Brinkworth ◽  
Manny Noakes ◽  
Jonathan D Buckley ◽  
Jennifer B Keogh ◽  
Peter M Clifton
Keyword(s):  
Weight Loss ◽  
Long Term Effects ◽  
Low Fat ◽  
Weight Loss Diet ◽  
Low Fat Diet ◽  
Low Carbohydrate

scholarly journals MON-LB101 5-Year Data of an Aggressive Pharmacological Approach to Moderate and Morbid Obesity: Is Prevention of Bariatric Surgery Feasible in the Long Run?

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Flavio Cadegiani
Keyword(s):  
Bariatric Surgery ◽  
Morbid Obesity ◽  
Weight Loss ◽  
Body Weight ◽  
Weight Regain ◽  
Morbidly Obese ◽  
Biochemical Profile ◽  
Initial Weight ◽  
Initial Weight Loss

Abstract Background: Maintenance of weight loss in patients that undergo weight loss interventions is highly challenging, irrespective of the type of approach to obesity (whether surgical, pharmacological, or non-pharmacological). We proposed a protocol of an aggressive clinical treatment for obesity aiming to prevent the need of bariatric surgery, in patients unwilling to undergo this procedure, by proposing a protocol that included the combination of different anti-obesity medications and non-pharmacological modalities, for longer duration, and with an active approach to prevent weight regain. Our initial 2-year data showed that 93% (40 of 43 patients) with moderate and morbid obesity were able to avoid the need of bariatric surgery, with concomitant improvements of the biochemical profile. However, whether these patients would maintain their successful rates after five years was uncertain. Our objective is to describe the efficacy and safety of a long term (5-year data) pharmacological and multi-modal treatment for moderate and severe obesity. Methods: The 40 patients that were successful in the two-year approach in our obesity center (Corpometria Institute, Brasilia, DF, Brazil) were enrolled. A long-term anti-obesity protocol was employed, with continuous or intermittent use of anti-obesity drugs, trimestral body composition analysis, psychotherapy, visit to a nutritionist every four months, and both resistance and endurance exercises at least four times a week. Body weight (BW), total weight excess (TWE), body fat, markers of lipid and glucose metabolism, liver function, and inflammation were analyzed. Subjects that dropped out were considered as weight regain. Therapeutic success for the 5-year follow-up included as the maintenance of >20% loss of the initial BW loss, and no weight regain (or < 20% of the initial weight loss). Results: A total of 27 patients (67.5%) were able to maintain the body weight, seven dropped out, and six regained more than 20% of the initial weight loss. Of these, 21 (77.8%) had significant further increase of muscle mass and decrease of fat loss, while 17 (63.0%) had further weight loss (p < 0.05), compared to the 2-year data. Improvements on the biochemical profile persisted in all 27 patients, and had significant further improvements in 24 (88.9%) of these patients. Conclusion: The risk of weight regain five years after a weight loss treatment for obesity was significantly lower compared to previous literature, and comparable to the long-term outcomes of bariatric procedures. An aggressive, structured, and long-term clinical weight loss approach has been shown to be feasible, even for morbidly obese patients.

Persons Successful at Long-term Weight Loss and Maintenance Continue to Consume a Low-energy, Low-fat Diet

1998 ◽  
Vol 98 (4) ◽  
pp. 408-413 ◽  
Author(s):  
SIAO MEI SHICK ◽  
RENA R WING ◽  
MARY L KLEM ◽  
MAUREEN T McGUIRE ◽  
JAMES O HILL ◽  
...  
Keyword(s):  
Weight Loss ◽  
Low Energy ◽  
Low Fat ◽  
Low Fat Diet

Increasing PUFA intake with walnuts in a low fat diet supports long term weight loss in diabetes

2008 ◽  
Vol 22 (S2) ◽  
pp. 708-708 ◽  
Author(s):  
Linda Clare Tapsell ◽  
Marijka Batterham ◽  
Lynda Gillen ◽  
Karen Elizabeth Charlton
Keyword(s):  
Weight Loss ◽  
Low Fat ◽  
Pufa Intake ◽  
Low Fat Diet

scholarly journals High-fibre, low-fat diet predicts long-term weight loss and decreased type 2 diabetes risk: the Finnish Diabetes Prevention Study

Diabetologia ◽  
2006 ◽  
Vol 49 (5) ◽  
pp. 912-920 ◽  
Author(s):  
J. Lindström ◽  
M. Peltonen ◽  
J. G. Eriksson ◽  
A. Louheranta ◽  
M. Fogelholm ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Weight Loss ◽  
Diabetes Prevention ◽  
Prevention Study ◽  
Low Fat ◽  
Diabetes Prevention Study ◽  
Low Fat Diet ◽  
High Fibre

scholarly journals Implementation and evaluation of a weight-reduction programme for diabetic patients at a primary health care facility in the Western Cape: a pilot study

2017 ◽  
Vol 59 (2) ◽  
pp. 34
Author(s):  
Adil Razak ◽  
Abdul Aziez Isaacs
Keyword(s):  
Weight Loss ◽  
Weight Reduction ◽  
Health Centre ◽  
Diet Group ◽  
Diabetic Patients ◽  
Low Fat ◽  
Carbohydrate Diet ◽  
Low Carbohydrate Diet ◽  
Low Fat Diet ◽  
Low Carbohydrate

Background: Diabetes is a common non-communicable disease and complications are resulting in increased disability, reduced life expectancy and enormous health costs for virtually every society. Medical Nutrition Therapy is important for the prevention, treatment, and self-management of diabetes, and the prevention or delay in onset of diabetes-related complications. The current nutritional guidelines for diabetes state that carbohydrates should comprise 45–60% of the total nutritional intake and that lowcarbohydrate or high-protein diets offer no long-term success over healthy eating plans. Recent studies suggest that there may be merit in using low-carbohydrate diets in diabetic patients for weight reduction and improved cardiovascular markers. This study aimed to implement and evaluate a pilot programme for weight loss in diabetes mellitus type 2 patients by comparing a low-carbohydrate diet with the conventional low-fat diet. Methods: The study design was that of a two-group parallel design, with one group following a low-fat diet and the other a low-carbohydrate diet. Diabetic patients attending the Mitchell’s Plain Community Health Centre in Cape Town were recruited, with 10 participants in each group. Both groups received similar advice on exercise and behaviour change. Changes in weight, waist circumference, blood pressure and blood parameters (creatinine, lipids and HbA1c) were recorded at baseline and again after 12 weeks. Results: There were reductions in weight (1.85 kg vs. 0.1 kg gain) and HbA1c (1.72 vs. 0.32) in the low-carbohydrate diet group when compared with the low-fat diet group. No significant change was seen in other parameters including BP, total cholesterol and serum creatinine for either group. Conclusion: Low-carbohydrate diets may be effective in promoting weight loss and improving glucose control in diabetic patients. Implementation of this programme would require a paradigm shift for staff and further studies to assess its acceptability for patients. (Full text of the research articles are available online at www.medpharm.tandfonline.com/ojfp) S Afr Fam Pract 2017; DOI: 10.1080/20786190.2017.1329490

Postprandial coagulation activation in overweight individuals after weight loss: Acute and long-term effects of a high-monounsaturated fat diet and a low-fat diet

2014 ◽  
Vol 133 (3) ◽  
pp. 327-333 ◽  
Author(s):  
Else-Marie Bladbjerg ◽  
Thomas M. Larsen ◽  
Anette Due ◽  
Jørgen Jespersen ◽  
Steen Stender ◽  
...  
Keyword(s):  
Weight Loss ◽  
Long Term Effects ◽  
Monounsaturated Fat ◽  
Low Fat ◽  
Coagulation Activation ◽  
Low Fat Diet

The defence of body weight: a physiological basis for weight regain after weight loss

2012 ◽  
Vol 124 (4) ◽  
pp. 231-241 ◽  
Author(s):  
Priya Sumithran ◽  
Joseph Proietto
Keyword(s):  
Weight Loss ◽  
Body Weight ◽  
Energy Expenditure ◽  
Weight Regain ◽  
Physiological Changes ◽  
Initial Weight Loss ◽  
Physiological Basis ◽  
Subsequent Discussion ◽  
Short And Long Term

Although weight loss can usually be achieved by restricting food intake, the majority of dieters regain weight over the long-term. In the hypothalamus, hormonal signals from the gastrointestinal tract, adipose tissue and other peripheral sites are integrated to influence appetite and energy expenditure. Diet-induced weight loss is accompanied by several physiological changes which encourage weight regain, including alterations in energy expenditure, substrate metabolism and hormone pathways involved in appetite regulation, many of which persist beyond the initial weight loss period. Safe effective long-term strategies to overcome these physiological changes are needed to help facilitate maintenance of weight loss. The present review, which focuses on data from human studies, begins with an outline of body weight regulation to provide the context for the subsequent discussion of short- and long-term physiological changes which accompany diet-induced weight loss.

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