Metabolic Parameters and Energy Expenditure Before and After Weight Loss

  • John M. Amatruda
Part of the Contemporary Biomedicine book series (CB, volume 15)


Much clinical research in diabetes has concentrated on weight loss, since obesity and weight gain are such important risk factors for noninsulin-dependent diabetes mellitus (NIDDM) and weight loss decreases this risk (1). Also, since both obesity and NIDDM are independent risk factors for cardiovascular disease (2–4) and since obesity predisposes to NIDDM and complicates existing disease (1,3), it is universally accepted that the initial treatment of an obese diabetic patient is dietary management (5),with specific emphasis on weight reduction. Several studies have demonstrated that weight loss leads to improvement in all metabolic measurements, including plasma glucose, HbA1C, insulin secretion and responsiveness, and lipid levels (3). Blood pressure also improves (3).


Obese Subject Obese Woman Lean Body Mass Total Energy Expenditure Rest Metabolic Rate 
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  1. 1.
    Colditz GA, Willett WC, Rotnitzky A, Manson JE. Weight gain as a risk factor for clinical diabetes in women. Ann Intern Med 1995; 122: 481–486.PubMedGoogle Scholar
  2. 2.
    Manson JE, Willett WC, Stampfer MJ, Colditz GA, Hunter DJ, Hankinson SE, Hennekens CH, Speizer FE. Body weight and mortality among women. New Engl J Med 1995; 333: 677–685.PubMedCrossRefGoogle Scholar
  3. 3.
    Amatruda JM, Welle S. Obesity. In: Endocrinology and Metabolism, 3rd ed. Felig P, Baxter JD, Frohman LA, eds. New York: McGraw-Hill, pp. 1271–1313, 1995.Google Scholar
  4. 4.
    Wingard DL, Barrett-Connor E. Heart disease and diabetes. In: Diabetes in America, 2nd ed. National Diabetes Data Group, NIH publication no. 95–1468, pp. 429–448, 1995.Google Scholar
  5. 5.
    Bauks P, Welch CB, Landrum S, eds. Medical Management of Non-Insulin Dependent (Type II) Diabetes, (3rd ed.) Alexandria, VA: American Diabetes Association Inc., pp. 28–31, 1994.Google Scholar
  6. 6.
    Stunkard A, McLaren-Hume M. The results of treatment of obesity: a review of the literature and report of a series. Arch Intern Med 1959; 103: 79–85.CrossRefGoogle Scholar
  7. 7.
    Lantigua RA, Amatruda JM, Biddle TL, Forbes GB, Lockwood DH. Cardiac arrhythmias associated with a liquid protein diet for the treatment of obesity. New Engl J Med 1980; 303: 735–738.PubMedCrossRefGoogle Scholar
  8. 8.
    Licata AA, Lantigua R, Amatruda J, Lockwood D. Adverse effects of liquid protein fast on the handling of magnesium, calcium and phosphorus. Am J Med 1981; 71: 767–772.PubMedCrossRefGoogle Scholar
  9. 9.
    Amatruda JM, Biddle TL, Patton ML, Lockwood DH. Vigorous supplementation of a hypocaloric diet prevents cardiac arrhythmias and mineral depletion. Am J Med 1983; 74: 1016–1022.PubMedCrossRefGoogle Scholar
  10. 10.
    Amatruda JM, Richeson JF, Welle SL, Brodows RG, Lockwood DH. the safety and efficacy of a controlled low-energy (“very-low calorie”) diet in the treatment of non-insulin-dependent diabetes and obesity. Arch Intern Med 1988; 148: 873–877.PubMedCrossRefGoogle Scholar
  11. 11.
    Hughes TA, Gwynne JT, Switzer BR, Herbst C, White G. Effects of caloric restriction and weight loss on glycemic control, insulin release and resistance, and atherosclerotic risk in obese patients with type II diabetes mellitus. Am J Med 1984; 77: 7–17.PubMedCrossRefGoogle Scholar
  12. 12.
    Henry RR, Schaeffer L, Olefsky JM. Glycemic effects of intensive caloric restriction and isocaloric refeeding in noninsulin-dependent diabetes mellitus. J Clin Endocrinol Metab 1985; 61: 917–925.PubMedCrossRefGoogle Scholar
  13. 13.
    Welle SL, Amatruda JM, Forbes GB, Lockwood DH. Resting metabolic rates of obese women after rapid weight loss. J Clin Endocrinol Metab 1984; 59: 41–44.PubMedCrossRefGoogle Scholar
  14. 14.
    Welle S, Forbes GB, Statt M, Barnard RR, Amatruda JM. Energy expenditure under free-living conditions in normal-weight and overweight women. Am J Clin Nutr 1992; 55: 14–21.PubMedGoogle Scholar
  15. 15.
    Amatruda JM, Statt MC, Welle SL. Total and resting energy expenditure in obese women reduced to ideal body weight. J Clin Invest 1993; 92: 1236–1242.PubMedCrossRefGoogle Scholar
  16. 16.
    Lissner L, Habicht J-P, Strupp BJ, Levitsky DA, Haas JD, Roe DA. Body composition and energy intake: do overweight women overeat and underreport? Am J Clin Nutr 1989; 49: 320–325.PubMedGoogle Scholar
  17. 17.
    Forbes GB, Brown MR. Energy need for weight maintenance in human beings: effects of body size and composition. J Am Diet Assoc 1989; 89: 499–502.PubMedGoogle Scholar
  18. 18.
    Leibel RL, Hirsch J. Diminished energy requirements in reduced-obese patients. Metabolism 1984; 33: 164–170.PubMedCrossRefGoogle Scholar
  19. 19.
    Leibel RL, Rosenbaum M, Hirsch J. Changes in energy expenditure resulting from altered body weight. New Engl J Med 1995; 332: 621–628.PubMedCrossRefGoogle Scholar
  20. 20.
    Blair D, Buskirk ER. Habitual daily energy expenditure and activity levels of lean and adult-onset and child-onset obese women. Am J Clin Nutr 1984; 45: 540–550.Google Scholar
  21. 21.
    Schoeller DA. Measurement of energy expenditure in free-living humans by using doubly labeled water. J Nutr 1988; 118: 1278–1289.PubMedGoogle Scholar
  22. 22.
    Forbes GB. Lean body mass-body fat interrelationships in humans, Nutr Rev 1987; 45: 225–231.PubMedCrossRefGoogle Scholar
  23. 23.
    Weinsier RL, Nelson KM, Hensrud DD, Darnell BE, Hunter GR, Schutz Y. Metabolic predictors of obesity: contribution of resting energy expenditure, thermic effect of food, and fuel utilization to four-year weight gain of post-obese and never-obese women. J Clin Invest 1995; 95: 980–985.PubMedCrossRefGoogle Scholar
  24. 24.
    Astrup A, Buemann B, Christensen NJ, Madsen J. 24-hour energy expenditure and sympathetic activity in post-obese women consuming a high-carbohydrate diet. Am J Physiol 1992; 262: E282 - E288.Google Scholar
  25. 25.
    Welle S, Barnard RR, Statt M, Amatruda JM. Increased protein turnover in obese women. Metabolism 1992; 41: 1028–1034.PubMedCrossRefGoogle Scholar
  26. 26.
    Welle S, Statt M, Barnard R, Amatruda J. Differential effect of insulin on whole-body proteolysis and glucose metabolism in normal-weight, obese, and reduced-obese women. Metabolism 1994; 43: 441–445.PubMedCrossRefGoogle Scholar
  27. 27.
    Petersen KF, Hendler R, Perseghin G, Price T, Held N, Roden M, Rothman DL, Shulman GI, Amatruda J. 13C and 311) NMR studies of the mechanism of insulin resistance in obesity. Int J Obesity (Suppl. 2)1995; 19: P252.Google Scholar
  28. 28.
    Rothman DL, Shulman RG, Shulman GI. 31P nuclear magnetic resonance measurements of muscle glucose-6-phosphate. Evidence for reduced insulin-dependent muscle glucose transport or phosphorylation activity in non-insulin-dependent diabetes mellitus. J Clin Invest 1992; 89: 1069–1075.PubMedCrossRefGoogle Scholar
  29. 29.
    Hendler RG, Welle SL, Statt MC, Barnard R, Amatruda, JM. The effects of weight reduction to ideal body weight on body fat distribution. Metabolism 1995; 44: 1413–1416.PubMedCrossRefGoogle Scholar

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© Springer Science+Business Media New York 1997

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  • John M. Amatruda

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