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Int J Obes Relat Metab Disord. 2000 Jun;24(6):711-8.

Energy, substrate and protein metabolism in morbid obesity before, during and after massive weight loss.

Author information

1
Departments of Surgery and Human Biology, University Hospital Maastricht, PO box 5800, 6202 AZ, Maastricht, The Netherlands. wg.gemert@wxs.nl

Abstract

OBJECTIVE:

To investigate the effect of surgically induced weight loss on energy, substrate and protein metabolism of morbidly obese patients.

DESIGN:

A prospective, clinical intervention study of morbidly obese patients before and after surgical treatment.

SUBJECTS:

Eight morbidly obese patients (BMI 47.88+/-7.03).

METHODS:

Total energy expenditure (TEE; doubly labeled water method), sleeping metabolic rate (SMR; respiration chamber), body composition (deuterium oxide component of doubly labeled water), substrate metabolism (48 h dietary records, 48 h urine collection and gaseous exchange in the respiration chamber) and whole body protein turnover (primed-continuous infusion of L-[1-13C]-leucine) were measured before, 3 and 12 months after vertical banded gastroplasty (VBG).

RESULTS:

The TEE decreased as a result of a decreased SMR (64%) and non-SMR (36%; P=0.001). SMR as a function of fat-free mass (FFM) decreased after weight loss (P<0.05). The physical activity index (PAI), defined as TEE/SMR, was low and was not influenced by weight loss. Protein and carbohydrate oxidation decreased significantly after VBG (P<0.05), although 3 months after VBG protein oxidation did not decrease enough to prevent loss of FFM. The energy used for protein turnover was approximately 24% of SMR and did not change after weight loss.

CONCLUSIONS:

Compensatory processes that oppose weight loss of morbidly obese patients exist, as demonstrated by the disproportional reduction of SMR, and a low PAI. Protein turnover is not a major contributor to the disproportional reduction of SMR.

PMID:
10878677
DOI:
10.1038/sj.ijo.0801230
[Indexed for MEDLINE]

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