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- November 20, 2008 |
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"Why does nearly everyone regain weight after weight loss?"Prof. Joseph Proietto (biography)
English - 2007-05-31 - 38 minutes
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Summary :
In this presentation Prof. Proietto discusses physiological adaptations that occur following weight loss that encourage re-gain of weight.
Interventions such as diet with or without physical activity, or even behaviour modification are not reliable methods for achieving substantial long-term weight loss. Only with surgery does this appear to be feasible. Why is this the case?
Weight is regulated by the brain, and the levels of expression of neurotransmitters that stimulate or inhibit food intake are in turn modulated by circulating factors released by peripheral tissues such as the gut, fat and the pancreas. Animal as well as human data indicate that weight is homeostatically regulated. A study published in the New England Journal of Medicine, for example, concluded that "Maintenance of a reduced or elevated body weight is associated with compensatory changes in energy expenditure, which oppose the maintenance of a body weight that is different from the usual weight. These compensatory changes may account for the poor long-term efficacy of treatments for obesity." (1). What is the component of energy expenditure being regulated? It is the activation of nonexercise activity thermogenesis that seems to be important for preserving leanness under conditions of overfeeding (2).
There is also evidence for weight being genetically determined. Studies of twins and adoptees suggest a strong genetic influence on body-mass index with a smaller contribution from the environment, and there are several gene mutations that are believed to cause obesity as well. Still, the prevalence of obesity in Australia has doubled only in the last twenty years (3). Why is that? Prof. Proietto talks about evidence for epigenetic changes leading to obesity, and finally some of the mechanisms causing weight re-gain after weight loss.
Copyright © 2007 E-MedHosting.com Inc.
Learning objectives :
After viewing this presentation the participant will be able to discuss:
- Peripheral signals influencing food intake
- Evidence in support of homeostatic regulation of weight (animal and human studies)
- Changes in the components of energy expenditure in relation to fat gain after overfeeding
- Evidence in support of weight being genetically determined
- Some gene mutations causing obesity
- Evidence in support of epigenetic change leading to obesity
- Some mechanisms promoting weight re-gain after weight loss
Bibliographic references :
1. Rudolph L. Leibel, M.D., Michael Rosenbaum, M.D., and Jules Hirsch, M.D.Changes in Energy Expenditure Resulting from Altered Body Weight N Engl J Med. 1995 Mar 9;332(10):621-8.
2. James A. Levine, Norman L. Eberhardt, Michael D. Jensen Role of Nonexercise Activity Thermogenesis in Resistance to Fat Gain in Humans Science. 1999 Jan 8;283(5399):212-4.
3. Adrian J Cameron, Timothy A Welborn, Paul Z Zimmet, David W Dunstan, Neville Owen, Jo Salmon, Marita Dalton, Damien Jolley and Jonathan E Shaw Overweight and obesity in Australia: the 1999–2000 Australian Diabetes, Obesity and Lifestyle Study (AusDiab) Med. J. Aust. 2003 May 5;178(9):427-32.
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