Fat‐free mass loss generated with weight loss in overweight and obese adults: what may we expect?
Abstract
There is concern that intentional weight loss may generate excessive loss of fat‐free mass (FFM). Idealists target minimal loss of FFM, while others consider that FFM loss of up to 25% of weight loss is acceptable. In a cross‐sectional study of 275 weight‐stable, overweight or obese adults, we used whole‐body dual‐energy X‐ray absorptiometry to measure FFM. A range of models was used to estimate the expected ΔFFM/Δweight ratio required to attain the body composition of a weight‐stable individual at a lower body mass index (BMI). Higher BMI was associated linearly with higher FFM in men and women. Proportional ΔFFM/Δweight was influenced by sex, BMI and age. Direct scatter plot analysis, quadratic curve fit modelling and linear FFM–BMI modelling provided similar estimates for each model of ΔFFM/Δweight ratio, with 40% for men and 33% for women. These results show that the 25% rule is inappropriate and our estimates are higher than those generally reported after intentional weight loss indicating favourable preservation of FFM.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Whole-body DEXA scans demonstrate a clear relationship of BMI to fat mass and fat-free mass.
“Despite these considerations, whole-body DEXA (dual-energy X-ray absorptiometry) scans demonstrate a clear relationship of BMI to fat mass and fat-free mass.17”
From Obesity Paradox in Hypertension: Is This Because Sympathetic Activation in Obesity-Hypertension Takes a Benign Form? (2018) · cites this paper as [17]
Cites
Changes in fat-free mass during significant weight loss: a systematic review
Chaston, T. B., Dixon, J. B., & O'Brien, P. E. (2007) · International Journal of Obesity · doi:10.1038/sj.ijo.0803483 · Cited by 493 · see citing works
Self-citationMyths, Presumptions, and Facts about Obesity
Casazza, K., Fontaine, K. R., Astrup, A., Birch, L. L., Brown, A. W., Bohan Brown, M. M., Durant, N., Dutton, G., Foster, E. M., Heymsfield, S. B., et al. (2013) · New England Journal of Medicine · doi:10.1056/nejmsa1208051 · Cited by 442 · see citing works
Heymsfield, S. B., Gonzalez, M. C. C., Shen, W., Redman, L., & Thomas, D. (2014) · Obesity Reviews · doi:10.1111/obr.12143 · Cited by 350 · see citing works
(1983) · PubMed · Cited by 245 · see citing works
Deliberate overfeeding in women and men: energy cost and composition of the weight gain
Forbes, G. B., Brown, M. R., Welle, S. L., & Lipinski, B. A. (1986) · British Journal Of Nutrition · doi:10.1079/bjn19860080 · Cited by 167 · see citing works
Webster, J. D., Hesp, R., & Garrow, J. S. (1984) · PubMed · Cited by 145 · see citing works
New fat free mass - fat mass model for use in physiological energy balance equations
Thomas, D. M., Das, S. K., Levine, J. A., Martin, C. K., Mayer, L., McDougall, A., Strauss, B. J., & Heymsfield, S. B. (2010) · Nutrition & Metabolism · doi:10.1186/1743-7075-7-39 · Cited by 49 · see citing works
Mason, C. E., Foster‐Schubert, K. E., Imayama, I., Xiao, L., Kong, A., Campbell, K. L., Duggan, C. R., Wang, C.-Y., Alfano, C. M., Ulrich, C. M., et al. (2012) · Metabolism · doi:10.1016/j.metabol.2012.06.012 · Cited by 38 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Zibellini, J., Seimon, R. V., Lee, C. M., Gibson, A. A., Hsu, M. S., Shapses, S. A., Nguyen, T. V., & Sainsbury, A. (2015) · Journal of Bone and Mineral Research · doi:10.1002/jbmr.2564 · Cited by 157 · see citing works
Esler, M., Lambert, G., Schlaich, M., Dixon, J., Sari, C. I., & Lambert, E. (2018) · Hypertension · doi:10.1161/hypertensionaha.117.09790 · Cited by 60 · see citing works
Self-citationZibellini, J., Seimon, R. V., Lee, C. M. Y., Gibson, A. A., Hsu, M. S. H., & Sainsbury, A. (2016) · Obesity Reviews · doi:10.1111/obr.12422 · Cited by 54 · see citing works
Coleman, C. D., Kiel, J. R., Mitola, A. H., Langford, J. S., Davis, K. N., & Arterburn, L. M. (2015) · Nutrition Journal · doi:10.1186/s12937-015-0062-8 · Cited by 34 · see citing works
Son, J. S., Chae, S. A., Park, B. I., Du, M., & Song, W. (2019) · Endocrinología, Diabetes y Nutrición · doi:10.1016/j.endinu.2018.12.005 · Cited by 21 · see citing works
- Authors
- Dixon, J. B., Lambert, E. A., Grima, M., Rice, T., Lambert, G. W., & Straznicky, N. E.
- Affiliations
- Baker Heart and Diabetes Institute (AU)
- Clinical Obesity Research, Baker IDI Heart & Diabetes Institute Melbourne Australia
- Corresponding author
- Dixon, J. B.
- Venue
- Diabetes, Obesity and Metabolism
- Publisher
- Wiley
- Published
- 2014-09-28
- Volume
- 17
- Issue
- 1
- Pages
- 91-93
- ISSN
- 1462-8902 (ISSN-L)
- 1463-1326
- OpenAlex
- W2042635293
- Cited by
- 40
- References
- 8
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 4 · 2023: 2 · 2022: 1 · 2021: 2 · 2020: 7 · 2019: 4 · 2018: 2 · 2017: 6 · 2016: 5 · 2015: 5
- FWCI
- 3.55
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes Obesity and Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Swinburne figshare (Swinburne University of Technology) (submittedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Keywords
- fat-free mass loss, weight loss, obesity, overweight adults, body composition, body mass index, sex differences, age effects, dual-energy X-ray absorptiometry
- MeSH terms
- Adult, Body Composition, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Models, Biological, Muscular Atrophy, Nutrition Surveys, Obesity, Sex Characteristics, United States, Victoria, Cohort Studies, Weight Loss, Absorptiometry, Photon, Body Mass Index, Muscle Development, White People, Overweight, Whole Body Imaging
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
