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The threshold shift paradigm of obesity: evidence from surgically induced weight loss

Ferrannini, Ele, Rosenbaum, Michael, Leibel, Rudolph L·2014·The American Journal of Clinical Nutrition
DOI 10.3945/ajcn.114.090167
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Abstract

Background The high prevalence of obesity has called attention to the near-intractable problem of sustained weight reduction and its underlying mechanisms. With diet-induced weight loss, achieved body weight is closely related to initial body weight. Objective The objective was to compare the relation between initial and achieved body mass index (BMI) in patients treated with diet-induced weight loss or bariatric surgery. Design We analyzed data from a cohort of 223 healthy individuals who lost a mean (±SD) of 5 ± 3 kg body weight over 3 y by diet (diet group) and data from 182 obese individuals [BMI (in kg/m(2)) ≥35] who had lost an average of 47 ± 17 kg 1 y after Roux-en-Y gastric bypass (a restrictive procedure; n = 71) or biliopancreatic diversion (a malabsorptive procedure; n = 111) (surgery group). Results In the diet group, final BMI was strongly related to initial BMI (r = 0.96, P Conclusion The strong predictivity of initial BMI for achieved BMI observed even when voluntary control of energy intake is interfered with through diverse anatomical rearrangements of the gastrointestinal tract supports the concept of a weight "threshold" paradigm: in the obese, anabolic responses are triggered by adiposity-related signals at a higher threshold, which leads to defense of a higher body weight.

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Metadata

Authors
Ferrannini, E., Rosenbaum, M., & Leibel, R. L.
Venue
The American Journal of Clinical Nutrition
Publisher
Elsevier BV
Published
2014-10
Volume
100
Issue
4
Pages
996-1002
ISSN
0002-9165
DOI
10.3945/ajcn.114.090167
Cited by
32
References
12
Language
en
Licence

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