How to tackle diet-resistant obesity and weight loss

The study that is reshaping the science of diet-resistant obesity by promoting personalised weight loss programmes that focus on exercise

For decades individuals with obesity have been told to embrace a diet low in calories in order to lose weight. Evidence shows that focusing on diet alone is not the answer for a subset of adults with obesity who are adherent to a clinical weight management programme.

Exercise training enhances muscle mitochondrial metabolism in diet-resistant obesity

New research published in the journal eBioMedicine challenges this deeply engrained notion that diet alone is enough to lose weight. Researchers have studied how exercise training enhances muscle mitochondrial metabolism in diet-resistant obesity.

The conclusions reached in this study could be pivotal in improving public health knowledge on how to treat obesity, lose weight and keep it off. It is hoped that the insights gained in this study will help individuals with diet-resistant obesity.

“It’s exciting and important work. These findings have clinical implications and reveal molecular mechanisms that will drive research for many years to come,” comments the study’s Senior Author Dr. Mary-Ellen Harper.

Exercise training should be prioritised

Understanding distinct obesity phenotypes is vital in gaining insight into individual variations in weight loss.

Individuals with diet-resistant obesity should focus on exercise

“Diet-resistant” obesity refers to the patients in the bottom 20% for the rate of weight loss following a low-calorie diet. The study suggests that these patients should prioritise exercise training because it decreases fat mass and boosts skeletal muscle metabolism.

The research team analysed clinical data from over 5,000 records and reviewed 228 files. A subset of 20 women with obesity were identified as suitable participants for a closely supervised exercise programme consisting of 18 progressive sessions using treadmills and weights done three times per week for six weeks.

Exercise preferentially improves skeletal muscle metabolism and enhances weight loss

Using bioinformatics and machine learning approaches to analyse skeletal muscle, the results indicate that exercise preferentially improves skeletal muscle metabolism and enhances weight loss capacity for individuals with obesity who are deemed diet resistant.

These are the type of patients who have suffered as a result of diet restriction; one because they have not lost weight, and two because they have likely been accused of not following diet plans.

Some individuals have enormous difficulty losing weight

“For those individuals who have obesity and who’ve had enormous difficulty losing weight, the message for them is: You are in a group of individuals for whom exercise is particularly important. And that’s really going to help you lose weight,” says Dr. Ruth McPherson.

Asian woman with ponytail drinking water in front of row of treadmills in gym
© Korn Vitthayanukarun

Two-thirds of Canadian adults are overweight or obese

Obesity has become an endemic global problem and as a result, it has increased the likelihood of individuals developing a slew of chronic diseases.

Over 42% of American adults are obese

In Canada, two out of every three adults are overweight or obese, and in the US, over 42% of adults are obese.

Unlocking the mysteries of mitochondrial energetics and genetic predictors of weight loss

Dr. Robert Dent described the study’s findings as the “crowning glory” of the research work carried out alongside Drs. Harper and McPherson over two decades. The three partners have collaborated numerous times over the years, helping to unlock the mysteries of mitochondrial energetics and the genetic predictors of weight loss.

Dr. Dent concludes: “If you look at a large group of people who are overweight and trying to lose weight, they don’t respond to exercise very much. But now we’ve found that people in this [diet-resistant] obesity phenotype really do.

“What the findings are telling us is that when we see individuals with obesity who don’t respond to dietary restriction, they should be shunted over to physical activity.”

The study has the potential to shake up the science of weight loss and set it on a new path. It emphasises that weight loss programmes should be customised for the individual because a one-size-fits-all approach is not appropriate for those with diet-resistant obesity.

The team is currently recruiting a larger sample size to continue their research into obesity and weight loss.

 

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How to tackle diet-resistant obesity and weight loss