Role of Adaptive Thermogenesis in Unsuccessful Weight-Loss Intervention

Angelo Tremblay; Geneviève Major; Éric Doucet; Paul Trayhurn; Arne Astrup

Disclosures

Future Lipidology. 2007;2(6):651-658. 

In This Article

Abstract and Introduction

Abstract

Numerous studies have been performed to examine the existence of a relationship between a weak thermogenic potential and the risk of developing obesity. These studies used a large variety of methodological approaches that have frequently revealed a potential physiological vulnerability in obesity-prone individuals. However, from a quantitative standpoint, they have not allowed the demonstration of differences or experimental effects that could explain large variations in energy balance. As discussed in this paper, a definition of adaptive thermogenesis as being a greater than predicted change in energy expenditure in response to changes in energy balance leads to clinically meaningful observations. This is particularly the case in the context of a weight-reducing program in which adaptive changes in thermogenesis can be sufficient to compensate for a prescribed decrease in daily energy intake. This paper also presents evidence suggesting that these thermogenic adaptations might indirectly contribute to the protection of body homeostasis by attenuating the decrease in the dilution space of some lipid-soluble pollutants.

Introduction

Energy expenditure is subjected to variations that are rarely of a pathological nature, which may explain why no reference value of 'metabolic rate normality' exists to diagnose physiological dysfunctions. In fact, when excess deviations in energy expenditure are observed in a patient, the medical diagnosis is generally made by referring to other variables as in the case of hypo- and hyperthyroidism. Another reason potentially explaining why energy expenditure has not been traditionally used in obesity as a variable of clinical diagnosis pertains to the inability of basic and clinical research to identify and characterize a thermogenic defect in obesity-prone individuals. However, in a context where the prevalence of obesity is increasing in an accelerated manner, it remains relevant to question whether variations in energy expenditure may be a matter of physiological vulnerability for some individuals.

In the present paper, we document this issue by specifically focusing on the hypothesis that adaptive thermogenesis might be a cause of unsuccessful body weight loss. In addition, factors that may well explain these variations, particularly those that are difficult to investigate under free-living conditions because of ethical considerations, will also be discussed.

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