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

Adaptive Thermogenesis as a Cause of Unsuccessful Weight Loss

The main implication that can be derived from the observations presented above is that adaptive thermogenesis can be sufficiently pronounced in some individuals to interfere with successful weight loss. On the basis of the studies of Leibel et al. and those performed in Laval University, this phenomenon could appear as an adaptation that promotes the early occurrence of resistance to lose fat. Indeed, in these two series of studies, greater than predicted decreases in energy expenditure were observed in subjects having experienced some weight loss.

Our clinical experience also reveals that such an adaptation can happen sufficiently early during the course of a weight-reducing program to totally prevent the achievement of weight loss. This is the case of a woman who participated in a weight-reducing program at Laval University several years ago. As shown in Table 2 , she experienced weight gain after 15 weeks of careful nutritional supervision aimed at promoting weight loss. This table also shows that this subject was compliant to nutritional guidelines since she was reporting a decrease in daily energy intake of approximately 500 kcal at the end of the study compared with initial measurements. Interestingly, indirect calorimetry measurements offered an explanation of the apparent paradox revealed by the weight gain at the same time as the subject was reducing her energy intake. Indeed, Table 2 shows that the decrease in daily resting metabolic rate was equivalent to the reported reduction in energy intake. If one considers that the energy efficiency displayed by the subject in the resting state at the end of the study was also likely to be present in the nonresting state, it becomes easily understandable that weight gain occured when the subject was compliant to nutritional guidelines promoting a decrease of caloric intake. This agrees with the observations of Miller and Parsonage[67] who found that some subjects were resistant to slimming despite a rigorous control over energy intake.

In summary, there seem to be some obese individuals who clearly overreact in energy expenditure when they are exposed to a negative energy balance. This adaptive thermogenesis may then clearly reduce the ability to achieve a successful body weight loss. To date, there is no clear explanation for the occurrence of such a phenomenon but, as discussed in the next section, we cannot exclude the possibility that it might happen so as to protect body homeostasis.

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