Konstantinos Tsoukalas

Cell Metabolism Journal

Research Quote

The results from the present study demonstrate the profound therapeutic effects of weight loss on metabolic function and other risk factors for cardiometabolic disease in people with obesity. Even a moderate 5% weight loss has considerable health benefits

Obesity is associated with a constellation of cardiometabolic abnormalities including insulin resistance. Most treatment guidelines, including those recently proposed by several major medical and scientific societies, recommend moderate weight loss of 5%–10% to achieve improvements in metabolic function and health outcomes (Jensen et al., 2014). However, it is much easier to achieve a 5% weight loss than it is to achieve a 10% weight loss, so it is important to understand the cardiometabolic benefits that occur with a 5% weight loss and what additional benefits, if any, can be expected with more weight loss in people with obesity.

Although 5%–10% weight loss is a commonly recommended therapeutic target for people with obesity (Jensen et al., 2014), the differences between 5% and 10% weight loss and the effects of additional diet-induced weight loss on body composition, adipose tissue biology, and cardiometabolic health outcomes are not clear. Therefore, we conducted a randomized controlled trial to determine: (1) the effects of 5% weight loss on metabolic function and both systemic and subcutaneous adipose tissue markers of inflammation; and (2) the effects of subsequent progressive weight loss on body composition, metabolic function, and global adipose tissue gene expression profile. The major findings from our study demonstrate that 5% weight loss improves multi-organ (adipose tissue, liver, and skeletal muscle) insulin sensitivity, β cell function, and multiple risk factors for cardiometabolic disease. These therapeutic effects occurred without a concomitant change in systemic or subcutaneous adipose tissue markers of inflammation, demonstrating that improvement of these selected markers of inflammation is not necessary for weight loss-induced improvements in metabolic function. Progressive 11% and 16% weight loss caused stepwise reductions in body fat mass, IAAT volume and IHTG content, progressive changes in adipose tissue biology (i.e., upregulation of metabolic pathways and genes involved in cholesterol flux and downregulation of metabolic pathways and genes involved in lipid synthesis, ECM remodeling and oxidative stress), further improvement in skeletal muscle, but not liver or adipose tissue, insulin sensitivity, and continued improvement in β cell function.

The results from the present study demonstrate the profound therapeutic effects of weight loss on metabolic function and other risk factors for cardiometabolic disease in people with obesity. Even a moderate 5% weight loss has considerable health benefits, including decreased IAAT volume, IHTG content, systolic blood pressure and plasma triglyceride concentration, and increased multi-organ insulin sensitivity and β cell function. Additional weight loss further improves many cardiometabolic outcomes and has a progressive effect on adipose tissue expression of genes involved in cholesterol flux, lipid synthesis, ECM remodeling, and oxidative stress. Future studies are needed to determine whether the weight loss-induced changes in adipose tissue biology contribute to the observed beneficial effects on cardiometabolic outcomes.

Journal of Exercise Science & Fitness

Excess weight in children and adolescents is a growing concern due to the elevated number of comorbidities [e.g., type 2 diabetes, hypertension, and metabolic syndrome (MS)],1 which may develop at this time and may be present later in adulthood.2 Thus, there is a need to develop intervention programs that encourage lifestyle changes in this population.

This study aimed to assess the impact of a multidisciplinary program of obesity treatment (MPOT) on adolescents who have maintained/gained weight or lost weight. Eighty-six adolescents aged 10–18 years were allocated in either the intervention group (IG; n = 44) or the control group (CG; n = 42). Each group was divided into two more groups: weight maintenance/gain and weight loss, as assessed after the intervention. The MPOT lasted 16 weeks and was conducted by a multidisciplinary team based on cognitive-behavioral therapy. We analyzed body composition and cardiometabolic parameters prior to and after the intervention. Adolescents from the IG who lost weight showed improvements in maximal oxygen uptake (23.54 ± 5.30 mL/kg/minute vs. 25.39 ± 5.63 mL/kg/minute), body fat percentage (49.29 ± 6.98% vs. 46.75 ± 8.56%), triglyceride levels (116.58 ± 46.50 mg/dL vs. 101.19 ± 43.08 mg/dL), diastolic blood pressure (75.81 ± 8.08 mmHg vs. 71.19 ± 6.34 mmHg), and the number of risk factors for metabolic syndrome (2.00 ± 1.06 vs. 1.58 ± 1.10). Adolescents from the IG who gained/maintained weight reported reduced body fat percentage (48.81 ± 5.04% vs. 46.60 ± 5.53%), systolic blood pressure (123.39 ± 14.58 mmHg vs. 115.83 ± 7.02 mmHg), diastolic blood pressure (74.83 ± 9.91 mmHg vs. 68.78 ± 5.95 mmHg), and number of risk factors for metabolic syndrome (from 1.67 ± 1.09 to 1.11 ± 0.68), and their lean mass (39.00 ± 7.20 kg vs. 41.85 ± 7.53 kg) and maximal oxygen uptake (23.74 ± 4.40 mL/kg/minute vs. 25.29 ± 5.17 mL/kg/minute) increased in a manner similar to those of adolescents who lost weight. Furthermore, we noted significant decreases in body mass index, body fat (kg), glycemia, and waist circumference in CG adolescents who lost weight, whereas those in the CG who maintained/gained weight had an increase in body mass index, hip circumference, body fat (kg), and lean mass. A 16-week MPOT promoted positive changes in body composition and cardiometabolic risk factors independently of weight changes.