Predicting Weight Gain and Weight Loss Associated With Overeating or Fasting
- Conditions
- Weight GainNutrition TherapyWeight LossObesityDiet Therapy
- Interventions
- Behavioral: OverfeedingBehavioral: Weight LossBehavioral: Overfeeding Low Pro
- Registration Number
- NCT00687115
- Brief Summary
This study will investigate how to better predict why some individuals gain or lose weight more easily than others. It will examine whether the increase in the amount of energy a body burns in 24 hours with overeating or the decrease over 24 hours with fasting can help determine how easily someone gains or loses weight.
Healthy people between 18 and 60 years of age who have a body mass index (BMI) between 18.5 kg/m(2) and 24 kg/m(2) (for overfeeding study) or a BMI greater than 27 kg/m(2) with a body weight less than 350 pounds (weight loss study) may be eligible for this study. The study requires a 10-week admission to the NIH Clinical Center (2-week baseline, 6-week overfeeding/weight loss, 2-week post-weight change).
Participants undergo the following tests and procedures during the hospital admission:
* Medical history, physical examination and laboratory studies
* Questionnaires to assess eating behavior, food preferences, body composition, and activity level
* Body composition assessment (height, weight, waist circumference, and fat mass and muscle content through DXA and MRI scans)
* Oral glucose tolerance test
* Meal test to measure the response of certain hormones to food
* Activity monitors to determine activity level
* Metabolic chamber study to measure calories burned over 24 hours and monitor body temperature
* Free-living energy use study to measure calories burned under normal home conditions over 7 days
* Fat and muscle biopsies
* Dietary intervention: Measurements of food intake and energy loss over a 6-week overfeeding (1.5 times the subject s normal food intake) or weight loss (one-half the subject s normal food intake) program
Followup procedures after the inpatient stay:
* Height and weight measurements at 6 months (overfeeding study participants) and monthly for the first year, at 3-month intervals for the second year, and then yearly for 3 more years (weight loss study participants)
* Yearly visits (2-night inpatient stay) for all participants for repeat meal test, DXA, oral glucose tolerance test, behavioral questionnaires and, in women who can become pregnant, pregnancy test
- Detailed Description
For obese individuals, losing weight and keeping it off are extremely difficult, whereas some other individuals are thin and report trouble gaining weight. In most weight loss and overfeeding studies there is a large variation in the amount of weight lost or gained, and it is not clear whether an individual s response to an intervention can be predicted. Measurement of the amount of energy an individual uses over 24 hours (24 hour energy expenditure or 24-EE) and the response of 24-EE to overfeeding and fasting may help predict which individuals will have the greatest changes in weight with changes in energy balance. In previous work, 24-EE responses to overfeeding and fasting were related such that individuals with the greatest increase in 24-EE upon overfeeding tended to have the smallest decrease in 24-EE upon fasting ( spendthrift phenotype) and those individuals with less increase in 24-EE during overfeeding had a greater decrease in 24-EE with fasting ( thrifty phenotype). Those with the spendthrift phenotype who had a greater increase in 24-EE in response to overfeeding gained less weight over time. Furthermore, studies have shown that diets with very low protein content may magnify the variability in response to overfeeding.
The aim of this study is to determine if a phenotype defined by 24-EE responses to overfeeding and underfeeding is related to weight loss or gain in 4 different under- and overfeeding settings: an inpatient weight loss group for obese individuals who will be administered one of two diets based on a 50% reduction of their daily energy needs for six weeks (standard reduction diet or calorie reduced diet that is still high in protein; 6 week weight reduction, 10 week stay, n=20/standard reduction diet group and n=10/relative high protein diet), and two overfeeding groups for lean, weight gain resistant individuals: a low-protein overfeeding group at 150% of daily energy needs for 6 weeks overfeeding (6% protein, 64% carbohydrate, 30% fat; 10 week stay, n=10), and a normal protein overfeeding group at 150% of daily energy needs for 6 weeks overfeeding (20% protein, 50% carbohydrate, 30% fat; 10 week stay, n=10). We will also examine additional metabolic and behavioral measurements to determine how they relate to weight change and changes in 24-EE. These include sympathetic nervous system activity, behavior, adipose and muscle tissue energy content, and abdominal adipocyte size. The study will evaluate the relationship between the percent increase in 24-EE in response to overfeeding/underfeeding and the amount of weight change over time in each subject. These findings may provide important information for predicting and adapting specific individualized interventions for obesity.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 83
Not provided
Not provided
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Overfeeding Overfeeding an inpatient overfeeding arm in which obesity resistant individuals are prescribed a 150% increase in a weight maintenance calorie diet for 6 weeks which (by random assignment) is either low in protein (6%) content. Overfeeding or Overfeeding Low Pro or with normal (20%) protein content Overfeeding Overfeeding Low Pro an inpatient overfeeding arm in which obesity resistant individuals are prescribed a 150% increase in a weight maintenance calorie diet for 6 weeks which (by random assignment) is either low in protein (6%) content. Overfeeding or Overfeeding Low Pro or with normal (20%) protein content Weight Loss Weight Loss a weight loss arm in which obese individuals are placed on a 50% decrease from a weight maintenance calorie diet for 6 weeks which (by random assignment) is either a standard 50% decrease in energy intake with all macronutrients held at the same percentage (20% protein, 50% carbohydrate, 30% fat) or a 50% decrease in energy intake with the same absolute protein content (in grams) as the weight maintaining diet while on our clinical research unit then followed as outpatients monthly for 10 months
- Primary Outcome Measures
Name Time Method The primary goal of the current study is to determine if changes in energy expenditure in response to acute over- and underfeeding are related to variation in changes in weight and body energy stores with longer-term over- and underfeeding. Ongoing Changes in energy expenditure, weight, and body energy stores measured via physical examinations, laboratory studies, questionnaires, body composition assessments, oral glucose tolerance tests, metabolic chamber studies, and free-living energy use studies
- Secondary Outcome Measures
Name Time Method Determine if hormones, responses to behavioral testing, adipocyte size, body composition, core temperature, spontaneous activity, and food absorption/excretion are related to changes in EE with over/under-feeding and variation in weight change. Ongoing Changes in hormones, behavior, adipocyte size, body composition, core temperature, spontaneous activity, food absorption/excretion, changes in EE, and weight measured via physical examinations, laboratory studies, questionnaires, body composition assessments, oral glucose tolerance tests, meal tests, activity monitors, metabolic chamber studies, free-living energy use studies, and fat and muscle biopsies
Related Research Topics
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Trial Locations
- Locations (1)
NIDDK, Phoenix
🇺🇸Phoenix, Arizona, United States