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Obesity not always associated with metabolic problems
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Metabolic changes that can lead to diabetes, heart disease and stroke are not the inevitable result of obesity, according to recent study findings published in The Journal of Clinical Investigation.
Elisa Fabbrini, MD, PhD, assistant professor of medicine at the Washington University School Medicine in St. Louis, and colleagues evaluated 20 participants with obesity who were either metabolically normal obese (MNO; n=12) — with normal intrahepatic triglyceride content and other metabolic measures — or metabolically abnormal obese (MAO; n=8) to determine the effect of weight gain over several months on metabolic function.
“Our goal was to have research participants consume 1,000 extra calories every day until each gained 6% of his or her body weight,” Fabbrini said in a press release. “This was not easy to do. It is just as difficult to get people to gain weight as it is to get them to lose weight.”
Samuel Klein
A dietitian supervised all participants with weight gain, which was acquired through added calories from fast-food restaurants. Body composition, insulin sensitivity and the ability to regulate blood sugar, liver fat and other measures of metabolic health were examined after weight gain.
At baseline, body fat percent and BMI did not differ between the two groups; however, the MAO group had higher amounts of visceral adipose tissue and intrahepatic triglycerides. Body weight was similarly increased among both groups with the high-calorie dietary intake (P=.307). The absolute increase in intrahepatic triglycerides was greater among the MAO group.
The MAO group had worsened cardiometabolic measures, including plasma triglycerides, VLDL, apolipoprotein B100, alanine aminotransferase, adiponectin concentrations and blood pressure, whereas weight gain did not cause negative changes for plasma insulin, free fatty acids, LDL cholesterol, HDL cholesterol and branched-chain amino acid concentrations.
“This research demonstrates that some obese people are protected from the adverse metabolic effects of moderate weight gain, whereas others are predisposed to develop these problems,” study researcher Samuel Klein, MD, director of Washington University’s Center for Human Nutrition, said in the release. “This observation is important clinically because about 25% of obese people do not have metabolic complications. Our data shows that these people remain metabolically normal even after they gain additional weight.”
However, most people with obesity do not belong to this metabolically normal group.
“The results from this study support the need for aggressive weight-management therapy in the subset of obese people who have nonalcoholic fatty liver disease because they are at high risk for continued deterioration of metabolic function with even moderate amounts of weight gain,” Klein told Endocrine Today.
Disclosure: The researchers report no relevant financial disclosures.
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