‘Metabolic flexibility’ required to achieve, maintain weight loss

BOSTON — Employing the concept of metabolic flexibility — the body’s ability to oxidize the type of fuel that is available — may offer the best hope for curbing obesity, according to a speaker at the Cardiometabolic Health Congress.

“One often overlooked issue is the role of metabolic dysfunction in development of obesity,” James O. Hill, PhD, director of the Colorado Nutrition Obesity Research Center at the University of Colorado, told Healio. “Metabolic inflexibility develops from lack of movement and excessive adiposity. It can be reversed to some extent with increased physical activity, but not with weight loss alone. It may be necessary to address metabolic inflexibility in order to permanently reduce obesity.”

People who are metabolically flexible are much better at burning fat, and adjust to different types of fuel than those who are metabolically inflexible. Metabolic inflexibility allows the body to store small amounts of fat each day, Hill said during his presentation.

Hill described several ways the body may maintain metabolic flexibility, some which may require a change in mindset about weight loss.

“We often hear comparisons between patients who struggle with obesity to those who struggle with smoking, but obesity is more like climate change than smoking,” Hill said.

“Climate change is all about understanding the system, modeling the system, then figuring out which things to change. With obesity we are going to have to use some of the climate change tools to understand complex systems of our body biology,” he said.

Addressing obesity will require thinking of more than one “villain” as its cause, according to Hill. Instead of blaming only excessive fat or sugar consumption or too little exercise, Hill advised exploring ways these components — together with sleep habits — fit together to affect energy balance.

Perhaps most important for achieving and maintaining weight loss, Hill said, is time spent in physical activity to help maintain a healthy amount of metabolic flexibility.

“We are really underestimating how much exercise people need,” Hill said. “We are pushing 30 minutes a day, but that is clearly not enough. We have some people who exercise 60 minutes a day [the equivalent of about 12,000 steps], and while you may think that is impressive, that is the reality and what it will take to make a difference.” – by Janel Miller

Reference:

Hill JO. Obesity and environmental influence. The big picture. Presented at: Cardiometabolic Health Congress; Oct. 24-27, 2018; Boston.

Disclosure: Hill reports he is a consultant for Gelesis, Retrofit and Zaluvida, and a partner with Shakabuku (State of Slim).