Notice bibliographique
Résumé
It is well established that substantial body fat loss in individuals with obesity can induce a state of metabolic vulnerability potentially favoring long-term weight regain. This is explained by a greater than predicted decrease in energy expenditure and an increase in appetite that are associated with biological adaptations such as reduced leptinemia and sympathetic nervous system activity (1, 2). However, despite the numerous research attempts to determine whether cycles of weight loss/regain may generate persistent metabolic vulnerability, this question has never been clearly answered and remains a significant matter of preoccupation for health professionals and individuals with obesity. In this issue of Obesity, Fothergill et al. (3) report a study that gave the opportunity to test participants of “The Biggest Loser” in whom resting metabolic rate (RMR) was measured before and after the competition as well as 6 years later. As expected, the mean 58.3 kg weight loss observed during the competition resulted in a substantial decrease in RMR that reached 610 kcal/day. These investigators also estimated that this decrease included a metabolic adaptation of 275 kcal/day representing a decrease exceeding what would have been predicted by the loss of fat mass and fat-free mass. Six years after the end of the competition, this decrease in adaptive thermogenesis was even more pronounced. The mean metabolic adaptation had increased to 499 kcal/day, which explains why RMR remained 704 kcal/day below the baseline level despite a 41 kg body weight regain. As described by the investigators, this large metabolic adaptation could not be attributed to the fact that RMR was measured with a different calorimeter 6 years after the end of the competition. Additionally, our research experience reveals that the reported persistent metabolic adaptation can only be partly attributable to an aging effect over a 6-year follow-up (4). Globally, the results of this study are well concordant with previous long-term studies having shown that substantial weight loss induces biological adaptations that promote weight regain (1, 2). Beyond these observations, the results of this study add bad news to this story which is related to the amplification of the metabolic adaptation over time. From a clinical standpoint, this should be viewed as an important argument in favor of the inclusion of weight maintenance periods within a weight-reducing program that could reveal that a healthy sustainable body weight is achieved and that striving for maximal weight loss is not relevant. Finally, the reported thermogenic adaptation over time also reminds us that the metabolic vulnerability of individuals with obesity persists even after their condition has supposedly been cured by weight loss.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,009 | 0,018 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,004 | 0,001 |
| Bibliométrie | 0,002 | 0,001 |
| Études des sciences et des technologies | 0,004 | 0,012 |
| Communication savante | 0,010 | 0,022 |
| Science ouverte | 0,004 | 0,005 |
| Intégrité de la recherche | 0,015 | 0,033 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,016 | 0,006 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».