Factors influencing the composition of the weight lost by obese patients on a reducing diet

Abstract

1.Weight loss, resting metabolic rate and nitrogen loss were measured in forty obese inpatients on reducing diets.2. Five subjects ate 3·55 MJ/d for 6 weeks (Expt I). Twenty-one subjects ate 4.2 MJ/d for the first week, 2·0 MJ/d for the second week and 4 2 MJ/d for the third week (Expt 2). Fourteen subjects ate 3·4 MJ/d for the first week and then 0.87 MJ protein or carbohydrate for the second or third weeks, using a cross-over design for alternate patients (Expt 3).3. Patients in Expt I had highest weight loss and N loss in the first 2 weeks, but adapted to the energy restriction over the remaining weeks. On average subjects were in N balance at the end of the study.4. In Expt 2 patients eating 2·0 MJ/d in week 2 showed increased weight loss compared with week I.N loss was not raised but it failed to decrease as it had in Expt I. Weight loss and N loss were reduced on return to 4.2 MJ/d for a third week.5. In Expt 3 patients eating 0·87 MJ protein showed significantly more weight loss and less N loss than patients eating 0·87 MJ carbohydrate.6. Resting metabolic rate decreased with time on the low-energy diet, but the manipulations of energy or protein content did not significantly affect the pattern of decrease.7. Both weight loss and N loss were greater the lower the energy intake, and both decreased with time. Diets with a high protein:energy value give a favourable value for N:weight loss at each level of energy intake.