Department of Nutrition, Exercise and Sports, University of Copenhagen, Rolighedsvej 26, 1958, Frederiksberg C, Denmark.
Department of Biological Chemistry, National and Kapodistrian University of Athens Medical School, Athens, Greece.
Curr Obes Rep. 2022 Jun;11(2):33-44. doi: 10.1007/s13679-022-00470-4. Epub 2022 Feb 8.
Weight loss has multiple beneficial effects on body composition and metabolism, but whether these depend on the rate at which body weight is lost is not clear. We analyzed data from studies in which the same amount of weight loss was induced rapidly or gradually.
Thirteen studies were included in which the same percentage weight loss was achieved at slow or fast rates (range: 0.2 to 3.2 kg/week) by means of dietary calorie restriction, exercise, and bariatric surgery. Faster rates of weight loss may result in more fat-free mass and less fat mass being lost during the dynamic phase of weight reduction compared with slower rates of weight loss, in conjunction with greater declines in resting energy expenditure. However, these differences are attenuated after 2-4 weeks of stabilization at the new, lower body weight, and do not affect the rate and amount of weight regain 9-33 months later (nor the tissue composition of regained weight). Differences in waist circumference, visceral and liver fat contents, resting blood pressure, fasting blood lipid profile, and insulin and adipokine concentrations in response to different rates of weight loss are trivial. The decline in fasting glucose concentration and the improvement in insulin sensitivity after 6-11% weight loss are both greater with rapid than gradual weight loss, but not different after 18-20% weight loss. Changes in body composition and metabolism after losing the same amount of body weight at different rates are largely similar, and occasional differences are likely not meaningful clinically for the long-term management of obesity and cardiometabolic diseases.
减肥对身体成分和代谢有多种有益影响，但这些影响是否取决于体重下降的速度尚不清楚。我们分析了通过快速或缓慢减肥率诱导相同减肥量的研究数据。
纳入了 13 项研究，通过饮食热量限制、运动和减肥手术以较慢或较快的速度（范围：0.2 至 3.2kg/周）实现相同的体重减轻百分比。与较慢的减肥速度相比，快速减肥速度可能导致在体重减轻的动态阶段丢失更多的去脂体重和更少的脂肪体重，同时静息能量消耗下降更大。然而，这些差异在新的较低体重稳定 2-4 周后会减弱，并且不会影响 9-33 个月后体重的复重速度和量（也不会影响复重的组织成分）。不同减肥速度对腰围、内脏和肝脂肪含量、静息血压、空腹血脂谱、胰岛素和脂肪因子浓度的影响微不足道。快速减肥比缓慢减肥引起的空腹血糖浓度下降和胰岛素敏感性改善更大，但在减轻 18-20%体重后没有差异。以不同速度减轻相同体重后身体成分和代谢的变化基本相似，偶尔的差异在肥胖和心血管代谢疾病的长期管理方面可能在临床上没有意义。
