Leibel R L, Hirsch J
Metabolism. 1984 Feb;33(2):164-70. doi: 10.1016/0026-0495(84)90130-6.
In assessing the reasons for the frequent regaining of weight by reduced-obese patients, we examined retrospectively the seven-day energy intake requirements for weight maintenance of 26 obese patients (12 males, 14 females) at maximum weight (152.5 +/- 8.4 kg) and after weight loss (100.2 +/- 5.7 kg). These results were compared with those obtained in 26 age- and sex-matched control patients who had never been obese (62.6 +/- 2.3 kg). The obese and control subjects required comparable caloric intakes: 1432 +/- 32 kcal/m2/d vs 1341 +/- 33 kcal/m2/d, respectively. Following weight loss, the reduced-obese subjects required only 1021 +/- 32 kcal/m2/d, a 28% decrease (P less than 0.001) in requirements relative to their obese state and a 24% decrease relative to the control patients (P less than 0.001). The mean individual energy requirement of the reduced-obese subjects (2171 kcal/d) was less than that for the control subjects (2280 kcal/d) despite the fact that they still weighed 60% more than the controls. In order to maintain a reduced weight, some reduced-obese or even partially reduced patients must restrict their food intake to approximately 25% less than that anticipated on the basis of metabolic body size. The reasons why this finding is unlikely to be an artifactual consequence of changes in lean body mass or body water content are discussed. This finding has implications with regard to the pathophysiology and treatment of obesity in humans.
在评估肥胖症患者体重减轻后频繁反弹的原因时，我们回顾性研究了26例肥胖患者（12例男性，14例女性）在最大体重（152.5±8.4kg）时以及体重减轻后（100.2±5.7kg）维持体重所需的七日能量摄入量。将这些结果与26例年龄和性别匹配、从未肥胖过的对照患者（62.6±2.3kg）的结果进行比较。肥胖组和对照组的热量摄入相当：分别为1432±32kcal/m²/d和1341±33kcal/m²/d。体重减轻后，肥胖症患者仅需1021±32kcal/m²/d，相对于肥胖状态需求降低了28%（P<0.001），相对于对照患者降低了24%（P<0.001）。尽管肥胖症患者减轻体重后仍比对照组重60%，但其平均个体能量需求（2171kcal/d）低于对照组（2280kcal/d）。为了维持减轻后的体重，一些肥胖症患者甚至部分体重减轻的患者必须将食物摄入量限制在比基于代谢体重预期的摄入量低约25%。本文讨论了这一发现不太可能是瘦体重或身体含水量变化的人为结果的原因。这一发现对人类肥胖症的病理生理学和治疗具有启示意义。
