Metabolic Consequences of Weight Reduction #MMPMID34283511
Farhana A; Rehman A
StatPearls-/-ä 2024[Jan]; ä (ä): ä PMID34283511show ga
Metabolism is a dedicated network of enzyme and metabolite-derived mechanisms that is a hallmark of life activities. A healthy metabolism is a basic necessity for a healthy life that depends on lifestyle, energy intake, and expenditure. A balanced lifestyle comprising healthy eating habits, exercise, sleep cycle, and behavioral features is the utmost regulator of healthy body weight and robust metabolism. The present-day world is challenged by an increasing prevalence of overweight and obesity, amounting to epidemic proportions. This creates a public health concern and points to our lack of success in achieving healthy population indices in terms of healthy body weight maintenance. Increased weight parallels with several comorbidities such as type-2 diabetes, some types of cancers, cardiovascular disorders, liver and kidney diseases, digestive problems, sleep apnea, osteoarthritis, etc. Recent research indicates that the inability to maintain a healthy weight perturbs the body's metabolic and immunological axis, increasing the risk for severe illnesses such as COVID19 and other infectious diseases. It is notable that absolute weight loss with long-term maintenance directly correlates with improvements in all health risk factors. Maintaining a healthy body weight, especially after weight reduction, requires equalized input and energy output to regulate optimal metabolism. This comprises a concerted regulation of enzyme activities, ATP synthesis, utilization, hormonal functions, neurological and muscular activities, etc. However, a general preference for high-tasting vis-a-vis less nutritious food and a sedentary lifestyle has led to a global increase in weight and also a reduced tendency of long-term maintenance of a healthy weight after effective weight loss. It is believed that weight loss at a slow rate is better sustained than weight loss more rapidly. However, scientific evidence correlates that greater initial weight loss is positively related to long-term weight maintenance. This follows through a metabolic adaptation process, consequently leading to healthier metabolic functions. Nonetheless, healthy weight maintenance achieved through weight loss regimes also requires care and treatment, usually through diet regimes or restrictions and exercise. However, no specific diet or exercise program has been truly established as a successful regime in weight maintenance. Presently, weight management strategies underline the significance of attaining a 5% weight loss to maintain a healthy metabolism. Prior to understanding the consequences of weight loss on metabolism, it is imperative to recognize that at the metabolic level, weight loss is a continuous metabolic adaptation process progressing through many biochemical and physiological changes involving the role of hormones, enzyme functions, metabolite effectors, and bioenergetics. Maintaining a healthy weight is challenging. It is shown that most individuals tend to have regained a significant amount of the lost weight within a year after weight loss. With this increased prevalence of recidivism, weight management is viewed as a chronic issue. Hence, long-term care is expected for weight management and maintenance after weight loss, and programs of over a year are currently recommended by the guidelines. This review will focus on the metabolic parameters (initiators, activators, pathways, and endpoints) achieved consequent to various weight-loss regimes, i.e., dietary modulations, exercise, drug, and surgical intervention aimed at improving metabolic health and long term healthy weight maintenance.
StatPearls-/-ä 2024 ; ä (ä): ä
