Download PDF
Adipositas - Ursachen, Folgeerkrankungen, Therapie 2015; 09(04): 217-220
DOI: 10.1055/s-0037-1618938
Übersichtsarbeit
Schattauer GmbH

Langsam abnehmen, um das Gewicht zu halten?

Ein Mythos der AdipositastherapieSlow weight loss for a better weight maintenance?A myth about obesity therapy
A. Bosy-Westphal
1   Institut für Ernährungsmedizin, Universität Hohenheim, Stuttgart;
,
M. J. Müller
2   Institut für Humanernährung und Lebensmittelkunde, Christian-Albrechts-Universität zu Kiel
› Author Affiliations
Further Information

Publication History

Publication Date:
22 December 2017 (online)

Also available at
    Permissions and Reprints

Zusammenfassung

Empfehlungen und Leitlinien vieler Länder sprechen sich für eine langsame Gewichtsreduktion aus, um einen nachhaltigeren Gewichtserhalt zu erreichen. Neue Studien zeigen jedoch, dass der Jo-Jo-Effekt unabhängig vom “Abnehmtempo” ist. Dennoch gibt es auch eine zu schnelle Gewichtsabnahme, die durch einen erhöhten Verlust an Magermasse gekennzeichnet ist, der wiederum ein Risiko für eine erneute Gewichtszunahme sein kann. Ein “gesundes Energiedefizit” ist daher wichtig und muss individuell berechnet werden, da es von der Ausgangskörperzusammensetzung, der körperlichen Aktivität und dem Proteinbedarf abhängt. Individuelle Empfehlungen für die Geschwindigkeit der Gewichtsreduktion sollten darüber hinaus die Phase der Gewichtsabnahme berücksichtigen. Der Therapieverlauf kann anhand von mathematischen Modellen von Gewichtsverläufen überprüft werden.

Summary

Dietary guidelines in several countries recommend a slow and gradual weight loss based on the belief that rapid weight loss is more quickly regained. Contrary to these recommendations recent studies show that, with similar total weight loss, the rate of weight loss does not affect weight regain. However a rapid weight loss more likely leads to a higher percentage of weight loss as fat free mass and the rate of fat free mass loss was found to be associated with weight regain. A healthy energy deficit depends on initial body composition, physical activity as well as protein requirement. In addition, personalized recommendations for the rate of weight loss should consider the phase of weight loss and can be evaluated based on mathematic modeling of weight loss trajectories.

Schlüsselwörter

Geschwindigkeit der Gewichtsabnahme - Gewichtserhalt - Jo-Jo-Effekt - Adipositastherapie - Körperzusammensetzung

Keywords

Rate of weight loss - weight maintenance - jojo dieting - weight management - body composition
 

  • Literatur

  • 1 Wing RR, Hamman RF, Bray GA, Delahanty L, Edelstein SL, Hill JO, Horton ES, Hoskin MA, Kriska A, Lachin J, Mayer-Davis EJ, Pi-Sunyer X, Regensteiner JG, Venditti B, Wylie-Rosett J. Diabetes Prevention Program Research Group. Achieving weight and activity goals among diabetes prevention program lifestyle participants. Obes Res 2004; 12: 1426-1434.
    CrossrefPubMedGoogle Scholar
  • 2 McGuire MT, Wing RR, Hill JO. The prevalence of weight loss maintenance among American adults. International journal of obesity and related metabolic disorders: journal of the International Association for the Study of Obesity 1999; 23: 1314-1319.
    CrossrefPubMedGoogle Scholar
  • 3 Weiss EC, Galuska DA, Kettel LKhan, Gillespie C, Serdula MK. Weight regain in US adults who experienced substantial weight loss, 1999–2002. Am J Prev Med 2007; 33: 34-40.
    CrossrefPubMedGoogle Scholar
  • 4 Turk MW, Yang K, Hravnak M, Sereika SM, Ewing LJ, Burke LE. Randomized clinical trials of weight loss maintenance: a review. J Cardiovasc Nurs 2009; 24: 58-80.
    CrossrefPubMedGoogle Scholar
  • 5 Kraschnewski JL, Boan J, Esposito J, Sherwood NE, Lehman EB, Kephart DK, Sciamanna CN. Long-term weight loss maintenance in the United States. Int J Obes (Lond) 2010; 34: 1644-1654.
    PubMedGoogle Scholar
  • 6 Bray GA. Obesity: maintenance of weight loss: setting our goals higher. Nat Rev Endocrinol 2010; 06: 657-658.
    CrossrefPubMedGoogle Scholar
  • 7 NICE. Obesity: Guidance on the prevention, identification, assessment and management of overweight and obesity in adults and children. Dec, 2006 http://www.nice.org.uk/guidance/cg43 (Zugriff 29.9.2015).
    PubMedGoogle Scholar
  • 8 NHS, National Health Service. Why is gradual weight loss better than a crash diet?. http://www. nhs.uk/chq/Pages/2468.aspx?CategoryID=51 (Zugriff 29.9.2015).
    PubMedGoogle Scholar
  • 9 Pi-Sunyer X, Becker D, Bouchard C. Expert Panel on the Identification, Evaluation, and Treatment of Overweight in Adults. Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: executive summary. Am J Clin Nutr 1998; 68: 899-917.
    CrossrefPubMedGoogle Scholar
  • 10 AID: Mein Weg zum Wohlfühlgewicht 1389 /2011 Herausgegeben vom aid infodienst Ernährung, Landwirtschaft Verbraucherschutz e. V. Bonn.
    PubMedGoogle Scholar
  • 11 Interdisziplinäre Leitlinie der Qualität S3 zur “Prävention und Therapie der Adipositas” Version 2.0. (April 2014), S.46 http://www.adipositas-gesells chaft.de/fileadmin/PDF/Leitlinien/S3_Adipositas_Praevention_Therapie_2014.pdf.
    PubMedGoogle Scholar
  • 12 Casazza K, Brown A, Astrup A, Bertz F, Baum C, Brown MB, Dawson J, Durant N, Dutton G, Fields DA, Fontaine KR, Heymsfield S, Levitsky D, Mehta T, Menachemi N, Newby PK, Pate R, Raynor H, Rolls BJ, Sen B, Smith Jr DL, Thomas D, Wansink B, Allison DB. Weighing the evidence of common beliefs in obesity research. Crit Rev Food Sci Nutr. 2014 June 20. DOI:10.1080/10408398.2014.922044..
    PubMedGoogle Scholar
  • 13 Casazza K, Fontaine K, Astrup A, Birch LL, Brown AW, Bohan MMBrown, Durant N, Dutton G, Foster EM, Heymsfield SB, McIver K, Mehta T, Menachemi N, Newby PK, Pate R, Rolls BJ, Sen B, Smith Jr DL, Thomas DM, Allison DB. Myths, presumptions, and facts about obesity. N Engl J Med 2013; 368: 446-454.
    CrossrefPubMedGoogle Scholar
  • 14 Toubro S, Astrup A. Randomized comparison of diets for maintaining obese subjects’ weight after major weight loss: ad lib, low fat, high carbohydrate diet fixed energy intake. BMJ 1997; 314: 29-34.
    CrossrefPubMedGoogle Scholar
  • 15 Unick JL, Hogan PE, Neiberg RH, Cheskin LJ, Dutton GR, Evans-Hudnall G, Jeffery R, Kitabchi AE, Nelson JA, Pi-Sunyer FX, West DS, Wing RR. Look AHEAD Research Group. Evaluation of early weight loss thresholds for identifying nonresponders to an intensive lifestyle intervention. Obesity (Silver Spring) 2014; 22: 1608-1616.
    CrossrefPubMedGoogle Scholar
  • 16 Wing RR, Phelan S. Long-term weight loss maintenance. Am J Clin Nutr 2005; 82: 222S-225S.
    CrossrefPubMedGoogle Scholar
  • 17 Astrup A, Rossner S. Lessons from obesity management programs: greater initial weight loss improves long-term maintenance. Obes Rev 2000; 01: 17-19.
    CrossrefPubMedGoogle Scholar
  • 18 Nackers L, Ross K, Perri M. The association between rate of initial weight loss and long-term success in obesity treatment: does slow and steady win the race?. Int J Behav Med 2010; 17: 161-167.
    CrossrefPubMedGoogle Scholar
  • 19 Vink R, Roumans N, Arkenbosch L, Mariman E, van Baak M. The effect of rate of weight loss on long-term weight regain in adults with overweight and obesity. Obesity. 2015 in press..
    PubMedGoogle Scholar
  • 20 Purcell K, Sumithran P, Prendergast LA, Bouniu CJ, Delbridge E, Proietto J. The effect of rate of weight loss on long-term weight management: a randomised controlled trial. Lancet Diabetes Endocrinol 2014; 02 (12) 954-962.
    CrossrefPubMedGoogle Scholar
  • 21 Pawan GL, Semple SJ. Effect of 3-hydroxybutyrate in obese subjects on very-low-energy diets and during therapeutic starvation. Lancet 1983; 01: 15-17.
    PubMedGoogle Scholar
  • 22 Johnstone A, Horgan G, Murison S, Bremner D, Lobley G. Effects of a high-protein ketogenic diet on hunger, appetite, and weight loss in obese men feeding ad libitum. Am J Clin Nutr 2008; 87: 44-55.
    CrossrefPubMedGoogle Scholar
  • 23 Chearskul S, Delbridge E, Shulkes A, Proietto J, Kriketos A. Effect of weight loss and ketosis on postprandial cholecystokinin and free fatty acid concentrations. Am J Clin Nutr 2008; 87: 1238-1246.
    CrossrefPubMedGoogle Scholar
  • 24 Sumithran P, Prendergast LA, Delbridge E, Purcell K, Shulkes A, Kriketos A, Proietto J. Ketosis and appetite-mediating nutrients and hormones after weight loss. Eur J Clin Nutr 2013; 67: 759-764.
    CrossrefPubMedGoogle Scholar
  • 25 Wadden TA, Neiberg RH, Wing RR, Clark JM, Delahanty LM, Hill JO, Krakoff J, Otto A, Ryan DH, Vitolins MZ. Look AHEAD Research Group. Four-year weight losses in the Look AHEAD study: factors associated with long-term success. Obesity (Silver Spring) 2011; 19 (10) 1987-1998.
    CrossrefPubMedGoogle Scholar
  • 26 Forbes GB. Lean body mass-body fat interrelationships in humans. Nutr Rev 1987; 45 (08) 225-231.
    PubMedGoogle Scholar
  • 27 Strychar I, Lavoie ME, Messier L, Karelis AD, Doucet E, Prud’homme D, Fontaine J, Rabasa-Lhoret R. Anthropometric, metabolic, psychosocial, and dietary characteristics of overweight/ obese postmenopausal women with a history of weight cycling: a MONET (Montreal Ottawa New Emerging Team) study. J Am Diet Assoc 2009; 109 (04) 718-724.
    CrossrefPubMedGoogle Scholar
  • 28 Leibel RL. Molecular physiology of weight regulation in mice and humans. Int J Obes (Lond) 2008; 32 (Suppl. 07) S98-S108.
    CrossrefPubMedGoogle Scholar
  • 29 Vogels N, Diepvens K, Westerterp-Plantenga MS. Predictors of long-term weight maintenance. Obes Res 2005; 13: 2162-2168.
    CrossrefPubMedGoogle Scholar
  • 30 Vogels N, Westerterp-Plantenga MS. Categorical strategies based on subject characteristics of dietary restraint and physical activity, for weight maintenance. Int J Obes (Lond) 2005; 29: 849-857.
    CrossrefPubMedGoogle Scholar
  • 31 Vogels N, Westerterp-Plantenga MS. Successful long-term weight maintenance: a 2-year follow-up. Obesity (Silver Spring) 2007; 15: 1258-1266.
    CrossrefPubMedGoogle Scholar
  • 32 Goyenechea E, Parra D, Crujeiras AB, Abete I, Martinez JA. A nutrigenomic inflammation-related PBMC-based approach to predict the weightloss regain in obese subjects. Ann Nutr Metab 2009; 54: 43-51.
    CrossrefPubMedGoogle Scholar
  • 33 Bosy-Westphal A, Schautz B, Lagerpusch M, Pourhassan M, Braun W, Goele K, Heller M, Glüer CC, Müller MJ. Effect of weight loss and regain on adipose tissue distribution, composition of lean mass and resting energy expenditure in young overweight and obese adults. Int J Obes (Lond) 2013; Oct; 37 (10) 1371-1377.
    CrossrefPubMedGoogle Scholar
  • 34 Dulloo AG, Jacquet J, Montani JP. How dieting makes some fatter: from a perspective of human body composition autoregulation. Proc Nutr Soc 2012; 71 (03) 379-389.
    CrossrefPubMedGoogle Scholar
  • 35 Blundell JE, Caudwell P, Gibbons C, Hopkins M, Näslund E, King NA, Finlayson G. Body composition and appetite: fat-free mass (but not fat mass or BMI) is positively associated with self-determined meal size and daily energy intake in humans. Br J Nutr 2012; 107 (03) 445-449.
    CrossrefPubMedGoogle Scholar
  • 36 Keys A, Brozek J, Henschel A, Mickelsen O, Taylor HL. The biology of human starvation. Minneapolis: University of Minnesota Press; 1950
    Google Scholar
  • 37 Chaston TB, Dixon JB, O’Brien PE. Changes in fatfree mass during significant weight loss: a systematic review. Int J Obes (Lond) 2007; 31: 743-750.
    CrossrefPubMedGoogle Scholar
  • 38 Hall KD, Sacks G, Chandramohan D, Chow CC, Wang YC, Gortmaker SL, Swinburn BA. Quantification of the effect of energy imbalance on body weight. Lancet 2011; 378 (9793): 826-837.
    CrossrefPubMedGoogle Scholar
  • 39 Guadalajara H, Sanz RBaro, Pascual I, Blesa I, Rotundo GS, López JM, Corripio R, Vesperinas G, Sancho LG, Montes JA. Is prophylactic cholecystectomy useful in obese patients undergoing gastric bypass?. Obes Surg 2006; Jul; 16 (07) 883-885.
    CrossrefPubMedGoogle Scholar
  • 40 Kempen KP, Saris WH, Westerterp KR. Energy balance during an 8-wk energy-restricted diet with and without exercise in obese women. Am J Clin Nutr 1995; Oct; 62 (04) 722-729.
    CrossrefPubMedGoogle Scholar
  • 41 Donnelly JE, Blair SN, Jakicic JM, Manore MM, Rankin JW, Smith BK. American College of Sports Medicine. American College of Sports Medicine Position Stand. Appropriate physical activity intervention strategies for weight loss and prevention of weight regain for adults. Med Sci Sports Exerc 2009; Feb; 41 (02) 459-471.
    PubMedGoogle Scholar
  • 42 Villareal DT, Chode S, Parimi N, Sinacore DR, Hilton T, Armamento-Villareal R, Napoli N, Qualls C, Shah K. Weight loss, exercise, or both and physical function in obese older adults. N Engl J Med 2011; Mar 31; 364 (13) 1218-1229.
    CrossrefPubMedGoogle Scholar
  • 43 Heymsfield SB, Thomas D, Martin CK, Redman LM, Strauss B, Bosy-Westphal A, Müller MJ, Shen W, Martin ANguyen. Energy content of weight loss: kinetic features during voluntary caloric restriction. Metabolism 2012; Jul; 61 (07) 937-943.
    CrossrefPubMedGoogle Scholar
  • 44 Bosy-Westphal A, Müller MJ. Measuring the impact of weight cycling on body composition: a methodological challenge. Curr Opin Clin Nutr Metab Care 2014; Sep; 17 (05) 396-400.
    CrossrefPubMedGoogle Scholar