Exercise training and diet-resistant obesity
A new interesting study was posted the other day in Lancet. Quoting the summary:
Exercise training enhances muscle mitochondrial metabolism in diet-resistant obesity00373-5/fulltext)
Background
Current paradigms for predicting weight loss in response to energy restriction have general validity but a subset of individuals fail to respond adequately despite documented diet adherence. Patients in the bottom 20% for rate of weight loss following a hypocaloric diet (diet-resistant) have been found to have less type I muscle fibres and lower skeletal muscle mitochondrial function, leading to the hypothesis that physical exercise may be an effective treatment when diet alone is inadequate. In this study, we aimed to assess the efficacy of exercise training on mitochondrial function in women with obesity with a documented history of minimal diet-induced weight loss.
Methods
From over 5000 patient records, 228 files were reviewed to identify baseline characteristics of weight loss response from women with obesity who were previously classified in the top or bottom 20% quintiles based on rate of weight loss in the first 6 weeks during which a 900 kcal/day meal replacement was consumed. A subset of 20 women with obesity were identified based on diet-resistance (n=10) and diet sensitivity (n=10) to undergo a 6-week supervised, progressive, combined aerobic and resistance exercise intervention.
Findings
Diet-sensitive women had lower baseline adiposity, higher fasting insulin and triglycerides, and a greater number of ATP-III criteria for metabolic syndrome. Conversely in diet-resistant women, the exercise intervention improved body composition, skeletal muscle mitochondrial content and metabolism, with minimal effects in diet-sensitive women. In-depth analyses of muscle metabolomes revealed distinct group- and intervention- differences, including lower serine-associated sphingolipid synthesis in diet-resistant women following exercise training.
Interpretation
Exercise preferentially enhances skeletal muscle metabolism and improves body composition in women with a history of minimal diet-induced weight loss. These clinical and metabolic mechanism insights move the field towards better personalised approaches for the treatment of distinct obesity phenotypes.
Generally speaking, it is broadly assumed that you cannot outrun your own fork. Exercise is crucial to your well-being and overall health, but a lot less important than nutrition as far as weight loss is concerned. This is a pretty good article explaining why:
Why you shouldn't exercise to lose weight, explained with 60+ studies
It really seems though that there are some people where exercise seems to help their weight loss goals a lot more than previously suspected. That is very interesting and also indicative of the fact that a "one size fits all" approach in weight loss is at best sub-optimal, if not plain wrong.
Thoughts? I'm willing to bet that some think that "diet-resistant obesity" is not even a thing.
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