Using the Energy Gap to Prevent Weight Regain

描述(申请人提供)：肥胖治疗的主要障碍不是产生减肥效果，而是随着时间的推移保持减肥效果。以前的大多数研究都是为了了解与减肥有关的因素，并比较不同的减肥干预措施。我们认为，减肥和减肥保持是不同的过程，一些对减肥有效的策略对保持体重不起作用。具体地说，我们认为，大多数节食者用来保持体重的策略--饮食限制--不太可能成功地保持体重。我们认为，人体具有维持高能量消耗(即高能量吞吐量)的生理驱动力。高能量消耗可以通过保持高水平的体力活动或增加体重来获得。肥胖者达到了高水平的能量消耗，部分原因是肥胖的过程。减肥后，由于新陈代谢下降，总能量消耗减少。我们将这种减少称为“能量缺口”，填补“能量缺口”是减肥维持的挑战。我们认为，大多数人都试图通过限制能量摄入来填补“能源缺口”。从长远来看，这是困难的，因为它既反对生物学，也反对环境。我们之前来自国家体重控制登记处的数据表明，那些成功保持长期减肥的人通过体力活动来缩小“能量缺口”，从而在高能量消耗(即高能量吞吐量)的情况下实现能量平衡。我们建议通过随机将个体分配到不同的方法来评估这一假设，以填补减肥后的“能量缺口”。我们假设，那些被指派通过体力活动来填补“能量缺口”的人，比那些被指派仅通过限制食物或在增加体力活动和限制食物的情况下填补“能量缺口”的人，体重恢复得更少。我们还建议使用前沿技术来评估由高水平的活动产生的高能量吞吐量如何影响能量平衡的组成部分和摄入量与支出的匹配。如果我们的假设是正确的，那么可以在临床实践中估计“能量缺口”，并为减肥维持所需的生活方式改变提供定量的处方。这将提供一种新的策略，帮助公众更成功地保持减肥。

DESCRIPTION (provided by applicant): The major obstacle for obesity treatment is not producing weight loss but in maintaining weight losses over time. Most previous research has been aimed at understanding the factors involved in weight loss and comparing different interventions for weight loss. We propose that weight loss and weight loss maintenance are different processes and that some strategies that work well for losing weight do not work well for keeping weight off. Specifically, we propose that the strategy used by most dieters to keep weight off - food restriction - is not likely to lead to success in keeping weight off. We believe that the body has a physiological drive to maintain a high level of energy expenditure (i.e. high energy throughput). The high energy expenditure can be obtained by maintaining a high level of physical activity or by increasing body weight. Obese individuals have achieved a high level of energy expenditure in part through the process of becoming obese. After weight loss, total energy expenditure is reduced due to declines in metabolism. We have termed this reduction as the "energy gap" and filling the "energy gap" is the challenge for weight loss maintenance. We believe that most people try to fill the "energy gap" by restricting energy intake. This is difficult over the long-term because it opposes both biology and the environment. Our previous data from the National Weight Control Registry suggest that those individuals who are successful in long-term weight loss maintenance close the "energy gap" by physical activity, thus allowing energy balance to be achieved at high energy expenditure (i.e. high energy throughput). We propose to evaluate this hypothesis by randomly assigning individuals to different methods for filling the "energy gap" following weight loss. We hypothesize that those who are assigned to close the "energy gap" with physical activity will regain less weight than those assigned to close the "energy gap" with food restriction alone or with a combination of increased physical activity and food restriction. We further propose to use leading edge techniques to assess how a high energy throughput produced by a high level of activity affects components of energy balance and matching of intake with expenditure. If our hypothesis is correct, estimating the "energy gap" could be done in clinical practice and could provide a quantitative prescription for lifestyle changes required for weight loss maintenance. It would provide a new strategy to help the public be more successful at maintaining a weight loss.