Purpose of Review

Despite the great progress in obesity-tackling strategies, a negative energy equilibrium between energy expenditure and energy intake remains the cornerstone in obesity management. The present review article aims to shed light on the complicated interrelations of resting metabolic rate to weight fluctuations.

Recent Findings

Energy expenditure depends on body composition and is highly affected by weight changes, exerting a significant role in subsequent weight regain and underlining the metabolic resistance that people with obesity face when dealing with weight maintenance. The main tissue involved in energy expenditure is fat-free mass, as opposed to fat mass, which exerts a substantially lower impact. Although people with obesity display higher energy expenditures than their lean counterparts, these decrease substantially in the setting of weight loss. Metabolic adaptation is the difference between measured and predicted RMR after weight loss, either via lifestyle modification or after obesity surgery. Plausible explanations for this include differences in body composition, with loss of fat-free mass playing a significant role. This becomes especially apparent in the setting of rapid and massive weight loss, as in the case of bariatric surgery.

Summary

A better understanding of energy expenditure pathophysiology may aid in further enhancing weight loss and promoting weight maintenance in people with obesity.

中文翻译：

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重新审视静息代谢率：与体重波动有何关系？

审查目的

尽管肥胖治疗策略取得了巨大进展，但能量消耗和能量摄入之间的负能量平衡仍然是肥胖管理的基石。本文旨在阐明静息代谢率与体重波动之间复杂的相互关系。

最近的发现

能量消耗取决于身体成分，并且受体重变化的影响很大，在随后的体重反弹中发挥着重要作用，并强调肥胖者在维持体重时面临的代谢阻力。参与能量消耗的主要组织是去脂组织，而不是脂肪组织，后者的影响要低得多。尽管肥胖者比瘦人表现出更高的能量消耗，但在减肥过程中，这些能量消耗会大幅减少。代谢适应是指通过生活方式改变或肥胖手术后减肥后测量的 RMR 与预测的 RMR 之间的差异。对此的合理解释包括身体成分的差异，其中去脂体重的减少起着重要作用。这在快速且大量减肥的情况下尤其明显，例如减肥手术。

概括

更好地了解能量消耗病理生理学可能有助于进一步增强肥胖症患者的减肥效果并促进体重维持。