Exercise training and diet-resistant obesity

NM, don't even want to get involved. If I could just delete this box I would. (Looking at you, MFP)

I mean, what's new here?

I remember reading something similar several years ago, though as I recall they called it mitochondrial dysfunction rather than diet resistant obesity. What I got out of it in laymen's terms is that basically with mitochondrial dysfunction, energy and nutrients aren't properly shuffled around the body making weight loss more difficult, weight gain more prevalent, and at the root of many of the diseases associated with obesity.

From what I remember, it encouraged regular exercise as a means to enhance mitochondrial health by increasing ATP and thus shuffling around energy and nutrients more efficiently making weight loss and healthy weight maintenance easier, beyond the simplicity of the CICO model. It in no way attempted to invalidate the CICO model in that it mentioned that CICO is the overarching principle of weight management, but that mitochondrial health or dysfunction add a layer of nuance that doesn't make things so black and white. It also went into quite a bit on nutrition and how quality nutrition and specific nutrients (can't remember them all) play a pretty important roll here as well.

Anecdotally I find merit in this in that when I initially started trying to lose weight it was with diet alone and a little walking. When I started exercising regularly with more intensive cardio and weight training things seemed to get much easier after about a month or so of regular exercise though I was in the same calorie deficit.

On the flip side of that, after a few years of regular, daily exercise I was injured and had to take a good 3 months off from doing much of anything. I didn't really change my diet or how much I was eating and just figured I'd gain weight and lose it later...I like to eat and didn't really want to cut back. I kept waiting to see the scale start to creep up, but it took around 6 weeks before I saw any weight gain and from that point on, it was pretty steady gain of about 10 Lbs in a couple of months. At the time I recalled the study I had read and wondered if I was just "running hot" with a fired up mitochondrial function from years of regular exercise and it took 6 weeks to start to go back into dysfunction...IDK

Dante_80 wrote: »

A new interesting study was posted the other day in Lancet. Quoting the summary.

Exercise training enhances muscle mitochondrial metabolism in diet-resistant obesity

Summary

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.

If this is broadly assumed, it's only by people who don't understand math.