RESTING ENERGY-EXPENDITURE IN LONG-TERM POSTOBESE SUBJECTS AFTER WEIGHT NORMALIZATION BY DIETING OR BILIOPANCREATIC DIVERSION

Resting energy expenditure (REE) was measured by indirect calorimetry in three groups of subjects closely matched for body weight (BW) and b ody composition. Five subjects had reduced from 103 kg (129-90) to nor mal BW by dieting. Fourteen subjects had normalized their weight (preo p 120 kg, from 168 to 100) following biliopancreatic diversion (BPD). All subjects in both groups had essentially maintained a stable weight for at least 2 years before the study. Ten healthy volunteers who had never been obese served as controls. No differences in REE were obser ved between post-BPD and control subjects, while lower (p < 0.05) valu es of REE were found in post-diet subjects. A long-lasting reduction o f REE, in spite of a normal body composition, might partly account for the very poor long-term results of conventional dietary treatment. Th e unreduced REE following BPD may contribute, along with the permanent intestinal malabsorption, to the excellent long-term weight maintenan ce caused by this surgical procedure.