Appetite after weight loss by energy restriction and a low-fat diet-exercise follow-up

OBJECTIVE: The aim of the present study was to determine the impact of weig ht loss on appetite as measured by visual analog scale (VAS). METHODS: Seventeen subjects (10 men and seven women) took part in a 15 week weight loss program which consisted of drug therapy (fenfluramine 60 mg/da y) or placebo coupled to an energy restriction (-2930 kJ/day; phase 1) foll owed by an 18 week low-fat diet-exercise follow-up (phase 2). Subjects were given a standardized breakfast before and after phase 1 as well as after p hase 2. Individuals were asked to fill out VAS before and at 0, 10, 20, 30, 40, 50 and 60 min after this test meal. Blood samples were drawn before th e meal and at 0, 30 and 60 min postprandially and analyzed for glucose and insulin. Easting plasma cortisol and leptin were also determined. RESULTS: An increase in the fasting desire to eat, hunger and prospective f ood consumption (PFC) was observed after phase 1 and to an even greater ext ent after phase 2 in both men and women. In the fasting state, positive cor relations were observed between changes in the desire to eat (r = 0.76; P < 0.05) as well as changes of PFC (r = 0.82; P < 0.05) and changes in cortis ol at the end of phase 1 for women. In response to phase 1, statistically s ignificant correlations were found between changes of hunger (r = 0.64; P < 0.05) and desire to eat (r = 0.67; P < 0.05) as measured by AUC in respons e to the meal and changes of fasting plasma cortisol in men. The most consi stent predictor of changes of baseline desire to eat (r = 0.68 P < 0.05), f ullness (r = -0.78, P < 0.05) and PFC (r = 0.91, P < 0.01) during phase 2 w as the change in fasting cortisol in men. Changes of fullness were also ass ociated with changes of fasting leptin in men (r = 0.68; P < 0.05) during p hase 2. CONCLUSION: These results suggest that weight loss is accompanied by an inc rease of baseline appetite in both men and women and that the most consiste nt predictor of these changes in appetite seems to be changes in fasting pl asma cortisor.