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Changes in fat-free mass during significant weight loss: a systematic review

International Journal of Obesity volume 31, pages 743–750 (2007)Cite this article

Abstract

Objective:

To identify the proportion of weight lost as fat-free mass (FFM) by various weight loss interventions.

Methods:

Medline and Embase were systematically searched for reliable measurements of FFM before and after weight loss of >10 kg and eligible data were pooled. In a fixed effect model of % FFM loss/weight loss (%FFML), linear regression analysis was used to determine the influence of degree of caloric restriction, exercise, magnitude of weight loss, initial body mass index (BMI) and type of surgery.

Results:

Data were included from 26 cohorts treated with dietary and behavioral interventions and 29 cohorts of bariatric surgery patients. The degree of caloric restriction was positively associated with %FFML (r2=0.31, P=0.006) and in three randomized controlled trials exercise was shown to decrease %FFML. Compared with laparoscopic adjustable gastric banding (LAGB), biliopancreatic diversion (BPD) and roux en Y gastric bypass (RYGB) caused greater loge (natural log) %FFML (r2=0.453, P<0.001). Differences in loge %FFML between surgical procedures were independent of initial BMI and magnitude of weight loss.

Conclusions:

The degree of caloric restriction, exercise and rate of weight loss influence the proportion of weight lost as FFM after non-surgical interventions. For surgical interventions, BPD and RYGB result in greater %FFML than LAGB.

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Authors and Affiliations

  1. Australian Centre for Obesity Research and Education, Monash University, Monash Medical School, The Alfred Hospital, Melbourne, Victoria, Australia

    T B Chaston, J B Dixon & P E O'Brien

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  1. T B Chaston
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  2. J B Dixon
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  3. P E O'Brien
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Correspondence to J B Dixon.

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Chaston, T., Dixon, J. & O'Brien, P. Changes in fat-free mass during significant weight loss: a systematic review. Int J Obes 31, 743–750 (2007). https://doi.org/10.1038/sj.ijo.0803483

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  • DOI: https://doi.org/10.1038/sj.ijo.0803483

Keywords

  • body composition
  • dual X-ray absorptiometry
  • under water weighing
  • total body water

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