Graduate Thesis Or Dissertation
 

Differential thermogenic response in juvenile-onset type obesity and maturity-onset type obesity

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  • An increased metabolic efficiency may be a factor underlying the onset and maintenance of obesity. This study examined the Resting Metabolic Rate (RMR), the Thermic Effect of Food (TEF), the Thermic Effect of Exercise (TEE), and the Potentiation (P) of the TEF by Exercise in Juvenile-onset type obesity (JOTO), and Maturity-onset type obesity (MOTO). It was hypothesized that individuals categorized as JOTO would exhibit a greater metabolic efficiency and that this fact would necessitate a differential diagnosis and treatment schema. The RMR's of eight Juvenile-onset obese and eight Maturity-onset obese middle aged women were measured for five minutes every half hour for four hours under four conditions: 1) R-postabsorptive, 2) RF-postprandial, 3) RE-postabsorptive--exercised, and 4) RFE-postprandial-- exercised. Metabolic measurements were made via the technique of indirect open circuit calorimetry. The TEF (derived from integrating the total area under the 4 hour response curve) was 40.8 Kcal and 31.5 Kcal for the JOTO and MOTO subjects, respectively. The TEF after exercise amounted to 36 Kcal for the JOTO individuals and 34 Kcal for the MOTO individuals. These increases were significant (p<.001) compared to the baseline (R). The energy expenditure was not significantly elevated following the Exercise (RE) condition. JOTO individuals realized a 6.4 Kcal increase while the energy expenditure increased by 4.7 Kcal for the MOTO individuals. These results suggest that the capacity for Juvenile-onset and Maturity-onset obese women to respond to thermogenic stimulation is essentially the same. No significant differences were apparent between these groups on any of the measures of metabolic efficiency. This is not to say, however, that metabolic efficiency is not an underlying factor in the development and persistence of the obese state. Both groups displayed a subnormal response to the food stimulus. Moreover, exercise after eating failed to potentiate the TEF as it does in lean individuals. These blunted metabolic responses may constitute a partial explanation for the etiology of obesity and may provide a rationale for a more enlightened therapeutic approach. Possible mechanisms for this blunted metabolic response might be a limited capacity to elevate metabolic rate, a reduced sensitivity to the neural and hormonal stimulation afforded by food and exercise, and a reduced rate of substrate cycling.
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  • File scanned at 300 ppi (Monochrome) using Capture Perfect 3.0 on a Canon DR-9050C in PDF format. CVista PdfCompressor 4.0 was used for pdf compression and textual OCR.
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