TAILIEUCHUNG - Chapter 074. Biology of Obesity (Part 7)

The average total daily energy expenditure is higher in obese than lean individuals when measured at stable weight. However, energy expenditure falls as weight is lost, due in part to loss of lean body mass and to decreased sympathetic nerve activity. When reduced to near-normal weight and maintained there for a while, (some) obese individuals have lower energy expenditure than (some) lean individuals. There is also a tendency for those who will develop obesity as infants or children to have lower resting energy expenditure rates than those who remain lean. The physiologic basis for variable rates of energy expenditure (at. | Chapter 074. Biology of Obesity Part 7 WHAT IS THE STATE OF ENERGY EXPENDITURE IN OBESITY The average total daily energy expenditure is higher in obese than lean individuals when measured at stable weight. However energy expenditure falls as weight is lost due in part to loss of lean body mass and to decreased sympathetic nerve activity. When reduced to near-normal weight and maintained there for a while some obese individuals have lower energy expenditure than some lean individuals. There is also a tendency for those who will develop obesity as infants or children to have lower resting energy expenditure rates than those who remain lean. The physiologic basis for variable rates of energy expenditure at a given body weight and level of energy intake is essentially unknown. A mutation in the human 03-adrenergic receptor may be associated with increased risk of obesity and or insulin resistance in certain but not all populations. Homologues of the BAT uncoupling protein named UCP-2 and UCP-3 have been identified in both rodents and humans. UCP-2 is expressed widely whereas UCP-3 is primarily expressed in skeletal muscle. These proteins may play a role in disordered energy balance. One newly described component of thermogenesis called nonexercise activity thermogenesis NEAT has been linked to obesity. It is the thermogenesis that accompanies physical activities other than volitional exercise such as the activities of daily living fidgeting spontaneous muscle contraction and maintaining posture. NEAT accounts for about two-thirds of the increased daily energy expenditure induced by overfeeding. The wide variation in fat storage seen in overfed individuals is predicted by the degree to which NEAT is induced. The molecular basis for NEAT and its regulation is unknown. LEPTIN IN TYPICAL OBESITY The vast majority of obese persons have increased leptin levels but do not have mutations of either leptin or its receptor. They appear therefore to have a form of functional .

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