Body composition changes after weight-loss interventions for overweight and obesity

Background & aims: Weight-loss interventions to correct overweight and obesity are very popular but often inappropriate and unsuccessful. Methods: In this review we evaluated studies on body composition changes during and after different medical and surgical interventions aimed at achieving stable weight loss in overweight and obese individuals. Results: Most of the available literature and good clinical practice observations deal mainly with postmenopausal overweight and obese women, and, to a lesser extent adolescents and elderly, female and male, populations. These studies suggest that weight-loss maintenance interventions should have greater consideration and priority than simple weight-loss treatments. At a long term follow up (over one year), relatively high protein, moderately low calorie, low glycemic index diets, associated with a daily, moderate intensity, physical exercise (of at least 30 min), appear to be more successful in limiting long term relapse, maintaining fat free mass and achieving the highest fat loss. Diet alone or physical exercise alone does not produce similar results. Health professional training and practice also appear a challenging target. Conclusions: Adequate dietetic advice plus regular physical exercise avoid the fat-free-mass loss usually observed in the relapse of the weight cycling syndrome and prevent the onset of sarcopenic obesity. (C) 2012 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.