Endocrine Consequences of Massive Weight Loss: Surgery vs. Diet and Exercise

Timothy B. Curry, M.D., Ph.D.

IRB #05-004164

Almost two-thirds of Americans are classified as overweight, obese, or extremely (morbidly) obese and these numbers are expected to increase. Bariatric surgery has become an important therapeutic option because of its recognized effectiveness in causing significant weight loss with a subsequent improvement in comorbid conditions such as hypertension and diabetes. However, bariatric surgery is associated with significant morbidity and mortality, and it is unknown whether the metabolic changes that occur with the rapid weight loss that is induced with bariatric surgery are similar to those that occur after weight loss through behavioral modification (e.g. diet and exercise). The objectives of this protocol are (1) to evaluate whether there are differences between surgical and behavioral weight loss in the metabolic changes that occur, and (2) to use the experimental approaches involved in assessment of metabolic function as a mechanism for the applicant to acquire new research skills. In this proposal, we discuss studies designed to evaluate whether there are differences between surgical and behavioral weight loss in metabolic function, energy expenditure, and fat-free body mass. We hypothesize that the increased activity and preserved fat-free body mass associated with weight loss through behavioral changes results in important benefits that are not realized after weight loss through surgical means.