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Adipose tissue cellularity in relation to prognosis for weight reduction.

M Krotkiewski, L Sjöström, P Björntorp

    International Journal of Obesity
    |January 1, 1977
    PubMed
    Summary

    Obesity type impacts weight management. Hypercellular obesity (hyperplastic/combined) shows faster weight gain and regain than hypertrophic obesity, indicating a poorer long-term prognosis despite potential benefits from repeated treatments.

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    Area of Science:

    • Endocrinology
    • Metabolism
    • Human Physiology

    Background:

    • Adipose tissue cellularity differentiates obesity types: hypertrophic, hyperplastic, and combined.
    • Understanding these differences is crucial for predicting weight management outcomes.

    Purpose of the Study:

    • To analyze spontaneous weight development over six years in women with different obesity types.
    • To compare weight reduction and maintenance following a standardized low-energy diet.
    • To investigate the relationship between adipose tissue cellularity, weight change, and relapse rates.

    Main Methods:

    • Ninety obese adult women were classified into hypertrophic, hyperplastic, or combined obesity groups based on adipose tissue cellularity.
    • Spontaneous weight changes were tracked over six years.

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  • Weight reduction was assessed during a standardized 1100 kcal/day diet.
  • Weight regain and maintenance duration were monitored post-treatment.
  • Main Results:

    • Hyperplastic and combined obesity groups exhibited significantly higher annual weight gain (2.5-3.1 kg) compared to normal weight controls (0.25 kg) and the hypertrophic group.
    • Weight loss during treatment was greatest in the combined (20 kg), hyperplastic (15 kg), and hypertrophic (11 kg) groups.
    • Weight regain was faster and maintenance periods shorter in hyperplastic and combined groups, correlating positively with adipocyte number (FCN).
    • Hypertrophic obesity showed better weight maintenance (51 weeks) compared to hyperplastic (15 weeks) and combined (12 weeks) groups.

    Conclusions:

    • Hypercellular obesity (hyperplastic/combined) has a poorer long-term weight reduction prognosis than hypertrophic obesity due to faster regain.
    • Adipocyte number (FCN) is a key predictor of weight cycling speed and relapse.
    • Despite poorer prognosis, repeated treatments can mitigate the adverse spontaneous weight development in hypercellular obesity.