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Stepwise Weight Reduction in Obese Young Women: Clinical and Metabolic Responses¹

Graduate School of Nutrition, Cornell University, Ithaca, New York

The effect of stepwise weight reduction on the nitrogen, calcium and phosphorus metabolism of 5 obese young women was studied by means of the balance technic. Results were compared with those obtained for 5 control subjects receiving the same intake levels for these nutrients but with adequate calories for essentially weight maintenance.

The net weight losses of the reducers ranged from 10.75 to 23.25 pounds, with a mean loss of 17.1 pounds.

The caloric requirement for weight maintenance decreased markedly in subjects who had been subjected to 6 weeks of caloric restriction.

The rate of weight loss on a constant caloric intake decreased from 2.5 pounds/week early in caloric restriction to 1.9 pounds/week by the 7th and 8th weeks.

The basal caloric requirement at the end of 8 weeks' caloric restriction decreased a mean of 6.8% compared with that in the first week.

During the pre-reduction weight maintenance period all subjects were in a state of equilibrium or retention with regard to nitrogen and phosphorus. With caloric restriction at least some of the subjects lost nitrogen and, to a lesser extent, phosphorus. In contrast, control subjects without caloric restriction lost neither nutrient. Hence, the nitrogen and phosphorus deficits appear to be the result of caloric restriction per se in certain subjects.

There appeared to be no physiologic advantage for the stepwise reducing regimen over straight reduction as measured by elimination of nutrient deficits.

All 5 subjects receiving restricted calories showed calcium deficits by the 8th week of restriction.

Relative fatness as indicated by the sum of fat pad thickness measured on soft tissue x-rays at 5 locations on the body appeared to be related to the ability to stay in nitrogen equilibrium during caloric restriction.

From a psychological standpoint 4 of the 5 women subjected to caloric restriction felt they preferred stepwise reduction to an uninterrupted regimen.

Manuscript received 21 July 1959.

This article has been cited by other articles:

				J. W Krieger, H. S Sitren, M. J Daniels, and B. Langkamp-Henken Effects of variation in protein and carbohydrate intake on body mass and composition during energy restriction: a meta-regression 1 Am. J. Clinical Nutrition, February 1, 2006; 83(2): 260 - 274. [Abstract] [Full Text] [PDF]

				C. M. Young Management of the Obese Patient JAMA, December 7, 1963; 186(10): 903 - 904. [Abstract] [PDF]