Effect of weight loss on resting energy expenditure in obese prepubertal children

To assess the effect of weight loss on resting metabolic rate (RMR), the energy expenditure of eight obese prepubertal children (age 9 ± 1 years; weight 48.7 ± 9.1 kg; BMI 25.3 ± 3.9) and of 14 age-matched children of normal body weight (age 9 ± 1 years; weight 28.8 ± 5.6 kg; BMI 16.5 ± 1.7) was measured by indirect calorimetry. The obese children were reinvestigated after a mean weight loss of 5.4 ± 1.2 kg induced by a six-months mixed hypocaloric diet. Before slimming, the obese group showed a higher daily energy intake than the control group (10.40 + 3.45 MJ/day vs 7.97 ± 2.02 MJ/day respectively; P < 0.05) but a similar value was observed per unit fat-free mass (FFM) (0.315 ± 0.032 MJ/kgFFM/day vs 0.329 ± 0.041 MJ/kgFFM/day respectively). The average RMR of the obese children was greater than that of the control group (5217 ± 531 kJ/day vs 4477 ± 506 kJ/day) but similar after adjusting for FFM (4728 ± 3102 kJ/day vs 4899 ± 3102 kJ/day). Weight loss resulted in a reduction in RMR (5217 + 531 kJ/day vs 4874 ± 820 kJ/day), each kg of weight loss being accompanied by a decrease of RMR of 64 kJ (15.3 kcal) per day. The changes in RMR induced by weight loss paralleled the changes in FFM. No difference was found in average RQ in obese children vs controls (0.85 ± 0.03 vs 0.87 ± 0.03 respectively) and in the obese children before and after weight loss (0.87 ± 0.02). After weight loss the absence of variation of RMR adjusted for FFM corroborates the notion that there are no modifications in the metabolic activity of FFM in obese children after slimming