Relationship of insulin dynamics to body composition and resting energy expenditure following weight loss

Obesity (Silver Spring). 2015 Nov;23(11):2216-22. doi: 10.1002/oby.21213. Epub 2015 Sep 16.


Objective: To examine associations of baseline insulin dynamics with changes in body composition and resting energy expenditure (REE) following weight loss.

Methods: Twenty-one participants with overweight or obesity achieved 10-15% weight loss and then received 3 weight loss maintenance diets (high-carbohydrate, moderate-carbohydrate, and low-carbohydrate) in random order, each for 4 weeks. Body composition was measured at baseline and after weight loss. Insulin 30 min after glucose consumption (insulin-30; insulin response), C-peptide deconvolution analysis, HOMA, hepatic insulin sensitivity (IS), and REE were assessed at baseline and after each maintenance diet.

Results: Insulin-30, but not maximal insulin secretion, hepatic IS, or HOMA, predicted changes in fat mass (standardized β = 0.385, 1.7 kg difference between 10th and 90th centile of insulin-30, P = 0.04) after weight loss. Insulin-30 (β = -0.341, -312 kcal day(-1) , P = 0.008), maximal insulin secretion (β = -0.216, -95 kcal day(-1) , P = 0.0002), HOMA (β = -0.394, -350 kcal day(-1) , P = 0.002), and hepatic IS (β = 0.217, 225 kcal day(-1) , P = 0.0003) predicted change in REE during weight loss maintenance, independent of changes in body composition. The inverse relationship between insulin-30 and REE was substantially attenuated when the low-carbohydrate diet was consumed first.

Conclusions: These findings distinguish a novel phenotype, characterized by high insulin response, at risk for weight regain, and identify a dietary approach to ameliorate this risk.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Body Composition / physiology*
  • Body Weight
  • C-Peptide / blood
  • Diet, Carbohydrate-Restricted
  • Diet, Reducing
  • Energy Metabolism / physiology*
  • Female
  • Humans
  • Insulin / metabolism*
  • Insulin Resistance
  • Male
  • Obesity / diet therapy
  • Obesity / metabolism
  • Overweight / diet therapy
  • Overweight / metabolism
  • Rest*
  • Weight Loss / physiology*
  • Young Adult


  • C-Peptide
  • Insulin