Increased weight loading reduces body weight and body fat in obese subjects - A proof of concept randomized clinical trial

Claes Ohlsson; Edwin Gidestrand; Jacob Bellman; Christel Larsson; Vilborg Palsdottir; Daniel Hägg; Per-Anders Jansson; John-Olov Jansson

doi:10.1016/j.eclinm.2020.100338

Increased weight loading reduces body weight and body fat in obese subjects - A proof of concept randomized clinical trial

EClinicalMedicine. 2020 Apr 30:22:100338. doi: 10.1016/j.eclinm.2020.100338. eCollection 2020 May.

Authors

Claes Ohlsson^{1

2}, Edwin Gidestrand³, Jacob Bellman³, Christel Larsson⁴, Vilborg Palsdottir³, Daniel Hägg^{1

2}, Per-Anders Jansson^{5

6}, John-Olov Jansson³

Affiliations

¹ Centre for Bone and Arthritis Research, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
² Region Västra Götaland, Sahlgrenska University Hospital, Department of Drug Treatment, Gothenburg, Sweden.
³ Department of Physiology, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
⁴ Department of Food and Nutrition, and Sport Science, University of Gothenburg, Sweden.
⁵ Wallenberg Laboratory, Department of Molecular and Clinical Medicine, Institute of Medicine, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
⁶ Gothia Forum, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.

Abstract

Background: Recently we provided evidence for a leptin-independent homeostatic regulation, the gravitostat, of body weight in rodents. The aim of the present translational proof of concept study was to test the gravitostat hypothesis in humans.

Methods: We conducted a randomized controlled single center trial (ClinicalTrial.gov number, NCT03672903), to evaluate the efficacy of artificially increased weight loading on body weight in subjects with mild obesity (BMI 30-35 kg/m²). Subjects were either treated with a heavy (=high load; 11% of body weight) or light (=low load; 1% of body weight) weight vest for eight hours per day for three weeks. The primary outcome was change in body weight. Secondary outcomes included change in body fat mass and fat-free mass as measured using bioelectrical impedance analysis.

Findings: In total 72 participants underwent randomization and 69 (36 high load and 33 low load) completed the study for the primary outcome. High load treatment resulted in a more pronounced relative body weight loss compared to low load treatment (mean difference -1.37%, 95% confidence interval (CI), -1.96 to -0.79; p = 1.5 × 10^-5). High load treatment reduced fat mass (-4.04%, 95% CI, -6,53 to -1.55; p = 1.9 × 10^-3) but not fat free mass (0.43%, 95% CI, -1.47 to 2.34; p = 0.65) compared to low load treatment.

Interpretation: Increased weight loading reduces body weight and fat mass in obese subjects in a similar way as previously shown in obese rodents. These findings demonstrate that there is weight loading dependent homeostatic regulation of body weight, the gravitostat, also in humans.

Funding: Funded by Jane and Dan Olsson (JADO) Foundation, the Torsten Söderberg Foundation, The Knut and Alice Wallenberg's Foundation and the Novo Nordisk Foundation.