I am a Dietitian (acute care, not metabolic) working with an adult CPT2 patient who is interested in losing weight. I was curious if you have any resources or contacts that might help support this. From what I have been able to find in a brief search of the literature, there isn’t an abundance of information out there.
Thanks in advance.
Thanks for your question. You are correct, there are not resources for weight loss among patients with CPT2.
There is a published manuscript about 2 male patients, one with CPT2D and one with VLCADD that lost weight. In both cases they restricted total Calories to about 2000-2500 per day and added exercise. The goal was slow weight loss without inducing a metabolic crisis or rhabdomyolysis. For a women you might go a bit lower but extreme Calorie restriction will be a problem. Very low Calorie diets could induce rhabdomyolysis. (H. Zweers et al. JIMD Reports 2012)
Perhaps we should reframe the issue. Weight loss by definition is catabolic and requires fat oxidation. Patients with CPT2D can lose weight within the limitations of the small amount of residual enzyme that they have but it will be harder and slower for them than for the general population. To me the question should be how can they live a healthy, full life. Weight loss that induces a metabolic crisis is not healthy – and one hospitalization from rhabdomyolysis will reverse all the work toward weight loss. Perhaps the focus should be on improving fitness with routine moderate exercise, improving diet so you feel better and not focusing so much on the scale. This is similar to the “Healthy at every size” movement gaining acceptance in nutrition and dietetics circles right now. This seems particularly relevant for someone with CPT2D.
Melanie Gillingham PhD, RD
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