
McKaela R. answered 01/07/22
Medical Student
Hi Lola.
I assume you mean wasted? As in weight significantly below a given z-score.
The solution is within lipid metabolism, depending on how detailed your answer needs to be.
Generally speaking, those who are considered to be severely underweight are assumed to be malnourished which I believe you are suggesting when you say "controlling carbohydrate intake". I believe it is not important that it is 20 lbs or 5 lbs, in any case, the scenario you've described is an individual with no carbohydrate intake, the body is resorting to adipose for energy.
What is stored in an individual's body as fatty acids, during starvation when the body does not have sufficient glucose metabolism, stored fat (fatty acids) get metabolized to acetyl CoA, which is an intermediate of the citric acid cycle. In fact, acetyl CoA is the desired substance for the beginning of all TCA cycles. (In glucose metabolism, pyruvate from glycolysis is further metabolized to acetyl CoA).
Over some time, a byproduct called ketone bodies will begin to accumulate as a result of fatty acid breakdown. While they are water-soluble and are considered high energy, a body cannot sustain with high levels of ketone bodies. As far as the exercise component, "fat-burning" activities is not a biological term, but I assume high-energy consumption workouts that require a specific amount of fuel that may resort to fatty acids instead of glycogen. Then, it is not relevant since it has already been established that the body is undergoing fatty acid metabolism.
So to directly answer your question, the form in which your body releases fats is simply at the end of the fatty acid metabolic pathway - through urine from kidneys, through sweat from skin, and through exhalation of CO2 from your lungs. According to some studies, it is said that approximately 80% of fat is expelled through carbon dioxide.
Sorry if that explanation took a detour. As you can see, it is quite complex and I hope the answer you're looking for is in there somewhere.