Weight loss even associated with weight regain is shown to improve cardiovascular risks

Abstract

Losing weight with lifestyle changes in an intensive behavioural weight loss programme was associated with a decrease in risk factors for cardiovascular disease and Type 2 diabetes for at least 5 years—even if some weight was regained, according to a systematic review of research, published today in Circulation: Cardiovascular Quality and Outcomes, a peer-reviewed American Heart Association journal.

Individuals with obesity have a higher risk of developing cardiovascular risks due to adverse cardiovascular risk factors such as insulin resistance, high cholesterol and high blood pressure. Whilst lifestyle interventions such as dietary, exercise and behavioural intervention can help people lose and maintain a healthy weight, many patients experience weight regain. Some observational studies suggest that weight regain may increase cardiovascular risk but data from randomized trials and long-term follow-up studies is lacking.

A systematic review, published in the journal Circulation: Cardiovascular Quality and Outcomes, assessed international scientific studies available in 2018 to compare risk factors for cardiovascular disease and Type 2 diabetes amongst people who followed an intensive behavioural weight loss programme to those who followed a less intensive or no weight loss programme. The studies in the analysis included diet and/or exercise interventions, partial or total meal replacement, intermittent fasting, or financial incentives contingent on weight loss. A total of 124 studies involving more than 50 000 participants, with an average follow-up of 28 months were included in the analysis. Mean age at baseline was 51 years old with a body mass index of 33. The average weight loss across the different studies ranged from 2–5 kilogrammes. Weight regain averaged 0.12 to 0.32 kg/year.

Compared to people in a less intensive programme and those in no weight loss programme, participants who lost weight through an intensive weight loss programme had lower risk factors for cardiovascular disease and Type 2 diabetes, which persists for 5 years after weight loss intervention. Crucially, the decreased risk of being diagnosed with cardiovascular disease or Type 2 diabetes also appeared to remain lower even after weight regain. This finding provided some reassurance that weight loss programmes are effective in reducing cardiovascular risk factors even after some weight regain. The study also has relevance due to the well-recognized risks of weight regain following short term pharmacological intervention. Whether these temporary improvements in weight and cardiometabolic risk factors after weight loss intervention lead to long-term clinical benefit however remains unclear.