Sustained weight loss over 6 years delays the onset of the cardiometabolic side effects of type 2 diabetes, high blood pressure, and hyperlipidemia.
Sustained weight loss over several years not only delays the overall incidence of adverse cardiometabolic outcomes, including type 2 diabetes, hypertension, and hyperlipidemia. This was the result of a retrospective analysis of nearly 50,000 patients by researchers from Geisinger Health, Pennsylvania, USA. According to the World Health Organization (WHO), global obesity has tripled since 1975 and in 2016 more than 1.9 billion adults aged 18 and over were overweight, including over 650 million. Obesity is not limited to adults, however, and WHO data also suggests that 39 million children under the age of 5 were overweight or obese in 2020. In a 2017 article, the World Obesity Federation published a position statement arguing that obesity should be viewed as a chronic, relapsing disease process in which an overabundance of food coupled with low physical activity, various environmental factors and genetic vulnerabilities work together to create a positive energy balance. Increased weight and obesity are linked to higher incidences of cardiovascular disease, musculoskeletal disorders, and some cancers. Nonetheless, even sustained 5% weight loss improves metabolic function in several organs, although sustaining weight loss over the longer term is challenging – loss program averages 3.0 kg, or 23% of the initial weight loss. “
However, the influence of sustained weight loss on the development of cardiometabolic diseases remains unclear. For the present study, the researchers used data from the Geisinger Health System, which is one of the largest health organizations in the USA. The team looked at adult patients who had 3 or more electronic health records to measure their weight over a period of 2 years. Individuals were then categorized as obesity preserver (OM), that is, those with a history of obesity and who kept their weight within 3% of their baseline; Weight Loss Rebounders (WLRs) who lost> 5% of their body weight but regained> 20% of their 1 year loss and finally Weight Loss Maintainers (WLMs) who lost> 5% of their body weight but> 80% had maintained their 1 year of weight loss. The results of interest were the development of type 2 diabetes, hypertension and hyperlipidemia, all of which were extracted from the electronic health records. In their analysis, the researchers corrected several factors such as age, gender and various comorbidities.
Results
The sample consisted of 49,327 people with a mean age of 50.4 years (60.2% female), with the majority classified as OM (the reference group), and the entire sample was followed up for a mean period of 6.6 years. At 5 years, 11.1% of the OM, 9.1% of the WLR, and 6.5% of the WLM had developed type 2 diabetes, and those in the sustained weight loss group (WLM) had a 33% lower risk of developing type 2 diabetes To develop type 2 diabetes (adjusted hazard ratio, aHR = 0.68, 95% CI 0.62-0.74, p <0.0001). The WLM also showed a reduced risk of developing hypertension (aHR = 0.72) and hyperlipidemia (aHR = 0.86).
Based on these results, the authors concluded that sustained weight loss is associated with delayed onset of cardiometabolic disease and that these associations are reinforced in those with the greatest weight loss.
Quote
Bailey-DavisL et al. Effects of Sustained Weight Loss on Cardiometabolic Outcomes. On J Kardiol 2021
