Obese or overweight people have an increased risk of high cholesterol and
– factors that increase the risk of heart disease; As well as insulin resistance, a precursor to type 2 diabetes. Globally, overweight and obesity contributed to 2.4 million deaths in 2020, according to the American Heart Association’s 2023 Statistical Update.
Behavioral weight loss programs can help people lose and maintain a healthy weight by encouraging lifestyle and behavior changes, such as eating healthier foods and increasing physical activity. It is common for some weight to come back after practical weight loss programs. Some observational studies suggest that this weight change pattern of weight loss may lead to increased cardiovascular risk after weight loss. However, according to the authors of this analysis, there is a paucity of data from randomized trials and long-term follow-up studies.
Study co-senior author Susan A. Jebb, PhD, a professor of dietetics, says, “Many doctors and patients believe that weight loss often comes back after weight loss, and they fear that this makes the weight loss effort futile.” and Population Health at the University of Oxford in the United Kingdom. “This concept has become a barrier to supporting people to lose weight. For people who are overweight or obese, losing weight is an effective way to reduce their risk of type 2 diabetes and heart disease.”
In this review, researchers evaluated international scientific studies available in 2018 to compare risk factors for heart disease and type 2 diabetes in people who followed a less-intense or no weight-loss program compared to those who did not. Followed an intensive behavioral weight loss program. Studies in the analysis included dietary and/or exercise interventions, partial or total meal replacement, intermittent fasting, or financial incentives contingent on weight loss. Studies took place in a variety of settings and included different methods of delivery (in-person, app-based, telephone, etc.).
The researchers combined results from 124 studies totaling more than 50,000 participants with an average follow-up of 28 months. They used the combined results to estimate changes in risk factors for heart disease and type 2 diabetes after weight loss. The average weight loss in various studies ranged between 2–5 kg, or 5–10 pounds. There was an average increase in weight of 0.12 to 0.32 kg (0.26 lb to 0.7 lb) in one year. The average age of the participants was 51, with a body mass index of 33, which is considered obese.
Compared to people in a less intensive program and people in a weight loss program that did not, participants who lost weight through an intensive weight loss program had fewer risk factors for cardiovascular disease and type 2 diabetes. These reduced risk factors lasted at least five years after the weight loss program ended.
Based on the pooled results of the reviewed studies on average:
- Systolic blood pressure, the top number in a blood pressure reading, was 1.5 mm Hg (millimetres of mercury) lower at one year, and 0.4 mm Hg lower at five years after participating in an intensive weight loss program.
- In addition, the percentage of HbA1c, a protein in red blood cells used to test for diabetes, decreased by 0.26 at both one and five years after participating in an intensive weight loss program.
- The ratio of good cholesterol to total cholesterol — known as high-density lipoprotein (HDL) cholesterol — was 1.5 points lower after one year and five years after participating in an intensive weight loss program.
These changes are important because they represent improvements at the population level, Jebb explained.
In a preliminary finding, the lower risk of being diagnosed with heart disease or type 2 diabetes also appeared to decrease after weight gain. However, few studies followed people for longer than 5 years and “more information is needed to confirm whether this potential benefit persists,” Jebb said.
“Most trials look at whether new treatments are effective and focus on changes in weight in the short term rather than effects on disease later,” Jebb said. “Individual studies are often too small to detect differences between groups in the incidence of cardiovascular conditions because, fortunately, they affect only a small part of the whole group, and the effect on ‘hard’ outcomes The studies may not continue long enough to see,” such as a new diagnosis of type 2 diabetes or heart attack.
healthy weight = healthy heart
“Our findings should provide reassurance that weight loss programs are effective in controlling cardiovascular risk factors and are likely to reduce the incidence of cardiovascular disease.”
Evidence shows that following the American Heart Association’s Life’s Essential 8 health metrics improves heart health: eating healthy, being physically active, not smoking, getting enough sleep, maintaining a healthy weight, and cholesterol, Controlling blood sugar and blood pressure levels.
The analysis had several limitations: the information included in the review was not updated after 2019 and the review focused on research papers published in English, so eligible studies written in other languages may have been missed.
An accompanying editorial notes that much remains to be understood about the various weight loss interventions, their long-term effects and how this effect may be mitigated by regaining weight. Practical weight loss programs are the backbone of weight management in clinical practice. However, they are often resource intensive, and emerging drug therapies are costly, say editorial authors Vishal N. Rao, MD, MPH, and Neha J. Pagidipati, MD, MPH, both from the division of cardiology at Duke University School of Medicine in Durham, Ohio. in North Carolina.
“The present study has interesting implications for the effects of weight loss following pharmacological therapy,” they write. “What is still unknown is whether these temporary improvements in weight and cardiometabolic risk factors following weight-loss interventions (behavioral or pharmacological) lead to long-term clinical benefits. In other words, what should never be lost?” Better to be lost than to be regained at all?”Life Style