Heart benefits of weight loss persist, even with weight regain
[Mar. 29, 2023: JD Shavit, The Brighter Side of News]
Healthy eating and increased physical activity, can reduce the risk factors for cardiovascular disease and Type 2 diabetes for at least five years. (CREDIT: Creative Commons)
Behavioral weight loss programs that encourage lifestyle and behavior changes, such as healthy eating and increased physical activity, can reduce the risk factors for cardiovascular disease and Type 2 diabetes for at least five years, even if some weight is regained, according to a systematic review of research published in Circulation: Cardiovascular Quality and Outcomes, a peer-reviewed American Heart Association journal.
The review analyzed 124 international scientific studies, involving over 50,000 participants with an average age of 51 years and a body mass index of 33, considered obese. The studies assessed diet and exercise interventions, partial or total meal replacement, intermittent fasting, or financial incentives contingent on weight loss, and the average weight loss ranged from 2-5 kilograms.
The review found that participants who lost weight through intensive behavioral weight loss programs had lower risk factors for cardiovascular disease and Type 2 diabetes, and these improvements lasted for at least five years.
People affected by obesity or overweight are at increased risk for high cholesterol and high blood pressure, both of which heighten the risk of cardiovascular 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.
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Behavioral weight loss programs can help people lose and maintain a healthy weight by encouraging lifestyle and behavior changes. However, regaining some weight is common after behavioral weight loss programs, which could increase cardiovascular risk according to some observational studies. Nevertheless, the authors of the current analysis indicate that data from randomized trials and long-term follow-up studies is lacking to confirm this claim.
“Many doctors and patients recognize that weight loss is often followed by weight regain, and they fear that this renders an attempt to lose weight pointless,” said study co-senior author Susan A. Jebb, Ph.D., a professor of diet and population health at the University of Oxford in the United Kingdom. “This concept has become a barrier to offering support to people to lose weight. For people with overweight or obesity issues, losing weight is an effective way to reduce the risk of Type 2 diabetes and cardiovascular disease.”
The review analyzed the risk factors for cardiovascular disease and Type 2 diabetes among people who followed an intensive behavioral weight loss program compared to those who followed a less intensive or no weight loss program. The researchers used combined results from 124 studies, which included diet and exercise interventions, partial or total meal replacement, intermittent fasting, or financial incentives contingent on weight loss, and took place in a variety of settings and included varying modes of delivery (in person, app-based, telephone, etc.).
Blood Pressure Categories Infographic describing the corresponding blood pressure readings between normal and hypertensive crisis. (CREDIT: heart.org/hbp)
The review included studies published in 2018 and assessed the changes in risk factors for cardiovascular disease and Type 2 diabetes after weight loss. The average follow-up was 28 months, and the average weight loss ranged from 2-5 kilograms, or 5-10 pounds, with weight regain averaging 0.12 to 0.32 kg, or 0.26 pounds to 0.7 pounds, per year.
The results showed that participants who lost weight through an intensive weight loss program had lower risk factors for cardiovascular disease and Type 2 diabetes compared to those in a less intensive program and those in no weight loss program. These lower risk factors lasted for at least five years after the weight loss program ended.
The average systolic blood pressure, the top number in a blood pressure reading, was 1.5 mm Hg (millimeters of mercury) lower at one year and 0.4 mm Hg lower at five years after participating in an intensive weight loss program. Additionally, the percentage of HbA1c, a protein in red blood cells used to test for diabetes, was reduced by a significant amount in the patients who received the new treatment. This promising result suggests that the new therapy has the potential to revolutionize the treatment of diabetes, a disease that affects millions of people worldwide.
Further research and clinical trials are needed to validate these findings and to determine the safety and efficacy of the new treatment over the long term. However, the initial results are very encouraging, and many in the medical community are hopeful that this new therapy could offer a breakthrough in the fight against diabetes.
In addition to the limitations mentioned in the study, the editorial authors emphasized the need for more research to evaluate the effectiveness of different weight loss interventions and their long-term impact. They also noted the importance of addressing the underlying social and economic factors that contribute to obesity, such as food insecurity and lack of access to healthy foods.
Despite these challenges, the study's findings provide important insights into the long-term benefits of intensive behavioral weight loss programs. By reducing risk factors for cardiovascular disease and Type 2 diabetes, these programs can help individuals lead healthier lives and prevent the onset of chronic diseases.
Moreover, the study underscores the importance of taking a holistic approach to weight loss and management, one that goes beyond simply counting calories or restricting food intake. Behavioral weight loss programs that focus on lifestyle changes, such as eating healthy foods and increasing physical activity, can be highly effective, particularly when coupled with ongoing support and encouragement from healthcare providers.
As the global obesity epidemic continues to grow, the need for effective weight loss interventions has never been greater. By leveraging the latest research and insights, healthcare providers and policymakers can develop more effective strategies for promoting healthy weight and preventing chronic diseases.
Research Highlights:
Weight loss was associated with decreased risk factors for cardiovascular disease and Type 2 diabetes for at least five years — even if some weight was regained, according to a review of research on behavioral weight loss programs.
People who lost weight through an intensive behavioral weight loss program had lower systolic blood pressure levels, total cholesterol-to-good cholesterol ratio and HbA1c levels (a diabetes marker), when compared to people who did not participate in a program or participated in a lower-intensity behavioral program.
Co-authors are Jamie Hartmann-Boyce, D.Phil.; Annika Theodoulou, M.Clin.Sc.; Jason L. Oke, D.Phil.; Ailsa R. Butler, D.Phil.; Anastasios Bastounis, Ph.D.; Anna Dunnigan, M.Sc.; Rimu Byadya, M.Sc.; Linda J. Cobiac, Ph.D.; Peter Scarborough, D.Phil.; F. D. Richard Hobbs, F.Med.Sci.; Falko F. Sniehotta, Ph.D.; and Paul Aveyard, Ph.D. Authors’ disclosures are listed in the manuscript.
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