Research: Maintaining weight loss retains cardiometabolic benefits

Losing weight lowers the risks of high blood pressure, heart disease and stroke, particularly among patients with Type 2 diabetes. But keeping that weight off is just as important as losing it, a new study found.

The study, Change in Cardiometabolic Risk Factors Associated with…Weight Regain…, was published Oct. 9 in the Journal of the American Heart Association, the open-access journal of the American Heart Association.

Few studies have directly compared cardiometabolic risk between people who successfully lost weight and maintained the weight loss to those who regained weight, particularly among people with Type 2 diabetes.

“Regaining weight was associated with a reversal of the benefits seen from losing weight,” said senior and corresponding author Alice H. Lichtenstein, a nutrition scientist and director of the Cardiovascular Nutrition Laboratory at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University. “If you lose weight and maintain the weight loss for a long period of time, do the benefits continue? The answer is yes and sometimes the benefits get even stronger. If you lose weight and don't maintain it, the benefits are diminished or disappear. These findings emphasize the dual importance of not only achieving a heathy body weight but maintaining a healthy body weight.” 

“What we need to focus on now is how we can support not only healthy approaches to losing weight but healthy approaches to helping those who are successful in losing weight maintain the weight loss. The latter may be the most challenging,” she said. Lichtenstein is a member of the American Heart Association’s Council on Lifestyle and Cardiometabolic Health – Lifestyle Nutrition Committee.

Researchers analyzed data from nearly 1,600 participants with Type 2 diabetes in an intensive weight loss study who lost at least 3% of their initial body weight. They found that among those who lost 10% or more of their body weight and then maintained 75% or more of their weight loss four years later saw a significant improvement in risk factors, such as improved levels of HDL (good) cholesterol, triglycerides, glucose, blood pressure, waist circumference and diabetes control.

However, those benefits deteriorated among those who regained weight. Men and women who lost less than 10% of their initial weight but then regained any of the weight experienced a significant increase in their blood glucose levels, blood pressure and waist circumference. Men and women who lost 10% or more of their initial weight, then regained weight, also had a significant increase in blood glucose levels, according to the study.

The researchers used data from the Look AHEAD (Action for Health in Diabetes) study, which assessed a year-long intensive lifestyle intervention program to promote weight loss, compared to standard care for heart disease and stroke risk, among people diagnosed with Type 2 diabetes and who were overweight.

The intensive lifestyle intervention program focused on achieving weight loss through healthy eating and increased physical activity, while standard care consisted of diabetes support and education. A three-year maintenance phase included monthly group meetings and recommendations to replace one meal per day with something similar to a replacement shake or bar, and to continue engaging in regular physical activity.

Co-authors are Samantha E. Berger, Ph.D.; Gordon S. Huggins, M.D.; Jeanne M. McCaffery, Ph.D.; and Paul F. Jacques, D.Sc. The National Heart, Lung, and Blood Institute and the U.S. Department of Agriculture funded the study.

Source: American Heart Association