Weight loss reduces risks for obesity-related diseases to near pre-weight gain levels
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Adults with obesity who intentionally lost weight reduced their risks for type 2 diabetes and other diseases to nearly the same levels as adults who had maintained the lower weight, according to study data.
“This study demonstrates the benefits of an average 13% weight loss in reducing the risk of certain obesity-related conditions in real-world clinical practice, and concludes people with obesity could reduce their disease risk through weight loss interventions,” Christiane L. Haase, MSc PhD, health economics and outcomes research lead at Novo Nordisk A/S, told Healio.
The study's results were presented at the European and International Congress on Obesity virtual meeting.
Haase and colleagues investigated effects of weight loss among a group of adults (mean age, 54 years) from the Clinical Practice Research Datalink GOLD, a U.K. database of anonymous primary care records merged with Hospital Episode Statistics information. Each participant’s BMI was measured at an initial visit from 2001 to 2010 and again throughout a 4-year baseline period; mean follow-up was 8.4 years. Adults with a BMI between 25 kg/m² and 50 kg/m² at the first follow-up were included in the study. Participants were placed into a stable-weight group if their weight pattern stayed with 5% of initial body weight (n = 523,138) or a weight loss group if BMI decreased between 10% and 25%, with evidence of intervention or diet to confirm an intent to lose weight (n = 48,823).
Researchers assessed the risks for type 2 diabetes, sleep apnea, osteoarthritis, hypertension, dyslipidemia and unstable angina. The risks of outcomes were compared within the weight loss group from before weight loss to after weight loss. Researchers also compared the weight loss group with the stable weight group for each disease.
The weight loss group saw a median BMI reduction of about 13% during the study period. The weight loss group had a higher prevalence of all of the diseases included in the study when compared with the weight stable group.
When comparing risks before and after weight loss, there was a significantly reduced risk after weight loss for type 2 diabetes, sleep apnea, hypertension and dyslipidemia. For osteoarthritis, the risk was lower after weight loss except for adults with an initial BMI of 45 kg/m² or higher.
“Obesity is the cause of or contributes to many complications, such as type 2 diabetes, obstructive sleep apnea, high blood pressure and other cardiovascular risks as well as arthritis and high cholesterol,” Haase said. “While the benefits on these complications from weight loss has been well established in clinical trials of lifestyle modification, pharmacotherapy and weight loss surgery, this study shows that in real life people who intentionally lost weight substantially reduced the risks for all these complications.”
The weight loss group had lower risks after weight loss for hypertension and dyslipidemia than the weight stable group. For type 2 diabetes, the risks for those with a median initial BMI of 46 kg/m² (HR = 0.7; 95% CI, 0.64-0.77) and 40.3 kg/m² (HR = 0.87; 95% CI, 0.82-0.92) were lower than those for the weight stable group, but the risk for those with a initial BMI of 34.5 kg/m² (HR = 1.07; 95% CI, 1.01-1.13) was higher than that for the weight stable group, suggesting BMI is an independent risk factor, according to Haase.
For sleep apnea and osteoarthritis, the weight loss group’s risks remained higher than those for the stable weight group. Results were unconclusive for unstable angina in the study.
Haase said the findings emphasize the need for people with obesity to receive treatment and apply interventions to lose weight. Future research could focus more on the ways weight loss can be achieved.
“We could learn more about what it is that allows some people to be successful in losing weight and what is the best treatment for those others who struggle to achieve weight loss,” Haase said. “Not all complication risks returned to ‘normal,’ and we need to know more about the factors underlying the reversibility of these risks.”
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Haase CL, et al. Weight loss and risk reduction of obesity-related conditions in 0.5 million people: evidence from a UK primary care database. Presented at: European and International Congress on Obesity Annual Meeting; Sept. 5-9, 2020; (virtual meeting).
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