CV risk progression ‘slowed or stopped’ with obesity reversal
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Adults who transition from obesity to a healthy weight may reverse their progression of cardiovascular risk, even if they continue to smoke and especially if they quit, according to an analysis of data.
In an analysis comparing the CV risk factors of American adults with past obesity with those with current obesity and with those who always had a healthy weight, researchers also found risk for diabetes, but not hypertension or dyslipidemia, remained elevated over those who never had obesity, although diabetes risk fell with weight loss.
“The damage done by obesity is persistent, but its progression can be slowed or stopped if obesity stops,” Maia P. Smith, PhD, MS, a statistical epidemiologist and assistant professor in the department of public health and preventive medicine at St. George’s University School of Medicine, Grenada, told Healio. “It is like smoking: ‘Never’ is better than ‘ever,’ but ‘quit’ is better than ‘current.’ Both prevention and reversal are likely to improve health.”
Smith and colleagues analyzed data from 20,271 adults who participated in the 1999-2013 waves of the National Health and Nutrition Examination Survey, stratified into three groups: current obesity (n = 13,710), always healthy weight (n = 6,235) and past obesity (n = 326). Researchers compared the groups for prevalence of hypertension, dyslipidemia and diabetes; models were adjusted for age, sex, smoking and race. The data were presented at the European Association for the Study of Diabetes virtual meeting.
Within the cohort, participants with past obesity were older than those who never or currently had obesity and were more likely to smoke, with smoking prevalence rates of 36%, 24% and 19%, respectively.
In adjusted models, adults with past obesity had rates of hypertension and dyslipidemia that were comparable with participants who never had obesity, with ORs of 1.08 and 1.13, respectively (P < .01 for both). However, risk for diabetes was nearly three times greater among adults with former obesity compared with adults with healthy weight (OR = 2.93; P < .01), although diabetes risk was still lower compared with adults with current obesity (OR = 7.53; P < .01).
Participants with current obesity were also three times more likely to have hypertension (OR = 3.14; P < .01) and dyslipidemia (OR = 3.11; P < .01) compared with adults at a healthy weight.
“Clinicians should consider weight history, as well as current weight, when assessing disease risk,” Smith told Healio. “These findings, combined with our previous [research] on body-size perception, suggest weight-control counseling should be a standard part of care for all people with overweight and obesity. They may not know the risks they are taking, and this research shows they have the option of reversing much of that risk.”
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Smith M, et al. Abstract 84. Presented at: European Association for the Study of Diabetes Annual Meeting; Sept. 27-Oct. 1, 2021 (virtual meeting).
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