Impact of Sustained Weight Loss on Cardiometabolic Outcomes

Bailey‐Davis, Lisa; Wood, G. Craig; Benotti, Peter N.; Cook, Adam; Dove, James T.; Mowery, Jacob; Ramasamy, Abhilasha; Iyer, N.C.; Smolarz, B. Gabriel; Kumar, Neela; Still, Christopher D.

doi:10.1016/j.amjcard.2021.09.018

Cited by 21 publications

(30 citation statements)

References 28 publications

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“…A key finding of this meta-analysis was that weight cycled animals, and AOb animals have similar degrees of impairment in markers of metabolic health including glucose tolerance, plasma insulin levels, cholesterol levels, and hepatic triglyceride levels. Some studies, which follow-up subjects from clinical trials of weight loss interventions, show long-lasting health benefits despite weight regain, whereas other studies show these benefits reverse with even partial weight regain 5,6,10 . One reason for this discrepancy may be that lifestyle interventions in human studies result in long-lasting behavioural changes which may lead to health benefits independent of weight loss, 46 whereas animal studies eliminate such confounding factors.…”

Section: Changes To Adipocyte Size and Functionmentioning

confidence: 99%

“…Some studies show that these benefits persist despite weight regain 3,5–7 . However, results from other studies suggest that even partial weight regain is associated with return to baseline values of metabolic risk factors 8–10 . Moreover, several observational studies have suggested that weight fluctuation is associated with increased mortality and cardiovascular events 11,12 .…”

Section: Introductionmentioning

confidence: 99%

“…3,[5][6][7] However, results from other studies suggest that even partial weight regain is associated with return to baseline values of metabolic risk factors. [8][9][10] Moreover, several observational studies have suggested that weight fluctuation is associated with increased mortality and cardiovascular events. 11,12 The conflicting data highlight the methodological limitations of the various study designs.…”

Section: Introductionmentioning

confidence: 99%

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The impact of weight cycling on health outcomes in animal models: A systematic review and meta‐analysis

et al. 2022

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The pattern of weight loss and regain, termed "weight cycling," is common in overweight individuals. It is unclear whether the well-established benefits of weight loss persist following weight regain or whether weight cycling is harmful. Human studies of weight cycling have conflicting results reflecting limitations of the observational designs of these studies. By controlling the macronutrient content of diets in animal studies, weight cycling can be studied in a highly controlled manner, thereby overcoming the limitations of human studies. We conducted a systematic review and meta-analysis of animal studies which assessed the health consequences of weight cycling. Studies were classified into those which compared weight cycling to lifelong obesity and those which compared weight cycling to later onset obesity. There were no differences in health outcomes between weight cycled animals and those with lifelong obesity, highlighting that weight regain reverses health benefits achieved by weight loss. In comparison with animals with later onset obesity, weight cycled animals had higher fasting glucose levels and more impaired glucose tolerance following weight regain. Our review of animal studies suggests that health benefits of diet-induced weight loss do not persist after weight regain and weight cycling results in adverse metabolic outcomes.

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Section: Changes To Adipocyte Size and Functionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The impact of weight cycling on health outcomes in animal models: A systematic review and meta‐analysis

et al. 2022

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“…Specifically, adjusted regression models in a retrospective analysis of electronic health records from patients with a history of obesity who had either maintained their current weight (i.e. not lost weight), lost >5% of body weight and subsequently regained weight, or lost and maintained >5% of their body weight, revealed that achieving a weight loss of 5–10% reduces T2D risk and lowers HbA1c, and that weight loss of 10–15% improves blood pressure and reduces plasma LDL and increases HDL [ 16 ]. Weight loss of >20% is generally observed with bariatric surgery and is further associated with decreased risk of cancer and increased life expectancy by up to 3 years [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

Targeting skeletal muscle mitochondrial health in obesity

et al. 2022

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Metabolic demands of skeletal muscle are substantial and are characterized normally as highly flexible and with a large dynamic range. Skeletal muscle composition (e.g., fiber type and mitochondrial content) and metabolism (e.g., capacity to switch between fatty acid and glucose substrates) are altered in obesity, with some changes proceeding and some following the development of the disease. Nonetheless, there are marked interindividual differences in skeletal muscle composition and metabolism in obesity, some of which have been associated with obesity risk and weight loss capacity. In this review, we discuss related molecular mechanisms and how current and novel treatment strategies may enhance weight loss capacity, particularly in diet-resistant obesity.

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“…9,10 A review of electronic health record (EHR) data for over 6,000 patients with obesity discovered that those with >15% versus <7% weight loss in a 2-yr index period had less than half the risk of developing type 2 diabetes at 10-yr follow-up. 11…”

Section: Introductionmentioning

confidence: 99%

Communicating risk of diabetes to patients results in lower incidence at 1- and 3-year follow-up and improved preventive intervention

Bailey‐Davis¹,

Wood²,

McCabe

et al. 2022

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ObjectiveOne-third of American adults are estimated to have prediabetes but the vast majority are unaware. Accordingly, persons with prediabetes are equally unaware of their personal susceptibility of developing type 2 diabetes and the impact of weight loss on reducing the risk of progression. The primary aim of this study was to demonstrate that raising awareness of present risk, risk reduction, and offering available, accessible preventive interventions would result in fewer incidences of type 2 diabetes at 1- and 3-year follow-up periods. Secondary aims included clinician use of a novel diabetes risk calculator in primary care indicated by the proportion of patients being offered a preventive intervention.MethodsIn this single-arm study, persons with prediabetes from three primary care sites received a letter that communicated their personalized risk of progression to diabetes within three years; estimated risk reduction with 5, 10, 15% weight loss, reported in pounds, representing data illustrated in the diabetes risk calculator; and offered a choice of five free, 6-month, programs. Progression to type 2 diabetes was evaluated at 1- and 3-year follow-up periods using electronic health record data. Comparisons are made between the active participants and the non-respondent group. The diabetes risk calculator was implemented in 53 primary clinics in July 2020 and viewable in the electronic health record of persons with prediabetes without the need for clinician action. Electronic health record data were used to evaluate the rate of clinicians offering or referring persons with prediabetes to a preventive intervention—these rates of referral were compared between two phases (pre-implementation: 8/2019-2/2020; early implementation: 8/2020-2/2021).ResultsPersons with prediabetes (N=328) received letters and n=83 responded to the invitation to choose a preventive intervention (treatment). Follow-up data were available for n=55 treatment and n=169 non-respondents at 1- and 3-years. At 1-year follow-up, 2% of treatment and 20% of non-respondents developed type 2 diabetes (p<0.0001) and at 3-year follow-up, 25% of treatment and 42% of non-respondents developed diabetes (p=0.038). In the early implementation phase, N=8,771 persons had prediabetes, 0.4% received care, and 10.7% received a referral whereas in the pre-implementation phase, N=9,638 persons had prediabetes, 0.3% received care (p=0.088), and 9.7% were referred (p=0.029).ConclusionProgression to type 2 diabetes was halted at 1- and 3-year follow-up for a significantly higher proportion of persons who received diabetes risk calculator results and initiated a preventive intervention compared to those who did not. In the early implementation phase, clinicians referred a higher proportion of persons with prediabetes to preventive intervention when presented with diabetes risk calculator results as compared the pre-implementation period.

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Impact of Sustained Weight Loss on Cardiometabolic Outcomes

Cited by 21 publications

References 28 publications

The impact of weight cycling on health outcomes in animal models: A systematic review and meta‐analysis

The impact of weight cycling on health outcomes in animal models: A systematic review and meta‐analysis

Targeting skeletal muscle mitochondrial health in obesity

Communicating risk of diabetes to patients results in lower incidence at 1- and 3-year follow-up and improved preventive intervention

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