Losing weight, even if you gain a few pounds back, can help your heart in the long run, according to a study published Tuesday in the journal Circulation: Cardiovascular Quality and Outcomes.
The findings may be good news for those who found weight maintenance difficult and feared the risks thought to be associated with regaining the weight.
In the new study, the researchers analyzed data from 124 clinical trials with a total of more than 50,000 participants. They found that risk factors for heart disease and type 2 diabetes decreased for people who lost weight through intensive behavioral programs. The decreased risk persisted for years after the programs ended, even if some but not all of the weight was regained.
«As long as your weight is lower than it otherwise would have been, your risk factors for heart disease are lower than they would have been,» said co-author Susan Jebb, a professor of diet and population health at the University of Oxford in the United Kingdom, he said in an email.
In the US, 2 out of 5 adults are obese, according to the Centers for Disease Control and Preventionand heart disease is the number 1 cause of death, with 697,000 people died from the disease in 2020.
The new analysis included trials that looked at the impact of behavioral weight-management programs (those that provided, for example, counseling, training, and education) on heart disease risk factors and had follow-up periods of at least one year. The median follow-up of the trials was 28 months.
The included studies compared people who participated in such intensive weight loss programs with those who followed less intensive programs or no programme. Studies in the analysis included diet or exercise interventions or both, partial or full meal replacement, intermittent fasting, or financial incentives contingent on weight loss.
The researchers found that the average weight loss in the included studies was 5 to 10 pounds, while the average weight regain was 0.26 to 0.7 pounds per year. The participants’ average age at the start was 51, and their average body mass index was 33, meaning they were obese.
Compared to control groups, those in intensive programs improved in several heart disease risk factors:
- Systolic blood pressure, on average, was 1.5 points lower one year later and still 0.4 points lower five years later. (Systolic pressure is the top number in a blood pressure reading.)
- HbA1c, an indicator of a person’s blood sugar level over the previous three months, decreased with weight loss and, although it began to rise again with weight regain, was still better compared to the control group one year and five years after completing the studies. .
- The ratio of total cholesterol to HDL cholesterol, an indicator of LDL cholesterol levels, improved with weight loss, although those improvements were smaller as people regained weight.
Jebb acknowledged that improvements with weight loss start to reverse as a person gains weight back, but «at least you’ve reduced the metabolic load on your body for a period of time,» adding: «That may be enough to delay the onset of diabetes, for example, which has great benefits for the heart”.
The overall findings suggested that the risk of developing diabetes or having a heart attack was also reduced, but there is less information about this, «because most trials don’t follow up for a long time,» Jebb said.
A subset of the studies that looked at the risk of being diagnosed with heart disease or type 2 diabetes found that people in intensive programs had a lower risk compared to those in control groups. And the risk remained lower even after the weight gain.
Dr. Sean Heffron, a preventive cardiologist and assistant professor of medicine at NYU Langone and the NYU Center for Cardiovascular Disease Prevention, agreed that what is still needed is information about the long-term impact on «outcomes that we really care.» : heart attack, stroke and death.”
“The people in this study were relatively young, and it takes a long time for them to die” of heart disease, he said.
Still, the findings «support what we see clinically with a number of cardiovascular risk factors,» said Heffron, who was not involved in the new research. «They are quite responsive to weight loss, even when the amounts are not large.»
Dr. Matthew Tomey, an interventional cardiologist and assistant professor of medicine and cardiology at the Icahn School of Medicine at Mount Sinai in New York, compared episodes of weight loss to putting money into a bank account.
Weight loss at any point in life leads to gains through improvements in risk factors, and that «is a health-promoting investment that can be rewarded,» said Tomey, who was not involved in the study. investigation. “The reality is that it can be very difficult to achieve and maintain a target body weight. That doesn’t mean one should give up the search.»