Researchers have examined how different levels of long-term weight loss impact cardiometabolic health, revealing that even modest weight changes bring benefits, according to a recent study published in the European Journal of Preventive Cardiology.
Weight loss is widely accepted as a key factor in reducing risks for type 2 diabetes, cardiovascular disease, hypertension, and related mortality. Losing at least 5% of body weight typically improves important health markers such as body fat, waist circumference, HDL cholesterol, and blood pressure. However, sustaining weight loss remains a major challenge, with many individuals regaining lost weight within one to five years. Responses to lifestyle interventions vary greatly due to behavioral, metabolic, and genetic factors, often resulting in early success followed by weight regain or plateau.
The study pooled data from three long-term lifestyle weight loss trials, each employing different dietary and behavioral approaches but showing similar trends in weight change and health outcomes. Participants were divided into three groups based on weight loss: those losing more than 5% (successful), between 0% and 5% (moderate), and no loss or gain (resistant). Measurements included body metrics, blood pressure, fasting blood tests, and, in two trials, MRI scans assessing visceral fat and liver fat. Data were collected at baseline, six months, and the study’s end (18 or 24 months).
Researchers also conducted a sub-study analyzing baseline biological data—DNA methylation, proteomics, and metabolomics—to identify predictors of weight loss success. Advanced statistical models showed limited predictive power, with only a few DNA methylation regions moderately linked to outcomes, indicating that these markers are not yet ready for clinical application.
Key findings revealed that while weight loss resistant individuals were generally younger and more often female, after adjustments these differences were largely insignificant. Resistant participants showed some health improvements, such as increased HDL cholesterol and reduced visceral fat, but also experienced rises in total cholesterol and fasting glucose. Moderate weight loss led to broader benefits including lower blood pressure, triglycerides, liver fat, and insulin levels. Those with successful weight loss exhibited the most pronounced improvements across nearly all cardiometabolic markers.
Notably, each kilogram of weight loss corresponded with significant positive changes in HDL cholesterol, blood pressure, insulin resistance, triglycerides, leptin, and liver fat. These effects persisted after accounting for trial differences and demographic factors, with no variation between sexes.
The study underscores that sustained weight loss, even in small amounts, meaningfully enhances cardiometabolic health. Importantly, individuals who did not lose weight still gained some health benefits, highlighting lifestyle changes’ value beyond weight reduction alone. However, some risk factors worsened in this group, suggesting mixed effects and the need for cautious interpretation.
Strengths of the study include comprehensive data integration, robust statistical analyses, and high participant adherence. Limitations involve the predominance of male subjects (about 89%), restricting generalization to women, and a lack of intervention-specific analysis.
The findings reinforce lifestyle interventions as a cornerstone of cardiovascular disease prevention and provide clinicians with evidence-based guidance. Future research should focus on more diverse populations and further explore biological markers to tailor weight loss strategies. Meanwhile, maintaining healthy behaviors remains vital, regardless of weight loss success.
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