Chopping Veggies

Which Health Risks Drop Most After Weight Loss?

ECOICO 2020 is now one more milestone in our COVID diary of virtual meetings. It has been a week that quickly became a blur of many new findings and insights from diverse cultures around the world all grappling with the wicked problem of obesity. But one of the most memorable is an analysis of health risks after intentional weight loss. That’s because it offers solid insight for a key question. When a person with obesity maintains a healthier weight status, which health risks improve?

Clinical Practice Records in the UK

To answer this question, a team of health researchers from Novo Nordisk examined more than half a million UK patient records. These were all records of people living with various degrees of obesity. Also, they had evidence in their records that they were trying to lose weight. After four years, roughly ten percent of these patients had indeed lost weight and maintained a weight that was 10 to 25 percent lower than their initial weight.

The answers are not surprising. The biggest risk reduction came in type 2 diabetes, blood pressure, and cholesterol. For sleep apnea, the data suggested some reductions, but some risks remained. The story was similar for osteoarthritis. In the case of unstable angina and heart attacks, these data provided no evidence for a benefit.

Real World Outcomes

Christiane Haase led this research and explained its significance:

Our results demonstrate the benefits of intentional weight loss in reducing the health burdens of obesity in real-world clinical practice. It is important to emphasise that this is an observational study and can only show that there is an association between weight loss and reduced cardiovascular risk factors, not that weight loss causes that reduction in risk.

Nevertheless, the difference in the risk of these conditions is striking and indicates that people with obesity could markedly reduce their disease risk through intentional weight loss. What we need to focus on now is how we can support healthy, evidence-based approaches to losing weight and how best to maintain any weight loss achieved.

Outcomes for Specific Therapies

These data tell us that successful weight loss has a robust link to lower health risks – especially for cardiometabolic risk. We’ll be eager to see them published in greater detail after peer review.

But the research doesn’t tell us how to get there. These are observational data and they mainly speak to risk factors. Not major health outcomes. How can we best extend and improve the lives of people with obesity? The answers continue to come in small increments.

Click here for further perspective on this research and here for other recent insights on health outcomes after weight loss.

Chopping Veggies, photograph © World Obesity / Obesity Image Bank

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September 5, 2020

2 Responses to “Which Health Risks Drop Most After Weight Loss?”

  1. September 06, 2020 at 3:18 pm, Richard Atkinson said:

    It is unfortunate that this study done by Novo Nordisk danced around the current treatment of obesity and appears to be recommending lifestyle changes when only about 10% of patients had been able to keep off a 10% or more weight loss at four years. Some of Novo Nordisk’s drugs appear to do better than that if continued (of course drugs do nothing if they are not taken). A healthy diet is very important for a healthy life, but thousands of studies show that diet (and exercise) alone are inadequate for successful, long term weight loss. When will we treat obesity as a real disease and recommend drugs as a first line of treatment – as we do with diabetes and hypertension, both of which respond very well for the short term with the exact diet and exercise programs we prescribe for obesity? Obese Lives Matter and yet we continue to discriminate against obesity in our medial approach.

    • September 06, 2020 at 3:40 pm, Ted said:

      Richard, I certainly agree that people with obesity should receive treatment as needed with all available options. Also, you are right that the results with even intensive behavioral therapy alone are often inadequate. However, I believe that this study was not specific to any one type of therapy. Rather, it looked at that minority of patients with obesity who intentionally lost weight and maintained a healthier weight for four years. If you know that patients who received pharmacotherapy and surgery were excluded, I’d be eager to hear more. Neither the study abstract nor the news release says so. For patients to maintain a weight loss of 13 to 25 percent for four years with only behavioral therapy would really surprise me.