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Does Short-Term Weight Loss Reduce Cardiovascular Risk?



sharma-obesity-weight-gainIf you believe recent media headlines describing the findings of a paper published in The Lancet last week, you may be convinced that any weight loss – even if you don’t keep the weight off – reduces your risk for cardiovascular disease.

The study, reports on the relationship between lifelong patterns of BMI and cardiovascular risk a 60-64 year-old British  birth cohort born in 1946.

Participants were classified as normal weight or overweight or obese based on heights and weights measured during childhood (at ages 2, 4, 6, 7, and 11 years) and adulthood (at ages 36, 43, 53 and 60–64 years).

As may be expected, various measures of cardiovascular and metabolic risk factors were positively related to extent and duration of adiposity.

There were, however, two findings that may seem rather unexpected:

Firstly, adiposity in childhood did not seem to matter as a predictor of CV risk in adulthood.

Secondly, it appeared that individuals who dropped at least one BMI category at any time during adulthood, irrespective of whether or not this weight loss was maintained, had lower cardiovascular (but not diabetes) risk than did those who never lost weight.

From these findings the authors conclude that,

…cardiovascular benefit might arise from weight loss in adulthood, irrespective of when this weight loss is achieved, and support public health policies for lifestyle modifications for prevention and management of overweight and obese individuals at all ages.

While it is easy to see why sustaining weight-loss as an adult (particularly if you have risk factors for cardiovascular disease) may well be beneficial, it is hard to imagine a plausible biological pathway that would link a “short-term” weight loss to long-term improvements in cardiovascular risk.

Indeed, the authors provide no explanation for their findings. They also provide no further information on the people who lost weight compared to the people who did not.

My first response would be to look for biological plausible confounders – were people who lost weight at anytime as adults perhaps more conscious or concerned about their health than those who did not? Or, were they more metabolically healthy to start with?

Let us also not forget that this was merely an observational study – association does not prove causality.

This is not to say that the findings are entirely implausible. There is some literature on the long-term “legacy effect” of lifestyle interventions on metabolic risk factors – but the biological basis for this is unknown and some colleagues doubt wether this effect really exists.

Given that weight regain is rather common after weight loss, it will be interesting to see if other studies can demonstrate lasting benefits of short-term weight loss.

At this time some scepticism may well be warranted.

@DrSharma
Edmonton, AB

7 Comments

  1. Speaking of wt loss and then wt gain…..why oh why does it happen and how can it be avoided?????

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  2. That’s interesting that obesity in childhood was not a predictor of CVD for them. I also wonder what the biological reasoning for the reduction of CVD could be. There definitely needs to be more research done to find out.

    Thanks for sharing!

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  3. @LizLS Weight loss followed by weight gain is usually due to the individual “burning out” and falling back into old, bad habits. What happens is they see some results, but they are working so hard and eating so little they kind of snap, and go right back to their old habits, often worse than before. I see it a lot when people try to lose absurd amounts of weight in a short period of time, like 10lbs in a week. I actually wrote a guide on the best way to lose that amount of weight but in the best way possible to reduce any risks or health complications, read it here: http://healthylivingtomorrow.com/how-to-lose-10lbs-in-a-week/

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  4. I was forced to lose a large amount of weight and completely change my life because of steadily progressing health issues, including high cholesterol, heart rate irregularities, high blood pressure, shortness of breath, the list goes on.

    Up until last year, I was just over 315 pounds. Then I dropped 106 pounds by completely changing all my habits. My first change was switching to a high protein diet, balanced out with complex carbohydrates. This change alone helped me drop 48 pounds in the first month.

    At the same time, I gradually started to incorporate fitness. 5 days a week, 1 hour a day. Both strength training and cardio. That’s where I lost another 33 pounds.

    After a while I added supplements and dropped another 25 pounds of pure fat (and probably water, too). The biggest help has been a product called BELDT which is major energy (and mood) booster plus fat burner. It’s amazing for the price (got it here http://amzn.to/1odSEH5 ). I’m also using Optimum Nutrition protein ( http://amzn.to/1mfKU4d ) between meals to keep my carb-to-protein ratios balanced. In the beginning, I used glutamine to help recover from my workouts faster, but I sort of dropped it from my routine toward the end (can find link to one I used).

    I still pretty much maintain the same routine, but it’s fine because I enjoy it. It’s not an effort to get up and go workout anymore because the pleasure that comes with it now is so ingrained I can’t NOT get up and go workout!

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  5. “Short-Term” is a devastating word in the fat-loss endeavor. The immediate benefits are much less with the actual fat-loss and more to do with other events associated w/eating less. At any rate, I’ve included a link to a report addressing long-term fat loss.

    http://bit.ly/1haM5PT

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  6. I wonder if the people with less CV risk developed good habits while losing weight, and kept those habits (or some of them) even when they gained the weight back. They might be back at their heaviest weight, but maybe they walk several times a week instead of not at all, or they eat differently than they did before they started to lose the weight.

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  7. @LizLS

    It happens because weight loss dieting merely interrupts our bodies self regulation. It’s a bit like writing in the sand. The inevitable motion of the tide washes it away. It’s nothing personal.

    The way to avoid it is to find a way to alter weight that shifts its underlying basis of creation or intervening where a chain reaction can be started.

    Everything’s failed thus far because the inevitable tide of homeostasis washing it away.

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