Maintaining weight loss associated with more favorable heart disease, stroke, and diabetes risk factors

People who lose weight and keep it off can stabilize or even improve their cardiometabolic risk factors compared to people who regain weight, according to a new study by Tufts University in Boston, Massachusetts and published in the Journal of the American Heart Association.

The study used data from the Look AHEAD trial, a multicenter controlled clinical trial assessing the association between weight loss and cardiovascular disease risk in individuals with obesity and type 2 diabetes.

After a successful one-year intensive lifestyle weight-loss intervention, maintaining the weight loss, as opposed to regaining it, was better for all cardiometabolic risk factors assessed three years later, including HDL cholesterol, triglyceride, fasting glucose and glycated hemoglobin concentrations, blood pressure, and waist circumference.

"Regaining weight was associated with a reversal of the benefits seen from losing weight," said Alice Lichtenstein, DSc, senior and corresponding author of the study in a statement. "If you lose weight and maintain the weight loss for a long period of time, do the benefits continue? The answer is yes and sometimes the benefits get even stronger. If you lose weight and don't maintain it, the benefits are diminished or disappear. These findings emphasize the dual importance of not only achieving a heathy body weight but maintaining a healthy body weight."

The team also sought to identify the point distinguishing "maintaining" from "regaining" and at what percentage the cardiometabolic risk benefits of weight loss were diminished but found no clear point of demarcation. Few studies have directly compared successful weight loss maintenance with weight regain, in part because no standardized definition for successful weight-loss maintenance exists.

"What we need to focus on now is how we can support not only healthy approaches to losing weight but healthy approaches to helping those who are successful in losing weight maintain the weight loss,” said Lichtenstein. “The latter may be the most challenging.”