Could Sustained Weight Loss Decrease CV Risks in Patients with Obesity and Diabetes?

A new study suggests that patients who are obese, or overweight, and have diabetes are able to maintain weight loss for 5 years if they lost and sustained 7% or more in the first year.

The researchers evaluated 129 obese patients with diabetes who were enrolled in the 12-week Weight Achievement and Intensive Treatment program (WAIT). Participants were divided into group A or group B after 1 year according to their ability to maintain weight loss, and researchers followed up with participants for a total of 5 years. Group A included participants who maintained less than 7% of their weight loss within the first year (43.7%), and group B included participants who maintained 7% or more of their weight loss (52.7%).
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In addition, researchers measured A1C, lipid profile and direct low-density lipoprotein (LDL)-cholesterol, BP, serum creatinine, blood urea nitrogen (BUN), and urinary microalbumin and creatinine ratios before and after the 12-week intervention, and every 3 to 6 months during regular visits for 5 years.

Overall, participants lost 23.8 lbs in 12 weeks and had maintained 16.2 pounds at the 5-year follow-up. Participants in group A maintained -8.4 pounds, and participants in group B maintained -21.3 pounds of the initial weight loss at 5 years.

Group A participants' A1C at 12 weeks decreased from 7.5±1.3% to 6.7±0.9%, increased to 7.7±1.4% at 1 year, and rose again to 8.0±1.9% at 5 years. Improved low-density lipoprotein-cholesterol and high-density lipoprotein-cholesterol were maintained by group A, blood pressure did not change, but serum triglycerides worsened.

Group B participants' A1C decreased from 7.4±1.2% to 6.4±0.9%, at 1 year rose to 6.8±1.2%, and rose again to 7.3±1.5% at 5 years. The lipid profiles for group B improved for 5 years, and blood pressure decreased in participants for 18 months.

The findings indicate that patients were able to maintain a total of 6.4% weight loss 5 years after the WAIT program independently, and that patients who lost and sustained 7% or more in 1 year were more likely to maintain their weight after 5 years. Likewise, cardiovascular risk factors improved in both groups. However, the improvements disappeared over time, but at a slower pace for participants who were able to sustain 7% or more weight loss.

—Melissa Weiss

Reference:

Hamdy O, Mottalib A, Morsi A, et al. Long-term effect of intensive lifestyle intervention on cardiovascular risk factors in patients with diabetes in real-world clinical practice: a 5-year longitudinal study [published online January 4, 2017]. BMJ Open Diabetes Research & Care. doi:10.1136/bmjdrc-2016-000259.