Incremental weight loss improves cardiometabolic risk in extremely obese adults.

Abstract

OBJECTIVE:

Excessively obese adults often acquire many metabolic disorders that put them at high risk for developing type 2 diabetes mellitus and cardiovascular disease. We investigated the hypothesis that cardiometabolic risk in a primary care cohort of 208 excessively obese adults (body mass index 40-60 kg/m(2), 48 with type 2 diabetes mellitus) would deteriorate with additional weight gain and improve incrementally beginning with 5% weight reduction.

METHODS:

Further analysis of the Louisiana Obese Subjects Study of excessively obese patients enrolled and followed during 2005-2008 is reported.

RESULTS:

Weight loss correlated significantly with improvements in fasting plasma glucose, triglycerides, high- and low-density lipoprotein cholesterol, uric acid, alanine aminotransferase, lactate dehydrogenase, and high-sensitivity C-reactive protein. Most parameters deteriorated with weight gain and progressively improved with 5% or more weight loss. Except for low-density lipoprotein cholesterol, all risk factors significantly improved with ≥ 20% loss of body weight. Among patients who had not been diagnosed with type 2 diabetes mellitus and had normoglycemia at baseline, median fasting plasma glucose increased significantly (13%) with stable or gained weight at 1 year, but did not change significantly with reduced weight. Although glucose levels did not change significantly in patients with type 2 diabetes mellitus who gained weight, a decline beginning after 5% weight reduction culminated in 25% glucose reduction with ≥ 20% weight loss. Resting blood pressure declined independently of weight change.

CONCLUSION:

Very obese adults can improve their cardiometabolic risk under primary care weight management. Incremental success may help motivate further therapeutic weight reduction.

• Authors: William D Johnson, Meghan M Brashear, Alok K Gupta, Jennifer C Rood, Donna H Ryan
• Journal: The American journal of medicine (Am J Med) Vol. 124 Issue 10 Pg. 931-8 (Oct 2011) ISSN: 1555-7162 [Electronic] United States
• PMID: 21962313 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2011 Elsevier Inc. All rights reserved.

Chemical References

• Blood Glucose

Topics

• Adult
• Aged
• Blood Glucose
• Blood Pressure
• Cardiovascular Diseases (prevention & control)
• Diabetes Mellitus, Type 2 (complications)
• Female
• Humans
• Male
• Middle Aged
• Obesity (complications, metabolism)
• Obesity, Morbid (complications, metabolism)
• Weight Loss (physiology)