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Weight change and risk of 13 obesity-related complications

Benefits on 13 obesity-related complications are dependent on both magnitude of weight change and initial BMI.

Photo by Diana Polekhina on Unsplash

This study used data from the UK Clinical Practice Research Database to assess the effects of different degrees of weight loss or gain (10% or 20%), as related to baseline BMI, and the risk of complications in people with obesity. The 13 obesity-related comorbidities were:

  • Endocrine/metabolic: Type 2 diabetes, hypertension, dyslipidaemia and polycystic ovary syndrome (PCOS).
  • Biomechanical: Sleep apnoea, asthma and hip/knee osteoarthritis.
  • Cardiovascular: Heart failure, chronic kidney disease (CKD), atrial fibrillation, venous thromboembolism (VTE) and unstable angina/myocardial infarction (MI).
  • Mental health: Depression.

Weight was compared between baseline and 2­–4 years later, and obesity complications were recorded over a median follow-up of 7.3 years thereafter. A total of 418 774 participants with a BMI between 30 and 50 kg/m2 were analysed. The median weight change over the initial 4-year follow-up was +0.9%.

The impact of weight change on obesity complications was generally dependent on baseline BMI, with four distinct patterns identified:

  • Type 2 diabetes, sleep apnoea, hypertension and dyslipidaemia benefited from weight loss in all baseline BMI categories, but the greatest benefits were seen in those with a lower baseline BMI.
  • Asthma, hip/knee osteoarthritis and PCOS showed a weight loss benefit at a lower baseline BMI but not benefit in those with higher baseline BMI.
  • CKD, heart failure, atrial fibrillation and VTE showed benefit with weight loss up to 10% but no further benefit from greater weight loss.
  • Angina/MI and depression showed no clear relationship with weight change.

Similar but opposite patterns were observed with weight gain.

The authors conclude that benefits on obesity-related complications are dependent on weight loss magnitude and initial BMI, while weight gain is associated with similar risk increases. The four distinct patterns may support clinicians in taking a more individualised approach for obesity management.

Click here to read the study in full.

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