Unaffected by the approach or strategy used, a study involving nearly 200,000 participants found that people with obesity who intentionally lose weight can boost their long-term health. Lean people did not benefit from weight loss initiatives, which were linked to longer-term weight increase and higher risks of type 2 diabetes.
Those who lost more than 4.5 kg had reduced risks of type 2 diabetes and less weight gain than those who did not lose weight.
The research is publishing September 27 in the open-access journal PLOS Medicine.
Obesity can lead to higher risks of diseases including type 2 diabetes. Although long-term weight change and the likelihood of acquiring type 2 diabetes are not fully understood, controlling weight can be a useful strategy for preventing and managing obesity and related disorders.
Healthy participants from three prospective cohort studies from 1988 to 2017 were enrolled by Qi Sun and colleagues from the TH Chan Harvard School of Public Health in the United States.
People in the cohorts ranged in age from 24 to 78, with a female predominance of 11.6% and a male predominance of 14.2%. They grouped methods that led to weight loss of more than 4.5kg into seven categories: low-calorie diet, exercise, low-calorie diet plus exercise, fasting, commercial weight loss program, diet pills and a combination of fasting, commercial and diet pills (FCP).
However, we now know that such observations are supported by biology that unfortunately entails adverse health outcomes when lean individuals try to lose weight intentionally. Good news is that individuals with obesity will clearly benefit from losing a few pounds and the health benefits last even when the weight loss is temporary.Qi Sun
Exercise was most beneficial for long-term weight control and prevention in obese persons and was linked to the least amount of weight gain after four years, with average weight loss in obese adults of 4.2%, overweight individuals of 2.5%, and lean individuals of 0.4%. This was inverted for FCP, which saw individuals with obesity sustaining 0.3% weight loss, overweight people sustaining 2% more weight gain, and lean individuals 3.7% more weight gain.
24 years later, diabetes risk was decreased for obese people regardless of weight loss method, ranging from a 21% reduction with exercise to a 13% reduction with diet pills.
All weight loss was linked to an increased risk of type 2 diabetes in lean individuals, ranging from a 9% increase for exercise to a 54% increase for pills or FCP. For overweight individuals, the researchers observed a range of 9% reduction in type 2 diabetes risk for exercise to an increase of 42% risk for those who took pills.
The authors come to the conclusion that while weight loss can be advantageous for those who are overweight and obese, weight loss procedures do not yield the same benefits for those who are lean, and they should only be utilized by those who have a medical need for them.
“We were a bit surprised when we first saw the positive associations of weight loss attempts with faster weight gain and higher type 2 diabetes risk among lean individuals,” Sun adds.
”However, we now know that such observations are supported by biology that unfortunately entails adverse health outcomes when lean individuals try to lose weight intentionally. Good news is that individuals with obesity will clearly benefit from losing a few pounds and the health benefits last even when the weight loss is temporary.”