Weight loss and risk reduction of obesity-related outcomes in 0.5 million people: evidence from a UK primary care database

Abstract

High body mass index (BMI) is known to be associated with various conditions, including type 2 diabetes (T2D), osteoarthritis, cardiovascular disease (CVD) and sleep apnoea; however, the impact of intentional weight loss on the risk of these and other outcomes is not well quantified. We examined the effect of weight loss on ten selected outcomes in a population from the UK Clinical Practice Research Datalink (CPRD) GOLD database. Included individuals were >18 years old at the index date (first BMI value between January 2001 and December 2010). They were categorised by their weight pattern between year 1 post-index and year 4 post-index (baseline period) as having stable weight (−5% to +5%) or weight loss (−25% to −10%, plus evidence of intervention or dietary advice to confirm intention to lose weight). For inclusion, individuals also required a BMI of 25.0–50.0 kg/m2 at the start of the follow-up period, during which the occurrence of ten obesity-related outcomes was recorded. Cox proportional hazard models adjusted for BMI, comorbidities, age, sex and smoking status were used to estimate relative risks for weight loss compared with stable weight. Individuals in the weight-loss cohort had median 13% weight loss. Assuming a BMI of 40 kg/m2 before weight loss, this resulted in risk reductions for T2D (41%), sleep apnoea (40%), hypertension (22%), dyslipidaemia (19%) and asthma (18%). Furthermore, weight loss was associated with additional benefits, with lower risk of T2D, chronic kidney disease, hypertension and dyslipidaemia compared with maintaining the corresponding stable lower BMI throughout the study. This study provides objective, real-world quantification of the effects of weight loss on selected outcomes, with the greatest benefits observed for the established CVD risk factors T2D, hypertension and dyslipidaemia.

Understanding the link between obesity and headache- with focus on migraine and idiopathic intracranial hypertension

“…Obesity is a disease on pandemic proportions, affecting over 650 million individuals worldwide, where the prevalence is highest in the developed world and is associated with low socio-economic status [5]. Obesity is associated with excess adiposity and increases the risk of developing serious comorbidities including type 2 diabetes mellitus, cancer, musculoskeletal diseases, cardiovascular diseases, metabolic syndrome, mental health issues and premature death [2,3,6]. However, obesity is a modifiable disease where BMI reduction confers improvement of the comorbid conditions and can be curative [6].…”

“…Obesity is associated with excess adiposity and increases the risk of developing serious comorbidities including type 2 diabetes mellitus, cancer, musculoskeletal diseases, cardiovascular diseases, metabolic syndrome, mental health issues and premature death [2,3,6]. However, obesity is a modifiable disease where BMI reduction confers improvement of the comorbid conditions and can be curative [6].…”

Reduction of Major Adverse Cardiovascular Events (MACE) after Bariatric Surgery in Patients with Obesity and Cardiovascular Diseases: A Systematic Review and Meta-Analysis

“…Weight reduction, either through a surgical or non-surgical approach, has been shown to have positive effects on CV physiology. A study by Haase and colleagues [41] reported that a 13% reduction of body weight in patients with obesity significantly reduced CVD risks, including diabetes, hypertension and dyslipidemia. Moreover, studies also showed that patients with obesity who lost their weight had lower systolic blood pressure, HbA1c, low-density lipoprotein (LDL), triglycerides and CRP, and a higher high-density lipoprotein (HDL) [41,42].…”

Reduction of Major Adverse Cardiovascular Events (MACE) after Bariatric Surgery in Obese Patients with Cardiovascular Diseases: A Systematic Review and Meta-Analysis

“…Weight reduction, either through surgical or non-surgical approach, has been shown to have positive effects on CV physiology. A study by Haase and colleagues (33) reported that a 13% reduction of body weight in obese patients significantly reduced CVD risk, including diabetes, hypertension and dyslipidemia. Moreover, studies also showed that obese patients who lost their weight had lower systolic blood pressure, HbA1c, low-density lipoprotein (LDL), triglycerides and CRP, and a higher high-density lipoprotein (HDL) (33, 34).…”

“…A study by Haase and colleagues (33) reported that a 13% reduction of body weight in obese patients significantly reduced CVD risk, including diabetes, hypertension and dyslipidemia. Moreover, studies also showed that obese patients who lost their weight had lower systolic blood pressure, HbA1c, low-density lipoprotein (LDL), triglycerides and CRP, and a higher high-density lipoprotein (HDL) (33, 34). Non-surgical approaches, such as lifestyle/diet modifications and pharmacological intervention, are the primary managements of obesity.…”