Evaluation of weight change and cardiometabolic risk factors in a real-world population of US adults with overweight or obesity

Mar 30, 2023Preventive medicine

Weight changes and heart-related health risks in US adults with overweight or obesity

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Abstract

Among 882,712 individuals with BMI ≥25 kg/m, 52% maintained stable weight over 2 years.

Only 1.3% of participants used weight loss medications during this period.
Weight loss of 10% was linked to a small but significant reduction in systolic blood pressure by -2.69 mmHg.
Diastolic blood pressure decreased by -1.26 mmHg with the same level of weight loss.
Low-density lipoprotein cholesterol dropped by -2.60 mg/dL following a 10% weight loss.
Glycated hemoglobin levels decreased by -0.27% with the same weight loss, but these benefits were not maintained in the following year.

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Whether individuals in real-world settings are able to lose weight and improve cardiometabolic risk factors over time is unclear. We aimed to determine the management of and degree of body weight change over 2 years among individuals with overweight or obesity, and to assess associated changes in cardiometabolic risk factors and clinical outcomes. Using data from 11 large health systems within the Patient-Centered Outcomes Research Network in the U.S., we collected the following data on adults with a recorded BMI ≥25 kg/mbetween January 1, 2016 and December 31, 2016: body-mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDLC), triglycerides and glycated hemoglobin (HbA1c). We found that among 882,712 individuals with BMI ≥25 kg/m(median age 59 years; 56% female), 52% maintained stable weight over 2 years and 1.3% utilized weight loss pharmacotherapy. Weight loss of 10% was associated with small but significant lowering of mean SBP (-2.69 mmHg [95% CI -2.88, -2.50]), DBP (-1.26 mmHg [95% CI -1.35, -1.18]), LDL-C (-2.60 mg/dL [95% CI -3.14, -2.05]), and HbA1c (-0.27% [95% CI -0.35, -0.19]) in the same 12 months. However, these changes were not sustained over the following year. In this study of adults with BMI ≥25 kg/m, the majority had stable weight over 2 years, pharmacotherapies for weight loss were under-used, and small changes in cardiometabolic risk factors with weight loss were not sustained, possibly due to failure to maintain weight loss. 2 2 2

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Evaluation of weight change and cardiometabolic risk factors in a real-world population of US adults with overweight or obesity

Abstract

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