Losing weight in midlife may lower your long-term risk of diabetes, study finds

Losing weight in midlife may lower your long-term risk of diabetes, study finds

A decades-long study shows that shedding the extra weight in midlife without medication or surgery could reduce your risk of serious illness and help you live longer.

Study:Midlife weight loss, chronic disease incidence and all-cause mortality during longer follow-up. Photo credit: goffkein.pro/shutterstock.com

A recent paper published in the journal Jama Network Open examined the benefits of sustained weight loss throughout life and beyond the established reduction in diabetes risk.

introduction

Morbid obesity is treated both medically and surgically. Newer medications such as glucagon-like peptide one receptor agonist (GLP-1 RAS) and bariatric surgery induce significant weight loss. While these reduce chronic illness and death risks, they form their risks.

Overweight and obese people reduce their risk of diabetes mellitus when they lose weight. The change in risk of other chronic diseases is still unclear, possibly due to poor study design and insufficient study times. For example, reduced cardiovascular and total mortality after six years of lifestyle changes may manifest only three decades later.

The current study looked at healthy people in their 40s and 50s (midlife) who lost weight, as measured by changes in their body mass index (BMI), without pharmacological or surgical interventions. Their risk of chronic disease and/or death has been measured over several decades.

The study included 23,149 adults from three cohorts with height and weight measured over 12-35 years. These were the Whitehall II Study of 1985-1988 (WHII), the Helsinki BusinessMen Study (HBS) of 1964-1973 and the Finnish Finnish Public Sector Study (FPS).

They were divided into four groups: those with a stable BMI at <25 (persistent healthy weight), those with a BMI changing from 25 or more to <25 (weight loss), BMI changing from <25 to 25 or more (weight gain), and those who had a stable BMI at 25 or more (persistent overweight).

Study results

Overall, overweight adults who lost enough weight to get healthy and kept it off had a lower risk of chronic disease. This was independent of the change in type 2 diabetes risk. They also had a lower risk of death from all causes compared to those who remained overweight.

In the WHII and HBS cohorts, BMI trajectories remained stable until ages 66 and 80, respectively. Approximately 5% and 9% of participants, respectively, were classified as obese (BMI ≥ 30) at one or both early assessments, indicating a population largely free of morbid obesity at baseline.

Compared to overweight participants, WHII participants who lost or maintained within a healthy weight had a 50% lower risk of developing one or more chronic diseases over an average of 23 years of follow-up. After adjusting for the effect of reduced diabetes risk, the risk of the chronic disease remained 40% lower. This may be partly explained by the lower mean blood pressure and total cholesterol levels in those who lost weight.

In the FPS cohort, those who lost weight had their risk of chronic disease reduced by 60% over a median of 12 years. HBS participants had a 20% low risk of death over a median follow-up of 35 years. The average age of the survivor at the end of the study was 91 years.

Participants who gained weight from a healthy to overweight BMI also had an increased risk of chronic disease compared to those with sustained healthy weight, although lower than those with sustained overweight.

Proof

By selecting cohorts of healthy people with a relatively lower average age, the analysis excluded unintentional weight loss. Unintentional weight loss is often associated with frailty due to illness, age or cancer, so it is usually a marker of increased mortality risk.

Other studies have repeatedly shown a reduced risk of diabetes in people who intentionally lose weight, including those treated with medication or surgery. There was no consistent evidence of significant differences in cardiovascular risk or mortality.

This may be because medical or surgical procedures cause greater weight loss. Here too, control groups on statins or other medications that improve cardiovascular risk may be involved.

In addition, healthy but overweight people have a comparable mortality risk to those of healthy weights. In particular, follow-up periods that are too short prevent the detection of long-term benefits on health and mortality risk.

These results may not be generalizable to morbidly obese people who are typically on stariatric surgery or weight loss medications. In such people, weight loss may involve loss of lean (muscle) mass, which could pose a risk to health over time.

The FPS cohort used self-reported BMI data, which introduces some limitations compared to the measured data used in the other studies. This study did not assess whether weight loss was intentional, although the researchers likely did so based on the participant's age and health status and health status.

Studies in this area should attempt to cover the entire life course, as obesity or overweight in childhood predicts a higher risk of ischemic heart disease unless weight is normalized during adolescence.

The study did not directly assess whether weight loss was intentional. Because the participants were free of diagnosed illnesses and relatively young, the authors conclude that the weight loss was likely intentional and due to lifestyle changes.

Diploma

The study found that people who reduced their weight from overweight to a healthy range during midlife, without medication or surgery, experienced significant long-term health benefits. These included a reduced risk of developing chronic diseases and, in some cases, a reduced risk of death.

The benefits lasted even when the reduced risk of diabetes was taken into account, suggesting health benefits beyond reducing the risk of diabetes. Although sustained weight loss through lifestyle changes can be challenging, the results highlight their potential to improve long-term health outcomes when initiated significantly in midlife.

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