Association of weight loss maintenance and weight regain on 4-year changes in CVD risk factors

The action for health in diabetes (Look AHEAD) clinical trial

Action for Health in Diabetes (Look AHEAD) Study Group

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: Short-term weight loss improves cardiovascular disease (CVD) risk factors. We sought to determine the longer-term effects of maintaining weight loss or, conversely, regaining weight. RESEARCH DESIGN AND METHODS: We used data from Action for Health in Diabetes (Look AHEAD), a randomized trial of intensive lifestyle intervention (ILI) compared to a control condition in over weight/obese individuals with type 2 diabetes. ILI participants were grouped according to weight change patterns, as follows: 1) no weight loss (±3% at years 1 and 4); 2) moderate weight loss (3-8% at years 1 and 4); 3) large weight loss (8-20% at years 1 and 4); 4) moderate loss/full regain (3-8%atyear 1/±3%atyear 4);5) large loss/full regain (8-20% at year 1/± 3% year 4); and 6) large loss/partial regain (8-20% at year 1/3-8% at year 4) and changes in CVD risk factors were compared. RESULTS: Adjusting for baseline differences and medication use, larger weight losses produced greater improvements in HbA1c, systolic blood pressure, HDL cholesterol, and triglycerides at years 1 and 4 (all P ≤ 0.02). Despite maintenance of weight loss, HbA1c levels worsened between years 1 and 4, and remained below baseline only in those with large weight losses. We found no negative associations of losing and regaining weight relative to not having lost weight. Moreover, those who had large initial weight loss but full regain of weight had greater improvements in HbA1c levels at year 4 than those with smaller or no initial weight loss. CONCLUSIONS: Larger initial weight loss should be encouraged in individuals with type 2 diabetes, despite the possibility of regain.

Original languageEnglish (US)
Pages (from-to)1345-1355
Number of pages11
JournalDiabetes Care
Volume39
Issue number8
DOIs
StatePublished - Aug 1 2016

Fingerprint

Weight Loss
Cardiovascular Diseases
Maintenance
Clinical Trials
Weights and Measures
Health
Type 2 Diabetes Mellitus
Life Style
Blood Pressure
HDL Cholesterol
Triglycerides
Research Design

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialized Nursing

Cite this

Association of weight loss maintenance and weight regain on 4-year changes in CVD risk factors : The action for health in diabetes (Look AHEAD) clinical trial. / Action for Health in Diabetes (Look AHEAD) Study Group.

In: Diabetes Care, Vol. 39, No. 8, 01.08.2016, p. 1345-1355.

Research output: Contribution to journalArticle

@article{f9d3be32b9ee4ebaa7699f573c07b178,
title = "Association of weight loss maintenance and weight regain on 4-year changes in CVD risk factors: The action for health in diabetes (Look AHEAD) clinical trial",
abstract = "OBJECTIVE: Short-term weight loss improves cardiovascular disease (CVD) risk factors. We sought to determine the longer-term effects of maintaining weight loss or, conversely, regaining weight. RESEARCH DESIGN AND METHODS: We used data from Action for Health in Diabetes (Look AHEAD), a randomized trial of intensive lifestyle intervention (ILI) compared to a control condition in over weight/obese individuals with type 2 diabetes. ILI participants were grouped according to weight change patterns, as follows: 1) no weight loss (±3{\%} at years 1 and 4); 2) moderate weight loss (3-8{\%} at years 1 and 4); 3) large weight loss (8-20{\%} at years 1 and 4); 4) moderate loss/full regain (3-8{\%}atyear 1/±3{\%}atyear 4);5) large loss/full regain (8-20{\%} at year 1/± 3{\%} year 4); and 6) large loss/partial regain (8-20{\%} at year 1/3-8{\%} at year 4) and changes in CVD risk factors were compared. RESULTS: Adjusting for baseline differences and medication use, larger weight losses produced greater improvements in HbA1c, systolic blood pressure, HDL cholesterol, and triglycerides at years 1 and 4 (all P ≤ 0.02). Despite maintenance of weight loss, HbA1c levels worsened between years 1 and 4, and remained below baseline only in those with large weight losses. We found no negative associations of losing and regaining weight relative to not having lost weight. Moreover, those who had large initial weight loss but full regain of weight had greater improvements in HbA1c levels at year 4 than those with smaller or no initial weight loss. CONCLUSIONS: Larger initial weight loss should be encouraged in individuals with type 2 diabetes, despite the possibility of regain.",
author = "{Action for Health in Diabetes (Look AHEAD) Study Group} and Wing, {Rena R.} and Espeland, {Mark A.} and Jeanne Clark and Hazuda, {Helen P.} and Knowler, {William C.} and Pownall, {Henry J.} and Jessica Unick and Thomas Wadden and Lynne Wagenknecht",
year = "2016",
month = "8",
day = "1",
doi = "10.2337/dc16-0509",
language = "English (US)",
volume = "39",
pages = "1345--1355",
journal = "Diabetes Care",
issn = "1935-5548",
publisher = "American Diabetes Association Inc.",
number = "8",

}

TY - JOUR

T1 - Association of weight loss maintenance and weight regain on 4-year changes in CVD risk factors

T2 - The action for health in diabetes (Look AHEAD) clinical trial

AU - Action for Health in Diabetes (Look AHEAD) Study Group

AU - Wing, Rena R.

AU - Espeland, Mark A.

AU - Clark, Jeanne

AU - Hazuda, Helen P.

AU - Knowler, William C.

AU - Pownall, Henry J.

AU - Unick, Jessica

AU - Wadden, Thomas

AU - Wagenknecht, Lynne

PY - 2016/8/1

Y1 - 2016/8/1

N2 - OBJECTIVE: Short-term weight loss improves cardiovascular disease (CVD) risk factors. We sought to determine the longer-term effects of maintaining weight loss or, conversely, regaining weight. RESEARCH DESIGN AND METHODS: We used data from Action for Health in Diabetes (Look AHEAD), a randomized trial of intensive lifestyle intervention (ILI) compared to a control condition in over weight/obese individuals with type 2 diabetes. ILI participants were grouped according to weight change patterns, as follows: 1) no weight loss (±3% at years 1 and 4); 2) moderate weight loss (3-8% at years 1 and 4); 3) large weight loss (8-20% at years 1 and 4); 4) moderate loss/full regain (3-8%atyear 1/±3%atyear 4);5) large loss/full regain (8-20% at year 1/± 3% year 4); and 6) large loss/partial regain (8-20% at year 1/3-8% at year 4) and changes in CVD risk factors were compared. RESULTS: Adjusting for baseline differences and medication use, larger weight losses produced greater improvements in HbA1c, systolic blood pressure, HDL cholesterol, and triglycerides at years 1 and 4 (all P ≤ 0.02). Despite maintenance of weight loss, HbA1c levels worsened between years 1 and 4, and remained below baseline only in those with large weight losses. We found no negative associations of losing and regaining weight relative to not having lost weight. Moreover, those who had large initial weight loss but full regain of weight had greater improvements in HbA1c levels at year 4 than those with smaller or no initial weight loss. CONCLUSIONS: Larger initial weight loss should be encouraged in individuals with type 2 diabetes, despite the possibility of regain.

AB - OBJECTIVE: Short-term weight loss improves cardiovascular disease (CVD) risk factors. We sought to determine the longer-term effects of maintaining weight loss or, conversely, regaining weight. RESEARCH DESIGN AND METHODS: We used data from Action for Health in Diabetes (Look AHEAD), a randomized trial of intensive lifestyle intervention (ILI) compared to a control condition in over weight/obese individuals with type 2 diabetes. ILI participants were grouped according to weight change patterns, as follows: 1) no weight loss (±3% at years 1 and 4); 2) moderate weight loss (3-8% at years 1 and 4); 3) large weight loss (8-20% at years 1 and 4); 4) moderate loss/full regain (3-8%atyear 1/±3%atyear 4);5) large loss/full regain (8-20% at year 1/± 3% year 4); and 6) large loss/partial regain (8-20% at year 1/3-8% at year 4) and changes in CVD risk factors were compared. RESULTS: Adjusting for baseline differences and medication use, larger weight losses produced greater improvements in HbA1c, systolic blood pressure, HDL cholesterol, and triglycerides at years 1 and 4 (all P ≤ 0.02). Despite maintenance of weight loss, HbA1c levels worsened between years 1 and 4, and remained below baseline only in those with large weight losses. We found no negative associations of losing and regaining weight relative to not having lost weight. Moreover, those who had large initial weight loss but full regain of weight had greater improvements in HbA1c levels at year 4 than those with smaller or no initial weight loss. CONCLUSIONS: Larger initial weight loss should be encouraged in individuals with type 2 diabetes, despite the possibility of regain.

UR - http://www.scopus.com/inward/record.url?scp=84980416434&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84980416434&partnerID=8YFLogxK

U2 - 10.2337/dc16-0509

DO - 10.2337/dc16-0509

M3 - Article

VL - 39

SP - 1345

EP - 1355

JO - Diabetes Care

JF - Diabetes Care

SN - 1935-5548

IS - 8

ER -