Highlights This review evaluated the impact of large weight loss (≥10%) in overweight or obese patients. The authors observed improvements in type 2 diabetes remission and metabolic control, cardiovascular risk factors and diseases, cancer and associated risk markers, osteoarthritis, sleep apnea, chronic kidney disease, fertility and pregnancy, health-related quality of life, health care utilization, and economic benefits. They also list the adverse effects associated with various weight loss interventions. When modest weight loss has not resulted in sufficient effects on obesity-related complications, the authors suggest that the goal of treatment should be a weight loss of 10% or more. |
Aim
Modest weight loss (5%-10%) is clinically significant in overweight or obese patients. However, greater weight loss may be required to achieve improvements or remission of certain weight-related complications. Therefore, this study reviewed the effect of large weight loss (≥10%). Most studies that reported large weight loss and relevant outcomes used bariatric surgery or lifestyle modifications.
Results
The benefits of large weight loss were seen in patients with various complications related to overweight or obesity, including improvements in comorbidities such as type 2 diabetes and hypertension.
Improvements in glucose metabolism and cardiovascular risk factors were observed in patients who achieved large weight loss through lifestyle interventions or pharmacotherapy (phentermine/topiramate 15/92 mg once daily or subcutaneous semaglutide 2, 4 mg once a week).
Other benefits associated with major weight loss included reduced cancer risk and improvements in knee osteoarthritis, sleep apnea, fertility-related endpoints, and health-related quality of life. Although expensive, bariatric surgery is currently the most cost-effective intervention, although most weight management programs are considered cost-effective.
Conclusions
In general, large weight loss has a large beneficial impact on complications related to overweight and obesity. Large weight loss should be the primary goal of treatment when modest weight loss has not had sufficient effects on obesity-related complications and for patients with severe obesity.
Importance of the study
What is already known?
►The gap analysis showed that, to our knowledge, no reviews on the benefits of large weight loss have been published in recent years.
►The majority of reviews identified focused on weight loss in specific patient groups or on specific clinical outcomes.
What does this review contribute?
►In people who are overweight or obese, weight loss of 10% or more has important benefits regardless of the weight loss approach; Most available data relate to weight loss achieved through bariatric surgery or lifestyle modifications.
►Evidence has suggested greater improvements in certain outcomes with progressive and sustained weight loss.
How might these results change the direction of research or the focus of clinical practice?
►We suggest that weight loss of 10% or more should be the primary goal of treatment when weight loss of 5% to 10% has resulted in insufficient effects on obesity-related complications and for patients with severe obesity.
Conclusions
There are differences in weight loss depending on the type of intervention used, with surgery, rather than lifestyle intervention, generally having the greatest effect based on comparisons between studies and data from randomized controlled trials.
Weight loss has important benefits in people who are overweight or obese, regardless of the approach, although evidence has suggested greater improvements in certain outcomes with progressive and sustained weight loss.
Since large weight loss has a significant beneficial effect on complications related to overweight and obesity, we suggest that weight loss of 10% or more should be the primary treatment goal when modest weight loss has insufficient effects. on obesity-related complications and for patients. with severe obesity.
Reference: Benefits of weight loss of 10% or more in patients with overweight or obesity: A review Obesity Abd A. Tahrani,John Morton https://doi.org/10.1002/oby.23371
