RT Journal Article
SR Electronic
T1 Effect of weight loss on cardiometabolic risk: observational analysis of two randomised controlled trials of community weight-loss programmes
JF British Journal of General Practice
JO Br J Gen Pract
FD British Journal of General Practice
SP e312
OP e319
DO 10.3399/bjgp20X714113
VO 71
IS 705
A1 Morris, Elizabeth
A1 Jebb, Susan A
A1 Oke, Jason
A1 Nickless, Alecia
A1 Ahern, Amy
A1 Boyland, Emma
A1 Caterson, Ian D
A1 Halford, Jason
A1 Hauner, Hans
A1 Aveyard, Paul
YR 2021
UL http://bjgp.org/content/71/705/e312.abstract
AB Background Guidelines recommend that clinicians identify individuals at high cardiometabolic risk and support weight loss in those with overweight or obesity. However, we lack individual level data quantifying the benefits of weight change for individuals to guide consultations in primary care.Aim To examine how weight change affects cardiometabolic risk factors, and to facilitate shared decision making between patients and clinicians regarding weight loss.Design and setting Observational analysis using data from two trials of referral of individuals with overweight or obesity in primary care to community weight-loss groups.Method Linear mixed effects regression modelling examining the association between weight change and change in systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting glucose, glycated haemoglobin (HbA1c), and lipid profile across multiple timepoints (baseline to 24 months). Subgroup analyses examined changes in individuals with hypertension, diabetes, and hyperlipidaemia.Results In total, 2041 participants had a mean (standard deviation) age of 50 (SD 13.5) years, mean baseline weight of 90.6 (14.8) kg and mean body mass index (BMI) of 32.7 (SD 4.1) kg/m2. Mean (SD) weight change was −4.3 (SD 6.0) kg. All outcome measures showed statistically significant improvements. Each 1 kg weight loss was associated with 0.4 mmHg reduction in SBP and 0.3 mmHg reduction in DBP, or 0.5 mmHg and 0.4 mmHg/kg respectively in people with hypertension. Each 1 kg weight loss was associated with 0.2 mmol/mol reduction in HbA1c, or 0.6 mmol/mol in people with diabetes. Effects on plasma lipids were negligible.Conclusion Weight loss achieved through referral to community weight-loss programmes, which are commonly accessible in primary care, can lead to clinically relevant reductions in BP and glucose regulation, especially in those at highest risk.