Weight loss benefits overweight and obese people, not lean people

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Obesity is a common, serious, and costly chronic disease in adults and children.

An adult who has a BMI of 30 or higher is considered obese. Among children of the same age and sex, overweight is defined on CDC growth charts as a BMI at or above the 85th percentile and lower than the 95th percentile.

Obesity is defined as having a BMI at or above the 95th percentile.

In a study from Harvard University, scientists found intentionally losing weight can bring long-term health benefits for individuals with obesity, regardless of the method or strategy they use.

Those who lost more than 4.5kg had less weight gain and a lower risk of type 2 diabetes than those who did not lose weight, but lean people did not benefit, with weight loss attempts associated with longer-term weight gain and higher risks of type 2 diabetes.

Obesity can lead to higher risks of diseases including type 2 diabetes.

Controlling weight can be an effective strategy for preventing and managing obesity and related diseases, though long-term weight change and the risk of developing type 2 diabetes are not well studied.

In the study, researchers included healthy participants from three prospective cohort studies from 1988–2017.

People were aged between 24–78 and predominantly female—11.6% male and 14.2% male in the cohorts.

They grouped methods that led to a weight loss of more than 4.5kg into seven categories: low-calorie diet, exercise, low-calorie diet plus exercise, fasting, commercial weight loss program, diet pills, and a combination of fasting, commercial, and diet pills (FCP).

The team found exercise was most effective for long-term weight control and prevention in individuals with obesity and associated with the least weight gain after four years—4.2% overall average less weight than at the start in individuals with obesity, 2.5% weight loss in overweight, and 0.4% in lean people.

This was inverted for FCP, which saw individuals with obesity sustaining 0.3% weight loss, overweight people sustaining 2% more weight gain, and lean individuals with 3.7% more weight gain.

24 years later, the risk of diabetes was reduced for people with obesity irrespective of weight loss strategy—ranging from a 21% reduction for exercise to a 13% reduction for diet pills.

For overweight people, the researchers saw a range of 9% reduction in type 2 diabetes risk for exercise to an increase of 42% risk for those who took pills, and in lean individuals, all weight loss was associated with an increased risk of type 2 diabetes—ranging from a 9% increase for exercise and a 54% increase for pills or FCP.

The authors conclude that while weight loss can be beneficial for those who are overweight and obese, weight loss strategies do not bring the same gains for lean individuals and weight loss strategies should be used only by those who medically need them.

If you care about weight loss, please read studies about 10 small changes you can make to prevent weight gain, and this green diet could boost weight loss and protect the heart.

For more information about weight loss, please see recent studies that a vegan diet rich in legumes could improve metabolic health, and results showing a keto diet for weight loss can cause flu-like symptoms.

The study was conducted by Qi Sun et al and published in PLOS Medicine.

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