Weight-loss benefits survive later weight gain

Type 2 diabetics who lose weight soon after diagnosis are likely to still meet BP and glycemic control targets, even if they fail to keep the pounds off. That's the conclusion of a recent Kaiser Permanente study that followed about 2,600 patients for four years.

“We've known for a long time that weight loss is important in diabetes treatment and prevention,” says lead author Adrianne Feldstein, MD, MS, a physician-researcher in Portland, Oregon. “Now it appears there may be a critical window in which some lasting gains can be achieved, if people are willing to take immediate steps after diagnosis.”

Funded by a grant from NIH, the study focused on 2,574 adults aged 21-75 years. Researchers followed patients' weight-gain and -loss patterns for three years, then compared hemoglobin A1c (HbA1c) levels and BP readings in the fourth.

Participants fell into four study categories: higher stable weight (n=418); lower stable weight (n=1,542); weight gain (n=300); and weight loss (n=314). At 18 months after diagnosis, patients in the weight-loss group had shed a mean of 23.6 lb, but, on average, they started gaining it back almost immediately until the losses were nearly wiped out at 36 months.

Nevertheless, patients in the higher stable weight, lower stable weight, or weight gain groups were more likely to have HbA1c  >7% than those who lost weight (odds ratios [ORs] 1.66 vs. 1.52 vs. 1.77). Also, those with higher
stable weight or weight-gain patterns were more likely to have BP ³130/80 mm Hg than those who lost weight (OR 1.83 vs. 1.47).

The findings suggest that “the initial period post diagnosis may be a critical time to apply weight-loss treatments. Even in the face of weight regain, losing weight can have long-lasting benefits,” the authors conclude.
The study, which was published online, will appear in a future issue of Diabetes Care.
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