You've Lost the Weight -- Now Keep It Off to Keep Diabetes at Bay
The health of people with type 2 diabetes often improves dramatically with a 5% to 10% weight loss -- but to sustain the benefits, you need to keep the weight off, new research claims.
After losing weight with a yearlong intervention, blood sugar and blood pressure levels go down and cholesterol results improve. People who kept at least 75% of that weight off for another three years retained or had even greater health benefits, the study reported.
"A lot of times, the emphasis is put on weight-loss programs, but it's just as critical to help people maintain their weight loss," said study senior author Alice Lichtenstein. She's director of the Cardiovascular Nutrition Laboratory at Tufts University's Jean Mayer USDA Human Nutrition Research Center on Aging in Boston.
"People tend to think of diets as short-term, but it's really something that has to be lifelong. If you've found a successful way to lose weight, don't revert to old habits. Figure out how to incorporate the changes you made to lose weight," Lichtenstein suggested.
Excess weight is a major risk factor for developing type 2 diabetes. Studies have shown that losing weight can improve the symptoms of type 2 diabetes. And shedding around 10% of your body weight may even put the disease into remission, a recent study from Diabetic Medicine found.
The current study -- published Oct. 9 in the Journal of the American Heart Association -- included more than 1,500 people with type 2 diabetes who were recruited for an intensive lifestyle intervention that lasted one year.
After losing weight, participants entered a three-year maintenance phase that included monthly group meetings. They were encouraged to get regular physical activity and to use a single meal replacement product each day.
Lichtenstein and her team looked at blood pressure and levels of blood sugar, triglycerides (a type of blood fat linked to heart disease), and HDL (or "good") cholesterol. They checked just after the weight loss and again after three years of maintenance.
The researchers tried to find the specific point where people started to lose the benefits of weight reduction, but couldn't find one. But they did find that when people who lost 10% or more of their initial weight regained about one-quarter of the lost pounds, the health benefits began to wane.
"The more weight loss that is maintained, the better people will be in terms of [heart and metabolic] health. There's a long-term benefit from maintaining weight loss," Lichtenstein said.
Dr. Berhane Seyoum, chief of endocrinology at Detroit Medical Center, reviewed the study and said keeping weight off is no easy feat.
"Maintaining weight loss is the most difficult part as the body tries to bring back the weight that has been lost. Weight loss and maintenance is a lifetime struggle. You have to watch what you're eating and exercise," he said.
For type 2 diabetes patients who struggle with hunger, medications can help keep hunger at bay, Seyoum said.
Get more advice on maintaining weight loss from the U.S. Centers for Disease Control and Prevention.
SOURCES: Alice Lichtenstein, D.Sc., lab director and senior scientist, Cardiovascular Nutrition Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, and professor, nutrition science and policy, Tufts University, Boston; Berhane Seyoum, M.D., M.P.H., chief, endocrinology, Detroit Medical Center and Wayne State University, Detroit; Oct. 9, 2019, Journal of the American Heart Association