How does losing and regaining weight affect heart health? New study offers answer

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A new study has found that losing weight, even if you gain some of it back, may still have benefits for your heart longterm.

The research, published in the American Heart Association journal Circulation: Cardiovascular Quality and Outcomes, looked at more than 50,000 participants across 124 clinical trials of behavioral weight management programs. It found that losing weight through these programs reduced risk factors for heart disease and Type 2 diabetes, and the improvements lasted for years after the programs ended, even for people who regained some weight.

Heart disease is the No. 1 cause of death for women and men in the U.S., as well as for most racial groups, according to the U.S. Centers for Disease Control and Prevention. Of the roughly 37 million Americans who have diabetes, up to 95% of them have Type 2.

Losing weight can improve heart disease risk factors, even if you regain some of it

Of the behavioral weight management programs that the new study looked at, some focused on exercise, others on diet and others both. They often provided counseling and education and used various other strategies to facilitate weight loss, such as intermittent fasting, meal replacement or financial rewards for losing weight.

On average, participants lost 5 to 10 pounds and regained .26 to .7 pounds a year, NBC News reported. Average age at the start of the program was 51, and the average participant had obesity.

All of the trials followed up with participants at least one year later. Compared to the control group, whose members followed a less intense or no program, participants in these programs experienced improvements in blood pressure, blood sugar and cholesterol, all risk factors for heart disease. The improvements waned with time as participants regained weight, but they still had healthier markers than those in the control group on average.

Few studies followed participants for more than five years, so the study authors noted that it was difficult to conclude whether the risk of actually developing heart disease and Type 2 diabetes was lower. However, the available data does suggest this is the case, and the risk of developing Type 2 diabetes or heart disease stayed reduced after some weight regain compared to the control group.

“The whole time your weight is less than it would otherwise have been, your risk factors for heart disease are lower than they would have been,” co-author Susan Jebb, professor of diet and population health at University of Oxford in the U.K., told NBC News via email.

Even though the study suggested that improvements to certain health markers start to reverse as a person regains weight, "at least you have reduced the metabolic burden on your body for a period of time,” Jebb said. “That can be enough to delay the onset of diabetes, for example, which has a big benefit for your heart.”

More research needed on risk of developing heart disease and death

Dr. Sean Heffron, a preventive cardiologist at the NYU Center for the Prevention of Cardiovascular Disease who wasn't involved in the research, told NBC News that the study results align with what he sees in practice — that a lot of cardiovascular risk factors “are quite responsive to weight loss, even when the amounts are not large.”

But he added that more information is needed on how these programs may reduce risk of heart attack, stroke and death longterm. “The people in this study were relatively young, and it takes a long time for people to die (of heart disease),” he said.

Previous research has also shown that weight cycling, when a person continues to lose and regain weight usually due to dieting, can lead to adverse health outcomes.

A 2018 study found that weight cycling in people with obesity can reduce risk of developing diabetes but also heighten risk of death, according to the Endocrine Society, a leading medical organization in the fields of metabolism and endocrinology. A 2016 study found that weight cycling can lead the brain to think it's going through periods of famine, which can lead the body to store more fat.

Roughly 80% of people who lose weight gain back the same amount or more, per the Endocrine Society.

"Once an individual loses weight, the body typically reduces the amount of energy expended at rest, during exercise and daily activities while increasing hunger," the group noted in 2018. "This combination of lower energy expenditure and hunger creates a 'perfect metabolic storm' of conditions for weight gain."

How to keep weight off after losing it

Registered dietitian Kristin Kirkpatrick, former lead dietitian at Cleveland Clinic, previously shared the following advice with about losing weight and keeping it off.

  • Don't fixate on the number on the scale. Instead, focus on your lipid panel, blood sugar numbers or inflammation markers.

  • Make healthy food choices — most of the time — especially lower calorie foods that are still nutrient dense. A woman who lost 25 pounds and kept it off previously told that she sets a weekly goal of eating healthy for more than half her meals.

  • Celebrate your wins while continuing to set new goals. Journaling, including about your food intake, can help, too.

  • Move more. Exercise isn't as important for weight loss, but it is important to not gain it back.

  • Eat a lot of protein. Research has shown that high-protein diets can help maintain weight loss.

  • Be aware of how those close to you influence you. And don't be afraid to share with them what helps and hurts you.

  • Change your habits as you lose more weight. If you've lost 50 pounds but are still eating and working out in the same way, you'll be more likely to gain it back.

  • Take a break from dieting and focus on lifestyle changes instead. Because diets usually prioritize restriction, they can be hard to stick with and set you up to fail.

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