New research has found for the first time that extreme weight fluctuations in people living with obesity (PLWO) and cardiovascular disease significantly increases the risk of death with weight loss, as well as weight gain, raising risk levels.
Investigators from Anglia Ruskin University (ARU) - including Professor Barbara Pierscionek, Dr Rudolph Schutte and Dr Jufen Zhang of the Medical Technology Research Center at ARU - analysed data from 8,297 UK participants recruited as part of the UK Biobank study.
The PLWO participants all had established cardiovascular disease, were followed for nearly 14 years, with weight changes recorded over time. The findings revealed that those who gained more than 10 kg across the study period had a threefold increase in the risk of cardiovascular death and nearly double the risk of all-cause mortality compared to those who maintained a stable weight.
However, the study also found that weight loss of more than 10kg was also associated with a 54% higher risk of all-cause mortality, suggesting that both extremes of weight change can be detrimental.
A higher BMI, smoking and previous alcohol consumption were linked to an increased likelihood of significant weight gain. There was also an association between significant weight gain and younger age.
According to The Health Survey for England, the number of people living with obesity in the country rose from 15% in 1993 to 29% in 2022 and more than two-thirds of people over the age of 35 are considered overweight or obese. The issue is estimated to cost the NHS £6.5billion every year. Globally, more than half of all adults are expected to be overweight or living with obesity by 2050.
"This study is the first of its kind to examine the link between weight change and all-cause mortality in obese individuals with cardiovascular disease. Maintaining a stable weight, even within the obese range, appears to be crucial for reducing mortality risk in patients with cardiovascular disease. It was perhaps unsurprising that significant weight gain was associated with higher mortality, but interesting that a similar association was found among those who lost a lot of weight,” explained Zhang. "Clinicians should bear this in mind, particularly with regard to new drugs on the market, which have been lauded for delivering fast weight-loss. Although weight loss is recommended for obese adults, people in at-risk groups such as these should only attempt to lose weight in close consultation with their doctor."
The findings were reported in the paper, 'Association of weight change with cardiovascular events and all-cause mortality in obese participants with cardiovascular disease: a prospective cohort study', published in Heart. Please click here to access this paper (log-in maybe required)
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