Increased Waist Circumference with Weight Loss Can Raise CVD Risks

The Diabetes Prevention Program (DPP) trials is a landmark study that proved that intensive lifestyle intervention (ILI) can delay or prevent type 2 diabetes. Because of the success of the DPP trials, another study called the Look AHEAD  study was carried out. The purpose of the Look AHEAD study was to determine if ILI could reduce "cardiovascular morbidity and mortality in overweight individuals with type 2 diabetes.” A secondary analysis of the study was also done to determine the relationship between cardiovascular disease (CVD), waist circumference (WC) and weight loss.

The Look AHEAD failed to conclusively show that ILI could reduce cardiovascular morbidity and mortality in overweight individuals with type 2 diabetes, however, the study was a useful study. In the secondary analysis, the investigators concluded that even with weight loss, an increase in waist circumstance can cause an increase in CVD risk.

The analysis consisted of 5,490 participants, where four groups were formed. One group consisted of participants that had lost weight and reduced WC, another group that had gained weight and increased WC, a group that had gained weight and reduced WC and a group that had lost weight and increased WC. All changes happened within one year of baseline.

The researchers performing the secondary analysis concluded that "increased WC during the first year of ILI, independent of weight change, was associated with higher risk for subsequent cardiovascular outcomes."

Still, it should be noted that, in general, weight loss via ILI is associated with a lowering of the risk of negative cardiovascular outcomes. Further, in one Look AHEAD follow-on study that used machine-learning methods to analyze the Look AHEAD data, the investigators concluded that 85% of the Look AHEAD subjects did, in fact, experience a significant reduction in cardiovascular events as a result of weight loss.

It is possible to have an increase in CVD risk with weight loss, if there is a rise in WC. And while providers should be aware of the possibility of increased CVD risk with a rise in WC, employing ILI for weight loss is still a prudent approach to possibly lower CVD risks.

 -------------------------------------------------------

Tags: environmental scanning, balanced scorecard, business planning, strategic management, bariatric medicine, obesity medicine, medical practice start up, bariatric industry analysis, weight loss industry analysis, weight management industry analysis