ABSTRACT
OBJECTIVE: We evaluated long-term impact of sustained weight loss versus weight regain on cardiovascular risk factors in real-world clinical practice. METHODS: We evaluated 129 obese patients with diabetes enrolled in Weight Achievement and Intensive Treatment (Why WAIT) program, a 12-week clinical model of intensive lifestyle intervention. After 1â year, we divided participants into group A, who maintained <7% weight loss (47.3%) and group B (52.7%), who maintained ≥7% weight loss. We continued to follow them for a total of 5â years. RESULTS: The total cohort lost 23.8â lbs (-9.7%) at 12â weeks and maintained -16.2â lbs (-6.4%) at 5â years (p<0.001). Group A maintained -8.4â lbs (-3.5%) and group B maintained -23.1â lbs (-9.0%) at 5â years. In group A, A1C decreased from 7.5±1.3% to 6.7±0.9% at 12â weeks but increased to 7.7±1.4% at 1â year and 8.0±1.9% at 5â years. In group B, A1C decreased from 7.4±1.2% to 6.4±0.9% at 12â weeks and rose to 6.8±1.2% at 1â year and 7.3±1.5% at 5â years. Despite weight regain, group A maintained improvement in low-density lipoprotein-cholesterol and high-density lipoprotein-cholesterol with worsening of serum triglycerides and no change in blood pressure (BP). Group B maintained improvement in lipid profile for 5â years and had significantly lower BP for 18â months. CONCLUSIONS: Weight reduction in patients with diabetes can be maintained for 5â years and is predicted by patients' ability to maintain ≥7% weight loss at 1â year. A1C and triglycerides deteriorate with weight regain, while other lipid improvements are maintained. Sustained weight loss is associated with significantly lower A1C for 5â years and lowers BP for 18â months. TRIAL REGISTRATION NUMBER: NCT01937845.