Weight loss has always been suggested for those with a body mass index (BMI) over 30 in patients with cardiovascular disease as we know that obesity contributes to poor cardiac outcomes in that segment. However, a new study suggests that patients who experience a fluctuation in body weight may be at a higher risk for certain diseases and conditions, including coronary events, CV events, and stroke.
Body Weight Variability and Risk Factors
The study, published this week in the NEJM looked at 9509 patients with an established diagnosis of coronary artery disease, explores the relationship between fluctuations in body weight and the incidence of cardiac events. After adjustments for baseline lipid levels, mean body weight, other risk factors, and weight change, each fluctuation equal to at least 1.5 kg in body weight variability was found to be associated with an increase in risk for subsequent events.
Compared with patients having fewer fluctuations in weight or less than .93 kg on average, patients with the most seesawing exhibited the following increased risks:
- 64 percent for coronary events
- 85 percent for cardiovascular events
- 124 percent for death
- 117 percent for myocardial infarctions
- 136 percent for strokes
Sripal Bangalore, MD, MHA, the lead investigator for the study, warns similar fluctuations in weight also increase risks for developing adult onset diabetes at a rate increase of 95 percent.
Baseline Weight is an Important Factor
It’s important to note that patients with a normal weight at baseline who experienced similar body weight fluctuations did not appear to be at an increased risk for the same events. Therefore, those patients who are already overweight at when diagnosed with CAD and CVD are in the danger zone.
What This Means for Weight Loss
Obesity remains one of the greatest risk factors for many disease processes. Dramatic weight loss for curing obesity is still the best approach for lowering risk factors across the board. However, for this subset of patients, it is important that the weight loss is sustained. The goal should always be to achieve a healthy weight as this reduces the risk of developing cardiac disease to start with.
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