Weight Stability or Sustained Weight Loss May Help Prevent Heart and Metabolic Diseases: Study
Researchers have discovered that people who continue to lose and regain weight, a process referred to as weight cycling, are at significantly greater risk of acquiring a number of significant cardiometabolic illnesses, even if their baseline body mass index (BMI) is already elevated. The research highlights that weight cycling, in contrast to weight stability or maintained weight reduction, is more linked with negative health consequences like type 2 diabetes, heart failure, and liver disease. The study was conducted by Alison Z and colleagues published in the Journal of Clinical Endocrinology and Metabolism.
This is the first large-scale study to directly compare how various long-term weight trajectories, weight stability, weight gain, weight loss, and weight cycling, impact the risk of prevalent cardiometabolic disease in adults with comparably high baseline BMIs. The study, underpinned by de-identified health records across more than two decades, underlines the importance of clinical strategies that aim not only to achieve weight loss but to maintain weight over time.
The authors carried out a retrospective cohort study based on electronic health record data from Vanderbilt University Medical Center for adult patients between 1997 and 2020. Adults with elevated baseline BMI were included in the analysis and their longitudinal weight trajectories over time were followed. They were grouped into four categories according to their weight trajectory: weight stable, weight gainers, weight losers, and weight cyclers.
In order to determine disease risk, the researchers employed multivariate Cox proportional hazards regression models in a landmark study design. They investigated associations between weight trajectory and incidence of ten prevalent cardiometabolic diseases, controlling for confounding factors like age, sex, and comorbidities.
Key Findings
Weight cycling was found to be significantly linked to elevated risk of multiple cardiometabolic diseases versus weight stability:
• Heart Failure: Individuals with weight cycling were 54% more likely to develop heart failure (HR 1.54; 95% CI: 1.31–1.82). Weight gain (HR 1.29; 95% CI: 1.08–1.55) and weight loss (HR 1.32; 95% CI: 1.10–1.58) were also associated with higher risk of heart failure, though less so than with weight cycling.
• Obstructive Sleep Apnea: Weight cycler risk increased by 28% (HR 1.28; 95% CI: 1.15–1.42).
• Type 2 Diabetes Mellitus (T2DM): Weight cyclers had an increased risk of 23% (HR 1.23; 95% CI: 1.10–1.38).
• Metabolic Dysfunction–Associated Steatotic Liver Disease (MASLD): There was a 28% increased risk in weight cyclers (HR 1.28; 95% CI: 1.08–1.51).
The findings underscore the significance of enhancing long-term weight maintenance or permanent weight loss as primary preventive strategies against cardiometabolic disease. For people who have obesity, prevention of repeated weight change may be as important as how much weight they lose.
Reference:
Swartz AZ, Wood K, Farber-Eger E, Petty A, Silver HJ. Weight Trajectory Impacts Risk for Ten Distinct Cardiometabolic Diseases. J Clin Endocrinol Metab. 2025 Jun 11:dgaf348. doi: 10.1210/clinem/dgaf348. Epub ahead of print. PMID: 40498904
