Most people understand that reaching and maintaining a healthy weight is essential. For one thing, that knowledge can encourage you to get started on a weight loss program if you’re overweight or obese. Losing weight isn’t easy. The list of reasons to get to and stay at a healthy weight is long. Losing just a few pounds makes a big difference. Five percent of your body weight -- 10 pounds for a 200-pound person -- can improve all kinds of health problems, and make you feel better, too. Talk to your doctor about whether it might help you. You don’t have to slim down to your high school size to get real health benefits. Losing just a few pounds makes a big difference. Five percent of your body weight -- 10 pounds for a 200-pound person -- can improve all kinds of health problems, and make you feel better, too. Talk to your doctor about whether it might help you.
Heart Health Improvements
Obesity isn't just about carrying extra weight; it's a serious health condition that can lead to a host of problems, especially for your heart. Carrying extra weight isn’t just about how you feel in your clothes-it can have serious consequences for your heart. Obesity is one of the biggest risk factors for cardiovascular disease, including heart attacks, strokes, and high blood pressure. The good news? Obesity contributes to a number of heart-related health problems. Losing even a small percentage of body weight can make a big difference. Being overweight makes your heart work harder to move blood through the body. Shedding some weight reduces pressure on your arteries and stress on your heart.
Diabetes Management and Prevention
People with type 2 diabetes who take action to start losing weight typically experience improved insulin sensitivity. That’s because excess body fat causes inflammation that adversely affects how insulin (the hormone that regulates blood sugar) functions. If you’re more likely to get the condition, weight loss is one of two ways to prevent or delay it. The other is moderate exercise -- 30 minutes on 5 days a week. If you weigh 160 pounds, you could lose just 8-12 of them to get the benefit. If you already have diabetes, losing that weight can help you take less medication, keep control of your blood sugar, and lower the odds that the condition will cause other health problems. One begins to see improvement in glycemic measures and triglycerides with small amounts of weight loss, but with greater levels of weight loss there is even greater improvement. In fact, the relationship between weight loss and glycemia is one that is very close. This is fortunate for diabetes prevention; it takes only small amounts of weight loss to prevent progression to type 2 diabetes from impaired glucose tolerance and after the 10 kg of weight loss one cannot demonstrate much additional improvement in risk reduction. A diet and exercise intervention which achieved 5.7% weight loss on average, and compared to a control condition produced significant improvements in WOMAC (Western Ontario MacMaster University score, which measures self-reported function), the 6 minute walk distance (p<0.05), stair climb time (p<0.05) and knee pain.16 Knee joint loads were also assessed in those patients and the investigators found that each pound of weight lost resulted in a 4-fold reduction in the load exerted on the knee per step during daily activities.17 Accumulated over thousands of steps per day, a reduction of this magnitude would appear to be clinically meaningful.
The relationship between modest weight loss and improvement in glycemia is powerful and it is not limited to diabetes prevention. This is illustrated with analyses from the Look AHEAD study of >5000 individuals with type 2 diabetes. In one analysis,11 categories of weight loss were defined (stable weight, ≥2%<5%, ≥5%<10 %, ≥10%<15% and ≥15%). This analysis demonstrated that improvement in fasting glucose and hemoglobin A1c is observed beginning at only ≥2<5% weight loss. Of course, greater weight loss was associated with greater benefit to glycemic outcomes in a direct and linear fashion. It must be noted that these benefits to glycemic measures were achieved alongside reductions in antidiabetic medications. Data from the Look AHEAD Study also showed that health benefits of modest weight loss are not limited to glycemic measures. The analysis cited above11 also evaluated the impact of progressive categories of weight loss on other risk factors and showed that improvement in triglycerides and systolic blood pressure begins with ≥2<5% weight loss.j For diastolic blood pressure and HDL cholesterol, improvement begins at ≥5<10% weight loss.j All of these risk factors improved in a direct and linear fashion with greater weight loss being associated with greater risk factor benefit.
Stroke and Cancer Risk Reduction
Moving toward your target weight lowers your stroke risk. Weight loss lowers the risk of specific cancers. One study showed that older women who lost at least 5% of their body weight lowered their chances of breast cancer by 12%. There’s no such clear proof that losing weight protects you from other types, but some changes that happen when you shed pounds hint that it might. For example, overweight people who slim down have lower levels of some hormones linked to cancer, like estrogens, insulin, and androgens.
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Improved Mobility and Joint Health
Weight loss benefits your knees and other joints. Even minimal weight reduction reduces joint pain and makes it easier to move around. Just 10 extra pounds add 40 pounds of pressure on your knees and other lower body joints. That can wear them out quicker. Extra fat can also cause inflammation -- when chemicals in your body damage your own tissues over time, including your joints. Losing even a little weight can ease these effects. If you keep it off, you’re much less likely to get arthritis later in life.
Enhanced Sleep and Energy Levels
Weight loss improves sleep and boosts energy. People who are overweight frequently suffer from sleep apnea. It’s a condition where fat deposits in the neck make it harder to breathe, which results in frequent awakenings throughout the night. Losing weight may not eliminate the problem, but it can significantly improve sleep quality. People who are overweight gain extra tissue in the back of their throats. When your body relaxes when you sleep, that tissue can drop down and block your airway. It makes you stop breathing over and over all night, which causes all kinds of health problems, especially for your heart. Slimming down a little can often help with sleep apnea -- sometimes enough that you can stop using the bulky breathing devices that treat it. Some studies have shown that not getting enough ZZZs can make you more likely to be obese. Others show that losing at least 5% of excess weight can lead to better sleep. But don’t overdo it. Sleeping too much isn’t good for your weight or your health.
Increased Libido and Improved Taste
Shedding pounds can increase your sex drive. Losing weight can improve your sense of taste. It’s not clear why, but people who lose weight often report that it sharpens their sense of taste.
Boosted Self-Esteem and Mental Well-being
Not all the benefits of weight loss are physical. We’re all familiar with the idea of a downward spiral, where things go from bad to worse. Losing a few pounds gives you a little more energy, a little less joint point, and a healthy dose of confidence. Those benefits can then lead to increasing your exercise regimen and making additional improvements to your diet. Then, with your heart and circulatory system beginning to function more effectively, you may feel encouraged to take on even bigger challenges.
Weight loss may help chase your blues away. Scientists are still trying to work out why, but better body image and improved sleep may be part of the reason. In one study, depressed people who were very overweight felt better after they lost an average of 8% of their body weight. Other research shows you’ll continue to feel better, even after 2 years -- as long as you keep the weight off.
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Metabolic and Cardiovascular Benefits
Modest weight loss (5 to 10%) is also associated with improvement in systolic and diastolic blood pressure and HDL cholesterol. With all these risk factors more weight loss produces more improvement. For some comorbid conditions, more weight loss is needed - 10% to 15% - to translate into clinical improvement. This is true with obstructive sleep apnea, and non-alcoholic steatotic hepatitis. There is a graded improvement in improvements in measures of quality of life, depression, mobility, sexual dysfunction, and urinary stress incontinence, whereby improvements are demonstrable with modest weight loss (5-10%) and with further weight loss there are further improvements. For polycystic ovarian syndrome and infertility, modest weight loss (beginning at 2-5%) can bring improvements in menstrual irregularities and fertility Moderate weight loss (5-10%) has been shown to be associated with reduced health care costs. Reduction in mortality may take more than 10% weight loss, although definitive studies have not been done to demonstrate that weight loss per se is associated with mortality reduction. Clinicians in medical weight management should bear in mind that the target should be health improvement, rather than a number on the scale. A 5% for weight loss from baseline is generally accepted as a “clinically meaningful” amount.1 Certainly, the 2013 Obesity Guidelines recommended weight loss of 5-10% as the goal for medically supervised weight loss.2 Further, the US Food and Drug Administration Draft Guidance for medications for management of obesity has as one of the criteria for approval, that the medication achieve an average weight loss of 5% or greater than a placebo.
Weight changes were significantly correlated with changes in glycemic control, blood pressure, HDL cholesterol, and triglycerides; the greater the weight change, the greater the improvements in each risk factor in the full cohort and within the ILI and DSE group separately. Weight loss was not associated with improvements in LDL cholesterol. To better describe the associations between weight change and improvements in CVD risk factors, Look AHEAD participants were categorized by their percent weight changes over the first year. The average weight changes (means ± SD) were +4.73 ± 3.0 kg for weight gain; −0.11 ± 1.16 kg for remaining weight stable; and −3.48 ± 1.11, −7.25 ± 2.07, −12.13 ± 2.83, and −21.25 ± 7.05 kg for each increasing weight loss category, respectively. A strong graded association was seen for changes in glucose, HbA1c, SBP, DBP, triglycerides, and HDL cholesterol (all P values <0.0001). Each higher category of weight loss was associated with greater improvements in the risk factor.
The Impact of Modest Weight Loss
The health benefit of modest weight loss is best exemplified clinically in the relationship between weight loss and diabetes prevention. While an average weight loss of 6.7% reduced the incidence of diabetes by 58% in the group participating in the American Diabetes Prevention Program8 and similarly in the Finnish Diabetes Prevention Trial,9 it’s important to distinguish group benefits versus individual benefits. An analysis by Hamman, et al10 from the American Diabetes Prevention Program showed that in individuals with impaired glucose tolerance, for every kilogram of weight lost there was a 16% reduction in risk for progression to diabetes. Furthermore, after about 10 kg weight loss, there was negligible benefit, in terms of diabetes risk reduction, from further weight loss.
Of importance is the demonstration from another analysis11 from the large Look AHEAD data set (n>5000) that baseline BMI category (Obese stage I, II or III) does not alter the benefit of modest weight loss.12 Each of the BMI categories demonstrate the same amount of mean weight loss, when expressed as a percentage from baseline, with the same lifestyle intervention. Of course, those with higher BMI category would lose more weight when expressed in kilograms; but when expressed proportionally there is no significant difference across BMI categories in weight loss.
Sleep Apnea and Weight Loss
The Look AHEAD Study incorporated a substudy of sleep apnea, called Sleep AHEAD. More than 80% of the participants with type 2 diabetes in four sites of Look AHEAD had at least mild obstructive sleep apnea.13 With the intensive lifestyle intervention (ILI), mean weight loss at one year at these four sites was 10.8 kg vs. 0.6 kg in the diabetes support and education (DSE) group. At 1 year, remission of OSA (apnea hypopnea index, AHI, <5 events per hour) was 3 times more common in the ILI participants (13.6%) than in the DSE participants (3.5%). Further, the prevalence of severe obstructive sleep apnea among ILI participants (18.4%) was half that of the DSE group (37.9%). Participants with a weight loss of 10 kg or more had the greatest improvements. In fact, weight loss of 10 kg or more was required for significant association with AHI change. At 4 years, improvements persisted, despite some weight regain to 5.2 kg below baseline in the ILI group.14 Remission of OSA at 4 years was 5 times more common with intensive lifestyle intervention (20.7%) than diabetes support and education (3.6%).
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Osteoarthritis and Joint Health
Osteoarthritis of the knee is closely linked to obesity as a risk factor and is quite common. Nearly half of Americans are projected to experience osteoarthritis of at least one knee in their lifetime.15 A diet and exercise intervention which achieved 5.7% weight loss on average, and compared to a control condition produced significant improvements in WOMAC (Western Ontario MacMaster University score, which measures self-reported function), the 6 minute walk distance (p<0.05), stair climb time (p<0.05) and knee pain.
Practical Strategies for Weight Loss
There’s no one perfect diet to help you slim down, but there are some basic rules. Make half your plate fruits and vegetables. Keep your protein lean and unprocessed: Choose meats trimmed of fat, and eat seafood, beans, nuts, and seeds. Replace refined grains like white bread and white rice with whole grains like multigrain bread, brown rice, and oatmeal. You should be getting 30 minutes of moderate activity -- a bike ride or brisk walk -- on at least 5 days a week simply to stay in good health. To lose weight and keep it off, you may need more than that. Also include moves to strengthen your muscles, like pushups or light weight training.
Potential Downsides of Significant Weight Loss
If you lost a lot of weight, it’s because you’re eating less. When you make a major change in the amount of food you take in each day, your body begins to process it more slowly. This can make it harder to keep losing weight after you've already lost some. You can give your metabolisma little help with more exercise, including strength training to build muscle mass. Fixed meal times can help regulate the internal clock that keeps your body running on a 24-hour day. If you've changed when you eat to help you lose weight, you may also see changes in when you sleep and wake. If you want to keep losing, studies show that when you eat matters. For example, overweight and obese women may lose more weight when they eat a bigger breakfast and less at dinner even when the total calories for the day are the same.