Excess weight, often measured by a Body Mass Index (BMI) above 25 kg/m2, is associated with increased risk for mortality and cardiometabolic diseases, demonstrating increasing risk with increasing BMI. The good news is that even modest weight loss can trigger a cascade of positive health outcomes, making it a worthwhile goal for overall well-being. While individual results may vary, losing approximately 18 pounds (around 8 kilograms) can be a significant milestone on the path to a healthier life. This article explores the remarkable benefits of losing 18 pounds, drawing upon scientific studies and expert recommendations.
Understanding the Significance of Modest Weight Loss
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. The 2013 Obesity Guidelines recommended weight loss of 5-10% as the goal for medically supervised weight loss. Further, the US Food and Drug Administration Draft Guidance for medications for management of obesity has as one of the criteria for approval, that the medication achieve an average weight loss of 5% or greater than a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.
The Impact on Diabetes Prevention and Glycemic Control
The health benefit of modest weight loss is best exemplified clinically in the relationship between weight loss and diabetes prevention. 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.The relationship between modest weight loss and improvement in glycemia is powerful and it is not limited to diabetes prevention. Categories of weight loss were defined (stable weight, ≥2%<5%, ≥5%<10 %, ≥10%<15% and ≥15%). 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.
- Diabetes Prevention: Even a small amount of weight loss can significantly reduce the risk of progressing from impaired glucose tolerance to type 2 diabetes. Studies have shown that for every kilogram of weight lost, there is a notable reduction in the risk of developing diabetes.
- Improved Glycemic Measures: Weight loss, even in the range of 2-5%, can lead to improvements in fasting glucose and hemoglobin A1c levels, key indicators of blood sugar control. Greater weight loss is associated with even greater benefits in glycemic outcomes.
Cardiovascular Health: A Positive Transformation
Data from the Look AHEAD Study also showed that health benefits of modest weight loss are not limited to glycemic measures. Improvement in triglycerides and systolic blood pressure begins with ≥2<5% weight loss. For diastolic blood pressure and HDL cholesterol, improvement begins at ≥5<10% weight loss. All of these risk factors improved in a direct and linear fashion with greater weight loss being associated with greater risk factor benefit.
- Blood Pressure: Modest weight loss (5 to 10%) is associated with improvement in systolic and diastolic blood pressure and HDL cholesterol.
- Cholesterol and Triglycerides: Losing 18 pounds can positively impact cholesterol levels, particularly by increasing HDL (good) cholesterol and reducing triglyceride levels. These changes contribute to a healthier lipid profile and reduce the risk of heart disease.
Alleviating Sleep Apnea
The Look AHEAD Study incorporated a substudy of sleep apnea, called Sleep AHEAD. 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. For clinicians, weight loss can be a major modifier of symptoms of obstructive sleep apnea as measured by the apnea hypopnea index, but 10% or more should be the goal to impact clinical symptoms.
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- Reduced Apnea Hypopnea Index (AHI): Weight loss of 10 kg or more was required for significant association with AHI change.
- Remission of OSA: Remission of OSA at 4 years was 5 times more common with intensive lifestyle intervention (20.7%) than diabetes support and education (3.6%).
The Impact on Osteoarthritis and Joint Health
Osteoarthritis of the knee is closely linked to obesity as a risk factor and is quite common. 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. 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.
- Reduced Joint Load: Each pound of weight lost resulted in a 4-fold reduction in the load exerted on the knee per step during daily activities.
- Improvement in pain, function, IL-6 levels and a quality of life measure: 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.
The Role of Weight Loss in Polycystic Ovarian Syndrome (PCOS) and Infertility
For polycystic ovarian syndrome and infertility, modest weight loss (beginning at 2-5%) can bring improvements in menstrual irregularities and fertility
- Menstrual Regularity and Fertility: Modest weight loss (beginning at 2-5%) can bring improvements in menstrual irregularities and fertility
Weight Loss and Reduction in Healthcare Costs
Moderate weight loss (5-10%) has been shown to be associated with reduced health care costs.
- Reduced Healthcare Costs: Moderate weight loss (5-10%) has been shown to be associated with reduced health care costs.
Improvement in Quality of Life
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.
- Quality of Life: 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.
Weight Loss and Body Composition
Interestingly, body weight loss was associated with disproportionate loss of body fat across multiple compartments. The 5%, 11% and 16% weight loss was associated with 10%, 18% and 27% reduction in total kg fat mass, respectively and 9%, 23% and 30% reduction in intra-abdominal adipose tissue (cm3). Even more disproportionate is the reduction in intra-hepatic triglyceride, measured as percentage on Magnetic Resonance Imaging, a 13%, 52% and 65% reduction for each weight loss level, respectively. Thus, it appears that with total body fat loss, the stores of intra-abdominal and intra-hepatic fat are preferentially lost.
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- Body Fat Loss: The 5%, 11% and 16% weight loss was associated with 10%, 18% and 27% reduction in total kg fat mass, respectively and 9%, 23% and 30% reduction in intra-abdominal adipose tissue (cm3).
Practical Strategies for Achieving and Maintaining Weight Loss
Losing 20 pounds (lb) can have significant health benefits for people who are overweight or have obesity. Losing even 5 percent of your body weight can improve cholesterol, blood glucose, and blood sugar levels in people who don’t have a healthy body weight. Safe, sustainable weight loss can reduce your risk of chronic conditions like type 2 diabetes, reduce stress on your joints, and potentially improve sleep apnea.
- Set Realistic Goals: Aim for a gradual and sustainable weight loss of 1-2 pounds per week. This approach is more likely to lead to long-term success than rapid weight loss methods.
- Create a Caloric Deficit: Consume fewer calories than you burn. This can be achieved through a combination of dietary changes and increased physical activity. A consistent calorie deficit of about 500 to 750 calories each day can result in weight loss of around 1.5 lb per week.
- Embrace a Healthy Eating Pattern: Focus on a diet rich in fruits, vegetables, lean proteins, and whole grains. Limit processed foods, sugary drinks, and unhealthy fats.
- Incorporate Regular Physical Activity: Aim for at least 150 minutes of moderate-intensity aerobic exercise or 75 minutes of vigorous-intensity exercise per week. Include strength training exercises to build and maintain muscle mass.
- Seek Support: Enlist the support of friends, family, or a healthcare professional to help you stay motivated and on track. Consider joining a weight loss group or working with a registered dietitian.
- Monitor Progress: Track your weight, body measurements, and other health indicators to monitor your progress and make adjustments to your plan as needed. Counting calories may help you maintain control of this deficit. However, some people don’t feel comfortable tracking calories and instead choose to moderate intake in other ways, such as through eating only low-calorie meals or eating only during specific time frames, known as intermittent fasting.
- Prioritize Sleep and Stress Management: Aim for 7-8 hours of quality sleep per night and practice stress-reducing techniques such as meditation or yoga. Disturbed sleep, characterized by poor quality and insufficient duration, can lead to weight gain, often through snacking on high-fat or high-carb foods. High levels of cortisol may lead to the development of abdominal fat, increase cravings for snacks high in sugar, calories, and fat, and cause you to feel hungrier.
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