Obesity poses a significant global health challenge, influencing various aspects of health, from heart conditions to cancer outcomes. This article explores the multifaceted relationship between weight loss and health improvements, drawing on scientific studies and real-life stories. We will examine the impact of weight loss on conditions like atrial fibrillation (AF) and breast cancer, highlighting both the challenges and successes in achieving and maintaining a healthy weight.
Atrial Fibrillation and Weight Loss: A Complex Relationship
Atrial fibrillation (AF) is the most common persistent arrhythmia in adults, increasing the risk of stroke, dementia, and mortality. Risk factors for AF include hypertension, diabetes, obesity, and obstructive sleep apnea. Catheter ablation is a recognized treatment method to prevent AF recurrence, especially for drug-refractory symptomatic AF. However, the long-term success rate of AF ablation declines over time.
Obesity and AF: The Paradox
While the guidelines suggest obesity increases the risk of AF progressively, they do not definitively state that obesity is a risk factor for AF recurrence post-ablation, partly due to obstructive sleep apnea as a confounding factor. Research on controlling risk factors to reduce AF recurrence after ablation has become a hot topic, with obesity being a significant worldwide health problem contributing to AF incidence after ablation.
Studies on Weight Loss and AF Recurrence
A meta-analysis of studies involving 1283 patients aimed to determine whether weight loss can reduce the AF incidence and burden of AF in obese populations. The mean body mass index of all included studies was over 30 kg/m2. One randomized, open-labeled clinical trial and seven cohort studies were included in the analysis.
The clinical trial showed a non-significant benefit of weight loss intervention on AF recurrence (Odd risk [OR] = 1.02, 95% confidence interval [CI] 0.70-1.47). However, meta-analysis based on observational studies showed that the recurrence rate of AF after ablation was significantly reduced (RR = 0.43, 95% CI 0.22-0.81, I2 = 97%) in relatively obese patients with weight loss compared with the control group. Each 10% reduction in weight was associated with a decreased risk of AF recurrence after ablation (RR = 0.54, 95% CI 0.33-0.88) with high statistical heterogeneity (I2 = 76%).
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Methods of Weight Loss and Their Impact
The method of weight loss in the clinical trial was improved lifestyle. In four observational studies, the method of weight loss was an improved lifestyle; bariatric surgery was adopted for weight loss in one observational study, and the method of weight loss in the other two observational studies was unknown. Weight intervention was used in five of the studies before ablation, whereas three studies reported the use of an intervention after ablation.
Subgroup Analysis: Weight Loss Methods and Timing
Subgroup analysis revealed that bariatric surgery was associated with lower AF relapse after ablation (RR = 0.14, 95% CI 0.12-0.17). Although a nonsignificant association was noted for lifestyle management (RR = 0.56, 95% CI 0.18-1.69), a significant decreasing trend was observed. Pre-defined subgroup analysis stratified by the weight loss time showed that weight loss was associated with lower AF relapse when patients receive weight management before ablation (RR = 0.41; 95% CI 0.19-0.92). However, when patients received weight management after ablation, the weight loss did not significantly decrease AF recurrence (RR = 0.46, 95% CI 0.19-1.14).
Weight Loss and AF Severity, Symptoms, and Quality of Life
Evidence from the observational study showed that weight loss was significantly associated with reduced duration and symptoms of AF (P < 0.001). Weight loss significantly improved quality of life (P < 0.002) but not the symptom severity of AF (P = 0.84).
Conclusion: Weight Loss and AF
Weight loss, particularly through bariatric surgery or lifestyle changes implemented before ablation, shows promise in reducing AF recurrence. These findings highlight the importance of weight management as part of a comprehensive approach to AF treatment.
Weight Loss in African American Breast Cancer Survivors: The Moving Forward Study
African American (AA) women face higher breast cancer mortality rates compared to other groups, even after adjusting for various factors. Obesity is a significant concern among AA women, contributing to breast cancer progression and other chronic conditions. Weight loss interventions have shown positive effects on weight, behavior, biomarkers, and psychosocial outcomes in breast cancer survivors, but few interventions specifically target African Americans.
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The Moving Forward Intervention
The Moving Forward study was a community-based, randomized weight loss intervention trial with 246 overweight/obese AABCS. Participants were randomly assigned to either the 6-month Moving Forward Interventionist-Guided program (MFG) or the Moving Forward Self-Guided program (SG). The study supports the efficacy of a community-based interventionist-guided weight loss program targeting AABCS. Although mean weight loss did not reach the targeted 5%, the mean loss of > 3% at 6 months is associated with improved health outcomes.
Study Design and Methods
Eligible participants were AABCS (stages I-III), were ≥ 18 years of age, had a body mass index (BMI) of ≥ 25 kg/m2, had completed cancer treatment at least 6 months before recruitment (hormonal therapy allowed), were physically able to participate in a moderate physical activity program per health-care provider approval, and were agreeable to study procedures.
MFG included twice-weekly in-person classes with supervised exercise and twice-weekly text messaging targeting enhanced self-efficacy, social support, and access to health promotion resources. SG participants also received the program binder, but no classes or text messaging. They met once with a nonintervention staff member to receive and review program materials.
Anthropometric, body composition, and behavioral outcomes were measured at baseline, 6 months, and 12 months.
Study Results
Both groups lost weight. Mean and percentage of weight loss were greater in the guided versus self-guided group (at 6 months: 3.5 kg v 1.3kg; P < .001; 3.6% v 1.4%; P < .001, respectively; at 12 months: 2.7 kg v 1.6 kg; P < .05; 2.6% v 1.6%; P < .05, respectively); 44% in the guided group and 19% in the self-guided group met the 5% goal.
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Changes in Body Composition and Behavior
Within both groups, weight, waist and hip circumferences, and body fat were significantly reduced at both time points. Lean mass decreased slightly, but relative to total mass, the percentage of lean mass increased. Greater attendance in MFG was associated with greater weight losses (P = .019). Smoking was not associated with weight loss.
Within-group improvements were significant for moderate activity, daily energy intake, fiber, sodium, and added sugars in both groups at 6 and 12 months (P < .05). MFG participants also showed improvements for percentage of calories from fat, fruits, and vegetables at 6 months and for vigorous activity and meat at 6 and 12 months (P < .01).
Implications of the Study
The Moving Forward study is the first fully powered intervention trial to examine a targeted weight loss intervention’s effects on anthropometrics, body composition, and behavioral outcomes among AABCS. Weight management is particularly crucial for AABCS, given the high rates of obesity-related comorbidities.
Weight Loss Benchmarks and Future Directions
Weight loss beginning at 3% (for glycemic measures and triglycerides) and 5% (for blood pressure, HDL and LDL cholesterol) should be considered clinically meaningful. To encourage larger weight losses in future trials, emphasis and consideration should be given to the recommended energy prescription. Future studies will examine the associations between body composition changes and biomarkers of overall health and breast cancer recurrence in AABCS.
Mackenize Thomas Weight Loss Story
Kentucky singer MaKenzie Thomas survived the first round of live eliminations on “The Voice” on Tuesday night. Her silky, jazzy performance of “I Believe in You and Me” appeared effortless and lyrical.
Thomas, who is from Fleming County, is a gospel singer who performs with Elevated Praise and at times with the Black Gospel Ensemble at Morehead State University, where she had been a student.