Maintaining weight loss as important as losing it for older women

New research from Wake Forest Baptist Medical Center found that gaining weight back after intentional weight loss is associated with negative long-term effects on some cardiometabolic (CM) risk factors in postmenopausal women.

In this paper, published online by the Journal of Gerontology: Medical Sciences, lead authors Daniel Beavers, Ph.D., and Kristen Beavers, Ph.D., wanted to look at how weight regain affects health risk in these women. The researchers looked specifically at CM risk factors -- a cluster of risk factors that are indicators of a person's overall risk for type 2 diabetes and cardiovascular disease. They include blood pressure, HDL and LDL cholesterol, triglycerides, fasting glucose and insulin.

"In this group of women, weight loss and maintaining that loss offers the most health benefit, but therein lies the problem," Daniel Beavers said. "For most people, weight regain after intentional weight loss is an expected occurrence, and the long-term health ramifications of weight regain in older adults are not well understood."

Specifically, the researchers looked at how CM risk factors change in the year following significant, intentional weight loss and whether these changes are affected by weight regain.

"What we found was that all CM risk factors are improved with weight loss, which is not surprising, but most regressed back to their baseline values 12 months later, especially for women who were classified as 'regainers,'" Kristen Beavers said. "For women who had regained weight in the year after their weight loss, several risk factors were actually worse than before they lost the weight."

For the study, sponsored by the National Institute on Aging, the researchers evaluated 112 obese, postmenopausal women averaging 58 years of age, through a five-month weight loss intervention and a subsequent 12 month non-intervention period. Body weight/composition and CM risk factors were analyzed before and after the weight loss intervention and at six and 12 months after the intervention. During the intervention, women lost a significant amount of weight, an average of 25 pounds, and 80 women returned for at least one followup measurement. Weight regain status was based on whether a participant regained at least four pounds during the follow-up period. Two-thirds of the women fell into this category and, on average, regained approximately 70 percent of lost weight.

Beavers said these study results highlight the need for future research to better identify barriers to long-term weight loss success and develop effective strategies to promote the maintenance of weight loss in this population. These new findings build on previously published data from Wake Forest Baptist's gerontology research group that found when postmenopausal women lose weight and gain it back, they regain it mostly in the form of fat, rather than muscle.

"Our data suggest that for postmenopausal women, even partial weight regain following intentional weight loss is associated with increased cardiometabolic risk. Conversely, maintenance of or continued weight loss is associated with sustained improvement in the cardiometabolic profile," Kristen Beavers said. "The take away message for overweight, older women is to approach weight loss as a permanent lifestyle change, with weight maintenance just as important as weight loss."

This work was supported by the NIH (R01-AG/DK20583, R01-HL093713 and F32-AG039186), Wake Forest University Claude D Pepper Older Americans Independence Center (P30- AG21332), and Wake Forest University General Clinical Research Center (M01-RR07122). Co-authors are: Barbara Nicklas, Ph.D., and Mary F. Lyles, M.D., of Wake Forest Baptist.