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 A new retrospective study has concluded that patients whose weight
fluctuates the most die twice as quickly or have twice the risk of
heart attack or stroke compared to people who maintain a stable body
weight.
And their risk of developing diabetes grows by 78 percent.
The findings, which need to be confirmed by further research,
suggest a life-and-death conundrum. Being overweight is already
known to pose serious health risks. The new research says dropping
the pounds and putting them back on again poses additional dangers.
If you are an overweight person with heart disease who lost 20
pounds "you are worse off if you drop your weight and gain it back"
than if you didn't lose it in the first place, chief author Dr.
Sripal Bangalore, an interventional cardiologist and associate
professor of medicine at New York University's Langone Medical
Center told Reuters Health by phone.
The study is saying, "If you're going to lose weight, do it right
and you need to take it seriously," said Dr. Ira Ockene, a professor
of medicine at the University of Massachusetts Medical School in
Worcester, who was not connected with the research.
If people use the results as an excuse not to drop unhealthy pounds,
"that would be unfortunate,” Ockene told Reuters Health. “There's a
lot of data that says if you lose weight and keep it off, you do
better."
"Hopefully this will be used as a motivation to lose weight and
maintain weight," Bangalore said.
Such yo-yo dieting, where a person's weight fluctuates repeatedly,
is already known to be unhealthy in people without heart disease.
The new study in the New England Journal of Medicine explored
whether that was specifically true for people with coronary artery
disease, where fatty deposits have built up in the blood vessels
feeding the heart muscle. The researchers recycled data from 9,509
volunteers who were part of a Lipitor study published in 2005 and
sponsored by Pfizer.
Another important limitation of the study: It did not examine
whether patients lost weight because they tried to, or if their
weight fluctuated because they were battling illness.
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After adjusting for various factors such as high blood pressure,
smoking, race, gender, diabetes, cholesterol levels and treatment
with Lipitor, the Bangalore team found that people whose weights
fluctuated the most were 2.24 times more likely to die from any
cause within about five years, 2.17 times more likely to have a
heart attack and 2.36 times more likely to be hit with a stroke than
people whose weights were the most stable.
For every 3- or 4-pound change in body weight, their risk of heart
attack, cardiac arrest, chest pain, death from heart disease or the
need for surgery to open a clogged artery rose by 4 percent.
The dangers posed by shifting weight were least pronounced in people
who had a normal weight to begin with.
Ockene said people need to put weight loss in perspective.
"Studies show people set unattainable goals. Heavy people say, 'I
need to lose 40 pounds' and they set a goal that is largely
unattainable. And when they lose 10 pounds they're disappointed. And
they say, 'What the hell' and they just gain it back," he said.
"But if you lose 10 pounds and keep it off, your diabetes will be
better, your blood pressure will be better, your lipids will be
better, a lot of things will be better. You don't need to lose 30 or
40 pounds," he said. "That's an important issue for people to
understand."
As a typical example of patients in the study whose weights
fluctuated significantly, the researchers cited the case of a
53-year-old man whose weight went from 231 pounds to 244 pounds
three months later, then dropped to 211 pounds eighteen months later
before going up to 253 pounds after another 18 months had passed.
SOURCE: http://bit.ly/2nognpI New England Journal of Medicine,
online April 5, 2017.
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