Two-year changes in lipids and lipoproteins associated with the maintenance of a 5% to 10% reduction in initial weight: Some findings and some questions

Objective: This study assessed whether a 5% to 10% reduction in initial wei ght would be associated with as favorable long-term (i.e., 100 weeks) chang es in lipids and lipoproteins, as have been observed on a short-term basis (i.e., 8 weeks). Research Methods and Procedures: This was a prospective evaluation of 25 ob ese women, each of whom had lost greater than or equal to 5% of initial wei ght during 48 weeks of treatment and had maintained a weight loss of this m agnitude at 1-year follow-up (week 100). Lipids and lipoproteins were obtai ned at baseline and at weeks 8, 24, 48, and 100. All participants had a bas eline total cholesterol greater than or equal to 5.17 mmol/L (200 mg/dL). Results: At the end of the first 8 weeks, weight fell an average of 11.7+/- 2.8%, total cholesterol 20.6+/-7.5%, low-density-lipoprotein (LDL) choleste rol 23.0+/-18.1%, and triglycerides 26.0+/-20.1%. At week 48, weight had fa llen to 20.1+/-7.0% below baseline, but total cholesterol and LDL cholester ol were reduced only 11.5+/-10.4% and 12.0+/-14.0% below baseline, respecti vely. These latter reductions were significantly (p<0.05) smaller than thos e observed at week 8, despite the larger weight loss at week 48. High-densi ty-lipoprotein cholesterol declined significantly values by week 24. Patien ts gained 7.4+/-7.4 kg from weeks 48 to 100, during which time total and LD L cholesterol (but not triglycerides) rose significantly (p<0.05). Patients who, at week 100, maintained losses >10% of initial weight had significant ly greater reductions in total and LDL cholesterol values than did patients who maintained losses of only 5% to 10% of initial weight. Discussion: Results of this study underscore the importance of assessing lo ng-term changes in weight-related health complications when patients have l ost weight but are no longer dieting (and exercising) as aggressively as th ey did during the initial months of treatment.