Differentiated long-term effects of intentional weight loss on diabetes and hypertension

The beneficial effects of weight loss in the obese have been widely accepte d. Still, there is a lack of controlled studies displaying large maintained weight losses over long periods (>4 years). We wanted to examine the resul ts of long-standing intentional weight loss on the development of diabetes and hypertension in severely obese individuals over an 8-year period. In th e ongoing prospective Swedish Obese Subjects (SOS) study, 346 patients awai ting gastric surgery were matched with 346 obese control subjects on 18 var iables by a computerized matching program. The controls were drawn from a r egistry consisting of 1508 obese potential controls examined at primary hea lth care centers in Sweden. Of the 692 selected patients (body mass index 4 1.2+/-4.7 kg/m(2) [mean+/-SD]), 483 (70%) were followed for 8 years. No sig nificant weight changes occurred in the obese control group over 8 years. G astric surgery resulted in a maximum weight loss of -31.1+/-13.6 kg after 1 year. After 8 years, the maintained weight loss was still 20.1+/-15.7 kg ( 16.3+/-12.3%). Whereas this weight reduction had a dramatic effect on the 8 -year incidence of diabetes (odds ratio 0.16, 95% CI 0.07 to 0.36), it had no effect on the 8-year incidence of hypertension (odds ratio 1.01, 95% CI 0.61 to 1.67). A differentiated risk factor response was identified: a main tained weight reduction of 16% strongly counteracted the development of dia betes over 8 years but showed no long-term effect on the incidence of hyper tension.