Cardiometabolic Risk After Weight Loss and Subsequent Weight Regain in Overweight and Obese Postmenopausal Women

OVERWEIGHT and obesity are significant public health problems, with recent estimates suggesting that 72.3% and 64.1% of adult men and women, respectively, have a body mass index (BMI) greater than or equal to 25kg/m2 (1). In women, postmenopausal status is associated with higher prevalence of overweight and obesity (2). Excessive body weight often predisposes to chronic disease, and accordingly, overweight and obese postmenopausal women are at increased risk of developing several cardiometabolic conditions (3–7). Treatments for overweight and obesity, which result in significant weight loss, frequently yield immediate improvement in the cardiometabolic risk profile (8). For most, however, long-term weight loss maintenance remains elusive (9). Data show that about one third of individuals who lose weight will regain all of their lost weight within 1 year, and almost all individuals regress to their baseline weight within 5 years (10,11). Although nearly 60% of overweight women report trying to lose weight ([12] and previous data suggest that most will be unable to maintain their weight loss), the effect of a cycle of intentional weight loss followed by weight regain on cardiometabolic risk in overweight and obese postmenopausal women is not known. Such data are necessary to assess the long-term benefits and risks of intentional weight loss in this population. Observational studies in younger adults show that weight cycling is not associated with increased cardiometabolic risk (13–15). Further, weight regain in this population is not associated with adverse effects on body composition or fat distribution (16,17). However, recent data from our group suggest that, for postmenopausal women, body composition is negatively impacted by weight regain following intentional weight loss (18). Specifically, after a 13% weight reduction, women who regained at least 2kg of lost weight within a year experienced a greater accretion of fat mass, relative to lean mass. Due to the known association between elevated body fat and cardiovascular disease risk, preferential regain of fat suggests that cardiometabolic risk factors may be worse in older adults who regain weight after intentional weight loss, although further investigation is warranted. Therefore, the purpose of this study was to determine how cardiometabolic risk factors change in the year following significant intentional weight loss in postmenopausal women and if observed, changes are affected by weight and fat regain. We also assessed whether these risk factors were worse 1 year after intentional weight loss compared with baseline values in women who experienced weight regain.