Obese patients who decrease BMI to overweight range have significant changes in lifestyle and medical risk factors

Research has demonstrated that losing larger amounts of weight can provide greater health benefits than modest weight loss for obese individuals. Since people in general are more overweight than ever before, they need to lose more weight. The purpose of this study was to assess changes in medical and lifestyle risk factors in obese patients (BMI > 30 kg/m2) who had BMIs < 30 at the time of follow-up. All patients had completed a health risk appraisal (HRA) upon entering The HMR Program for Weight Management™ and a follow-up HRA during 1/08 to 3/09 (n=349). The HMR (Health Management Resources®) Program is an intensive program focusing on lifestyle change, including physical activity, vegetable and fruit intake, and use of meal replacements for portion-control. The average length of time at follow-up was 150 weeks (2.9 years); average age was 53 yrs. The average weight loss being maintained was 52 lbs (23.5% of initial body weight). Patients made significant lifestyle changes (p<.01), including physical activity, vegetable/fruit intake and dietary fat. There were significant decreases (p<.01) in all measured medical risk factors, including -17.1% total cholesterol/HDL, -32.4% triglycerides, -12.6% fasting blood glucose, -8 mm/Hg systolic blood pressure and -7 mm/Hg diastolic blood pressure. The total risk factor score (overall measure of risk factors) declined from +21 to -4 (Surgeon General’s healthy American). Those patients with initial BMIs > 40 (n=54) that were reduced to < 30 had even more significant changes. These patients were maintaining an average of 116 lb loss (41.3% of initial weight) over an average of 2.6 yrs. All measured medical risk factors declined significantly (p<.01) including -27% total cholesterol/HDL, -40.7% triglycerides, -17.8% fasting glucose, -11 mm/Hg systolic and -13 mm/Hg diastolic blood pressure. The total risk factor for this group declined from +32 to -8. 62.5% of these individuals who were initially on cholesterol, blood pressure or diabetes medications (oral and/or insulin) eliminated these medications (and others decreased their doses). Many health professionals do not encourage obese individuals to lose substantial amounts of weight believing that such weight loss and weight maintenance is not possible. This study demonstrates that it is possible for obese patients to lose and maintain large amounts of weight in an ongoing weight management program, and experience significant positive changes in medical risk factors.