Friday 4 March 2016

Even a 5% weight reduction matters in obesity: Good news for obesity clinics

Even a 5% weight reduction matters in obesity: Good news for obesity clinics
Dr K K Aggarwal What should be the amount of weight to be lost in obese patients? People with obesity who reduce their weight by 5% will have improvements in metabolic function in many tissues, including fat, liver, and muscle. Further weight loss of 10 to 15% results in additional improvements. Obesity is a risk factor for type 2 diabetes and heart disease. These health issues stem from underlying metabolic abnormalities that affect the liver, pancreas, muscle, fat, and other tissues. Most recommend that people who are overweight or obese aim to lose 5% to 10% of their weight to achieve improvements in health. A NIHHK /NIH study by Dr. Samuel Klein at Washington University School of Medicine in St. Louis, reported online on February 22, 2016, in Cell Metabolism, randomly assigned 40 sedentary people with obesity to maintain their body weight or to go on a diet to lose 5% of their body weight, followed by targets of 10% and 15%. Nineteen achieved the initial target of 5% weight loss after about 3.5 months. These people had significantly decreased body fat, including abdominal fat and fat in the liver. They had decreased plasma levels of glucose, insulin, triglycerides, and leptin. They also showed improved function of insulin-secreting β cells, as well as the ability of fat, liver, and muscle tissue to respond to insulin. Markers of inflammation are elevated in people with obesity. The researchers, however, found no changes in systemic or fat tissue markers of inflammation with 5% weight loss. Nine reached the subsequent targets, achieving about 11% weight loss at 10 months. The decreases in fat mass, plasma insulin, leptin, and triglyceride concentrations continued in tandem with the weight loss. These participants showed continued improvements in β cell function and in insulin sensitivity in muscle. Insulin sensitivity in liver and fat tissue, however, didn’t improve further with weight loss beyond 5%... (NIH)

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