title: Differentiated long-term effects of intentional weight loss on diabetes and hypertension.
abstract: The beneficial effects of weight loss in the obese have been widely accepted. Still, there is a lack of controlled studies displaying large maintained weight losses over long periods (>4 years). We wanted to examine the results of long-standing intentional weight loss on the development of diabetes and hypertension in severely obese individuals over an 8-year period. In the ongoing prospective Swedish Obese Subjects (SOS) study, 346 patients awaiting gastric surgery were matched with 346 obese control subjects on 18 variables by a computerized matching program. The controls were drawn from a registry consisting of 1508 obese potential controls examined at primary health care centers in Sweden. Of the 692 selected patients (body mass index 41.2+/-4.7 kg/m(2) [mean+/-SD]), 483 (70%) were followed for 8 years. No significant weight changes occurred in the obese control group over 8 years. Gastric 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 maintained weight reduction of 16% strongly counteracted the development of diabetes over 8 years but showed no long-term effect on the incidence of hypertension.
authors.affiliation: Departments of Anesthesiology and Intensive Care, University of Göteborg, Göteborg, Sweden. david.sjostrom@medfak.gu.se
authors.forename: C D
authors.initials: CD
authors.lastname: Sjöström
authors.forename: M
authors.initials: M
authors.lastname: Peltonen
authors.forename: H
authors.initials: H
authors.lastname: Wedel
authors.forename: L
authors.initials: L
authors.lastname: Sjöström
mesh_terms: D000328:Adult; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D015995:Prevalence; D011446:Prospective Studies; D015431:Weight Loss