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Losing Weight Matters




But there is some intriguing evidence that seems to indicate that it's not just that you're likely to have better blood pressure at a lower body weight, or that shedding some of the excess body fat can actually improve some of your blood chemistry. Apparently, there are health benefits to be gained from losing weight, the actual process of losing, even distinct from being at the eventual lighter weight achieved.



You can take your pick of relevant tests to see if there's been an improvement in comorbidities. Of course there's blood pressure and blood sugar and lipid levels; you can examine insulin production and whether it's too high or low; you can test cholesterol levels, track sleeping and breathing patterns. And then there are subjective measures like how a person feels, or even feels about themselves. Most of these measures as well as a few others were used for this study.

Here's how they figured it all out. The research was done in Australia, with a very carefully selected group of participants, all people who were roughly matched by age and size, with a stable BMI (body mass index) between 30 and 35, which is the range for the definition of clinical obesity. On a person who is 5-foot, 9-inches in height, that's up to about 235 pounds.


Now, the conventional wisdom would anticipate that people in that BMI range would experience all the usual health problems that are associated with obesity and the comorbidities listed above. But no! The researchers reported that these still-heavy-but-less- heavy-than-before folks were able to achieve major improvements in their comorbidities and overall quality of life such that they were "similar to normal."

In fact, the researchers admitted a certain puzzlement when they reported that the subjects' "continued state of obesity should be driving a compromised state of health and quality of life, and yet, the data indicate that the benefits of weight loss seem to override the harm of obesity."

So then they matched them with a group of controls who had not yet undergone any weight-loss program, people who were also 30-35 BMI, but prior to any effort to reduce.

When the investigators compared the health and quality-of-life indicators between the two groups, they found that the weight-loss group fared much better than the controls on almost every measurement. The weight-loss subjects had lower blood sugar and insulin levels, and better insulin sensitivity levels than the controls. The conventional measures of blood lipids associated with overweight were also more favorable in the weight-loss subjects, who had lower triglycerides, higher high-density-lipoprotein (HDL) cholesterol (that's the good cholesterol), and lower total cholesterol. All of those measures are markers of the metabolic syndrome, which most people know is a red-flag precursor to diabetes.

Overall, 38 percent of the control group had metabolic syndrome, compared to only 14 percent of the weight-loss group.

There were some measures that didn't offer any significant distinctions, such as specific body measurements, and blood pressure was about the same; hemoglobin levels and iron status were also pretty consistent.

On the mental/emotional side, the weight-loss subjects scored better than the controls for all the measures of quality of life, symptoms of depression and perception of appearance, including physical function, pain, general health, energy or vitality, social function and mental health. Probably no surprise there, while they were all about the same weight, for the weight-loss subjects, that weight was an improvement, whereas for the control group, it was likely the result of a long losing struggle against gain.

The researchers decided their results mean that they need to look more closely at the expectations of weight-loss therapies in general, but what it should say to the heavy person is "atta boy!" You may not have to be as slim as "average" folks to be as healthy, so don't psyche yourself out of an effort by thinking that before you even start.

Because there is one other interesting note. The weight-loss group also scored slightly higher on self- assessed quality-of-life indicators than the population at large, suggesting that the loss of weight in and of itself improved these folks' mental health, even though they were still heavier than the population average.

Of course, when you get down to it, that's probably not a surprise either. They might not have reached the body weight they'd always dreamed of, but they'd seen tremendous improvements, no doubt inspiring hope and optimism in general, and nothing succeeds like success, even when there's still an excess.


last update: February 2009

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