Absolute Weight Loss, and Not Weight Loss Rate, Is Associated with Better Improvements in Metabolic Health

OBJECTIVE: To determine if the rate of weight loss (WL) is associated with metabolic changes independent of the absolute WL. METHODS: WL and health changes were assessed in 11,281 patients attending a publicly funded clinical weight management program over a treatment period of 12.7 months. Early weight loss rate (WLR) in the first 3–6 months and overall WLR were categorized as Fast WLR (≥1 kg/wk), Recommended WLR (0.5 to 0.9 kg/wk), or Slow WLR (<0.5 kg/wk). RESULTS: On average, patients attained a 6.6 ± 7.3 kg (5.8 ± 5.7%) WL over 12.8 ± 13.1 months. Prior to adjusting for covariates, patients with Fast WLR (−24.7 ± 13.4 kg) at 3–6 months had a greater overall WL as compared to those with Recommended WLR (−13.3 ± 8.7 kg) and Slow WLR (−5.0 ± 5.4 kg). Fast WLR also had greater improvements in the overall waist circumference and blood pressure than patients with Slow or Recommended WLR. However, after adjustment for absolute WL, Early and overall Recommended and Fast WLR did not differ in the changes in any of the health markers (P > 0.05). Conversely, the absolute WL sustained is significantly associated with changes in metabolic health independent of WLR (P < 0.001). Similar results were observed with WLR over the entire treatment period. CONCLUSIONS: Faster rates of WL are associated with a greater absolute WL and larger improvements in waist circumference and blood pressure. However, after adjusting for the larger absolute WL sustained, early and overall faster WLR do not appear to have advantages for improving metabolic health markers. Thus, the absolute WL attained may be the most important factor for improving metabolic health.