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Cardiovascular and metabolic risk
Impact of weight loss on waist circumference and the components of the metabolic syndrome
  1. Amy E Rothberg1,2,
  2. Laura N McEwen1,
  3. Andrew T Kraftson1,
  4. Nevin Ajluni1,
  5. Christine E Fowler1,
  6. Catherine K Nay1,
  7. Nicole M Miller1,
  8. Charles F Burant1,
  9. William H Herman1,3
  1. 1Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
  2. 2Department of Nutritional Sciences, University of Michigan, Ann Arbor, Michigan, USA
  3. 3Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
  1. Correspondence to Dr Amy E Rothberg; arothber{at}med.umich.edu

Abstract

Objective Central adiposity is a component of the metabolic syndrome (MetS). Little is known about the impact of medical weight loss and decreased waist circumference (WC) on the MetS. Our objective was to assess the impact of changes in WC on blood pressure, lipids and glycemia.

Research design and methods We studied 430 obese patients enrolled in a 2-year, intensive, behavioral, weight management program. We report results for participants who completed 6-month and 2-year follow-up.

Results Participants were 49±9 years of age (mean±SD), 56% were women and 85% were white. Baseline body mass index (BMI) was 41±6 kg/m2 and baseline WC was 120±14 cm. At 6 months, BMI decreased by 6±3 kg/m2 and WC by 14±9 cm. Relative change in WC was defined as the 6-month or 2-year WC minus the baseline WC divided by the baseline WC. Systolic blood pressure decreased by 8 mm Hg for the tertile of participants with the largest relative decrease in WC and by 2 mm Hg for those with the smallest relative decrease in WC (p=0.025). Similar patterns of improvement were observed in total cholesterol (−29 vs −12 mg/dL, p=0.017), low-density lipoprotein-cholesterol (−19 vs −4 mg/dL, p=0.033), and glycated hemoglobin (−1.2 vs −0.3%, p=0.006). At 2 years, BMI decreased by 5±4 kg/m2 and WC by 11±11 cm and similar patterns of improvements were seen in components of the MetS. At both 6 months and 2 years, larger relative decreases in WC were associated with greater improvements in lipids and glycemia independent of sex.

Conclusions In obese people, greater relative decreases in WC with medical weight loss are associated with greater improvements in components of the MetS independent of sex.

  • Obesity
  • Body Mass Index
  • Waist Circumference
  • Metabolic Syndrome

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjdrc-2016-000341

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    Footnotes

    • Contributors AER wrote the manuscript. LNM and NMM performed the statistical analyses. WHH revised and edited the manuscript. AER, ATK, NA, CEF, CKN and CFB researched data and reviewed/edited the manuscript. AER and LNM are the guarantors of this work and, as such, had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

    • Funding The study was supported by the Michigan Nutrition Obesity Research Center (grant number DK081943), the Michigan Center for Diabetes Research (grant number DK089503), and the Michigan Center for Diabetes Translational Research (grant number P30DK092926). Additional support was provided by the A Alfred Taubman Medical Institute and the Robert C and Veronica Atkins Foundation.

    • Competing interests AER, ATK, NA, and CEF have received grant support from Optifast, Nestlé, SW. LNM, CFB and WHH, and CKN, and NMM have nothing to disclose.

    • Patient consent Obtained.

    • Ethics approval University of Michigan Institutional Review Board.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement No additional data are available.