This is a plain English summary of an original research article. The views expressed are those of the author(s) and reviewer(s) at the time of publication.
The health benefits of weight management programmes last for at least 5 years after the programme ends, even if people regain the weight they lost, research found.
Weight management programmes including diet and exercise can help people to lose weight, but many regain weight when the programme ends. The long-term effects of weight management programmes on health are not well-understood.
A review analysed long-term trials of behaviour weight management programmes. It found that risk factors for diseases of the heart and blood vessels (cardiovascular disease) and for diabetes were reduced for several years after taking part in a weight management programme. These risk factors included blood pressure, cholesterol, and blood sugar levels. If people regained weight, improvements to blood sugar levels remained
The review suggested that people’s risk of cardiovascular disease and of diabetes may be reduced after losing weight, but there was less evidence to support this finding.
The review should reassure clinicians and members of the public that taking part in weight management programmes and losing weight, even for a short period, is worthwhile.
The issue: many people regain weight after programmes finish
The Health Survey for England 2021 estimates that 1 in 4 (26%) adults in England have obesity and more than 1 in 3 (38%) are overweight. Obesity increases the risk of cardiovascular disease and diabetes. Weight management programmes have been shown to be effective in helping people to lose weight in the short term. However, many people who lose weight on these programmes go on to regain it after the programme finishes.
This study assessed the long-term health effects of weight regain following weight management programmes.
The project included 249 trials of adult weight management programmes from around the world. All participants had obesity or overweight at the start, and were randomly assigned either to an intense weight management programme or to a less intense (or no) intervention. The intense weight management programmes included diet and/or exercise, but not medications or surgery.
All trials ran for at least a year after the programme finished; the average follow-up was 28 months after programme end. At programme end, people assigned to receive little or no support had lost 2.1kg, while those receiving support had lost 4.9kg (a difference of 2.8kg). People who received support, and lost more weight, regained the lost weight more quickly. They put on an extra 0.32kg per year more, than people who lost less weight without support.
This analysis included the studies which had measured risk factors or disease outcomes: blood pressure (84 studies), cholesterol (82 studies) and blood sugar levels (94 studies). It also considered the fewer studies which had reported whether people had diabetes (10 studies) or cardiovascular disease (8 studies).
The researchers found that, 5 years after the end of a weight management programme, people who had been offered support still weighed less than those who got little or no support. Consequently, they still had lower blood pressure, cholesterol and blood sugar levels, despite greater regain.
Despite some regained weight:
- improvements to blood sugar levels remained
- improvements to other risk factors were less than at programme end but still evident
- risk of cardiovascular disease and diabetes were lower, but there were too few studies to be certain.
Why is this important?
The review reinforces the value of weight loss programmes, and shows they can have long-term health benefits. This should reassure clinicians and the public that even a temporary period of reduced weight can have long-lasting effects on their health.
The evidence on risk factors was clear. However, few studies examined the number of people who had cardiovascular disease and diabetes after 5 years. This finding is therefore less certain.
How will this research inform my discussions with people considering a weight management programme?
For someone considering a weight management programme
Is this finding reassuring?
The researchers hope their results will renew optimism among clinicians and patients that weight loss efforts are worthwhile.
You may be interested to read
This Alert is based on: Hartmann-Boyce J, and others. Long-term effect of weight regain following behavioral weight management programs on cardiometabolic disease incidence and risk: systematic review and meta-analysis. Circulation: Cardiovascular Quality and Outcomes 2023; 16: 263 – 276.
Other papers based on the same data set:
- The extent of weight regain and the impact on quality of life and the models the health economics of providing weight loss support
- The impact of weight regain on mental health
- The factors associated with greater weight regain
A plain-language report of the study published in The Conversation.
Funding: This research was supported by the British Heart Foundation and NIHR Oxford Biomedical Research Centre.
Conflicts of Interest: Two authors were investigators on a trial of a low-energy diet-replacement programme funded by the Cambridge Weight Plan.
Disclaimer: NIHR Alerts are not a substitute for professional medical advice. They provide information about research which is funded or supported by the NIHR. Please note that views expressed in NIHR Alerts are those of the author(s) and reviewer(s) at the time of publication. They do not necessarily reflect the views of the NHS, the NIHR or the Department of Health and Social Care.