I was ready to go look to see if the effect was caused by the participants who lost the most weight being the ones who weighed the most in total, or something. And in any case it's always better to not get so obese that the person end up with health problems in the first place. But it's interesting to see if it's not so simple as the problems going away once the person loses weight, apparently numerous individual studies and meta-analyses consistently demonstrate an ‘obesity paradox’, where patients with obesity and established CVD generally have a better prognosis than leaner patients with the same condition (maybe because non-obesity-related CVD only happens for serious reasons?)Many studies have explored the relationship between weight changes and mortality, as well as mortality in obese people with heart disease. These studies often suggest that excessive weight is unhealthy and that people with obesity and heart disease should lose weight.
However, findings from a recent study, of which I was a co-author, challenge this assumption. Our research indicates that significant weight loss – greater than 10kg – can actually increase the risk of early death in obese people with cardiovascular disease.
But that recent study is https://heart.bmj.com/content/early/202 ... 024-324383 and the abstract says:
So, it says "only large weight gain was associated with an increased risk of CV death and all-cause mortality" and a coauthor is writing in The Conversation saying "significant weight loss – greater than 10kg – can actually increase the risk of early death in obese people with cardiovascular disease".Results: Of the 8297 obese participants who had CVD with repeated weight measurements, 43.1% were female. The mean age was 56.6 (SD: 7.2) years. The overall median follow-up of the study was 13.9 (IQR: 13.1-14.6) years. 52.7% of the participants had stable weight change (weight loss or gain<5 kg), 14.2% had large weight loss (≥10 kg) and 5.1% had large weight gain (≥10 kg). Compared with stable weight, only large weight gain was associated with an increased risk of CV death and all-cause mortality (fully adjusted HR (95% CI): 3.05 (1.40 to 6.67) for CV death and 1.93 (1.15 to 3.26) for all-cause mortality).
Conclusions: Among obese individuals with CVD, large weight gain is associated with a higher risk of CV death and all-cause mortality. Further studies are needed to understand the exact mechanisms underlying the associations between weight loss or weight gain and mortality.
I also note that there's gaps between the categories, such that someone could have lost or gained 5-10 kg and they wouldn't be in any of these three categories. I'd hope that categories for small weight loss and small weight gain are in the paper. But either Pierscionek is pointing to a real result from the paper which wasn't significant enough in terms of effect size or error bars to mention even in the abstract or, well, f.cked if I know.
