Energy balance
In adults with obesity, sustained weight loss reduces the risk of coronary heart disease (CHD) and myocardial infarction, whereas in normal weight adults, both weight loss and weight gain increase the risk of cardiovascular disease (CVD).
If you have obesity, losing weight significantly lowers your risk of heart attacks and coronary heart disease. However, if you are already normal weight, losing weight actually increases your risk of heart disease and heart failure. Focus on maintenance if you are normal weight, and sustainable loss if you are obese.
Among individuals with obesity, the weight loss group had a lower risk of CHD and moderately lower risk of CVD. Weight gain increased the risk of CVD across BMI groups. In the normal weight, both weight loss and gain were associated with increased risk for CVD [HR vs weight maintenance=1.53 (1.18-1.98) and 1.43 (1.19-1.71 respectively)].
Why this rating
Large sample size (n=138,567) and rigorous causal inference methods (target trial emulation), but observational design limits causal certainty compared to RCTs.
Source
Weight change and the incidence of cardiovascular diseases in adults with normal weight, overweight and obesity without chronic diseases; emulating trials using electronic health records
Michail Katsoulis et al. · medRxiv · 2020
DOI 10.1101/2020.05.14.20102129
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