Adherence
Intensive lifestyle intervention (ILI) reduces cardiovascular event risk in adults with overweight/obesity and type 2 diabetes ONLY when the patient maintains at least 50% of the time in the target weight loss range (>50% TIR) after initial weight loss.
For adults with type 2 diabetes and obesity, the cardiovascular benefits of lifestyle changes (diet and exercise) are not guaranteed by weight loss alone; they are contingent on maintaining that weight loss. If you lose weight but regain it, you may not see the expected reduction in heart disease risk. Therefore, the primary goal of lifestyle intervention should be long-term weight maintenance, not just initial loss.
In adults with overweight/obesity and type 2 diabetes, ILI might help in lowering the risk of cardiovascular events when the lower body weight is maintained after weight loss.
Why this rating
Secondary analysis of a large, multi-center RCT (Look AHEAD) with long follow-up (median 9.5 years) and robust statistical methods (propensity score matching, E-values).
Source
Cardiovascular effects of intensive lifestyle intervention in adults with overweight/obesity and type 2 diabetes according to body weight time in range
Menghui Liu et al. · EClinicalMedicine · 2022
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