Weight loss does not lower cardiovascular risk in people with diabetes

Surely lowering body weight and maintaining it for 11 years will prevent heart disease and strokes in overweight people with diabetes. Apparently not, according to the findings of a much anticipated trial.

The Look AHEAD Study

People with type 2 diabetes have increased risk for cardiovascular disease. As overweight is often associated with cardiovascular risk factors it has always been assumed that excess body weight contributes to the burden of cardiovascular disease and that weight loss would lower it.

The Look AHEAD Study was conceived to test this hypothesis. This large, multi-centre, randomised controlled trial began 11 years ago in the United States. Over 5000 overweight men and women with type 2 diabetes were recruited – half received active weight loss intervention and the control group received a general program of support and education. The intervention group successfully lost weight. After one year they had lost nearly nine per cent of their initial body weight and at 11 years their average weight was still about five per cent less than baseline.

Over the years the good news started to flow from the Look AHEAD Study. A string of papers showed that weight loss in the intervention group was linked to improvements in fitness, mobility, blood glucose, sleep apnea, urinary incontinence, symptoms of depression, blood clotting and body image. And use of medications was reduced. All very positive, but the real test was yet to come: would weight loss lower rates of cardiovascular disease?

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