Yale School of Medicine, Department of Psychiatry, New Haven, Connecticut, USA.
Int J Eat Disord. 2023 Nov;56(11):2074-2083. doi: 10.1002/eat.24035. Epub 2023 Aug 2.
Modest weight losses may be associated with improvements in cardiovascular disease risk factors (CVDRF) in patients with obesity. The effects of weight losses on CVDRF in persons with binge-eating disorder (BED) are unknown. This study prospectively examined changes in CVDRF among patients receiving behaviorally-based weight-loss treatment (BBWLT) who attained modest weight losses (≥5 to <10% and ≥10%).
Of 191 participants, CVDRF variables were re-assessed in 168 participants at posttreatment and in 151 at 12-month follow-up. Participants who attained ≥5 to <10% weight loss were compared to those who did not on CVDRFs (total cholesterol, HDL, LDL, triglycerides, HbA1C, mean plasma glucose, heart rate, and systolic/diastolic blood pressure); similar comparisons were completed for those who attained ≥10% weight loss.
At posttreatment, ≥5 to <10% weight loss (N = 42; 25.0%) was associated with significant improvements in HbA1c and mean plasma glucose, whereas ≥10% weight loss (N = 40, 23.8%) was associated with significant improvements in total cholesterol, triglycerides, HbA1c, mean plasma glucose, and heart rate. At 12-month follow-up, ≥5 to <10% weight loss (N = 17; 11.1%) was related to significant improvements on HDL, triglycerides, HbA1c, and mean plasma glucose, whereas ≥10% weight loss (N = 40, 26.0%) was associated with significant improvements on all the CVDRF variables (except blood pressure).
Modest weight loss is associated with significant improvements in CVDRFs in patients with BED and obesity following treatment and at 12-month follow-up. Future work should examine whether improvements in CVDRF are attributable to weight loss per se and/or to other related lifestyle changes.
Individuals with binge-eating disorder and obesity who attain modest weight loss following treatment exhibit improvements in various measures of cardiovascular disease risk compared to those who do not. While weight loss has been challenging for individuals with binge-eating disorder, clinicians should inform patients of the potential health benefits of modest weight loss. Future research should investigate whether weight loss itself and/or related behavioral lifestyle changes drive improved cardiovascular disease risk factors.
适度的体重减轻可能与肥胖患者心血管疾病风险因素（CVDRF）的改善有关。暴食障碍（BED）患者体重减轻对 CVDRF 的影响尚不清楚。本研究前瞻性地检查了接受基于行为的体重减轻治疗（BBWLT）的患者中 CVDRF 的变化，这些患者达到了适度的体重减轻（≥5%至<10%和≥10%）。
在 191 名参与者中，在治疗后和 12 个月随访时重新评估了 168 名参与者的 CVDRF 变量。将达到≥5%至<10%体重减轻的参与者与未达到该体重减轻的参与者进行比较（总胆固醇、HDL、LDL、甘油三酯、HbA1C、平均血浆葡萄糖、心率和收缩压/舒张压）；对于达到≥10%体重减轻的参与者，也完成了类似的比较。
在治疗后，≥5%至<10%的体重减轻（N=42；25.0%）与 HbA1c 和平均血浆葡萄糖的显著改善相关，而≥10%的体重减轻（N=40；23.8%）与总胆固醇、甘油三酯、HbA1c、平均血浆葡萄糖和心率的显著改善相关。在 12 个月随访时，≥5%至<10%的体重减轻（N=17；11.1%）与 HDL、甘油三酯、HbA1c 和平均血浆葡萄糖的显著改善相关，而≥10%的体重减轻（N=40；26.0%）与所有 CVDRF 变量（除血压外）的显著改善相关。
在接受治疗和 12 个月随访后，BED 和肥胖患者的适度体重减轻与 CVDRF 的显著改善相关。未来的工作应该研究 CVDRF 的改善是否归因于体重减轻本身和/或其他相关的生活方式改变。
接受治疗后体重减轻适度的暴食障碍和肥胖患者与未减轻体重的患者相比，各种心血管疾病风险指标均有所改善。尽管对暴食障碍患者来说，减轻体重具有挑战性，但临床医生应告知患者适度减轻体重的潜在健康益处。未来的研究应调查体重减轻本身和/或相关的行为生活方式改变是否会导致心血管疾病风险因素的改善。
