Sustained improvement in blood lipids, coagulation, and fibrinolysis after major weight loss in obese subjects.

OBJECTIVE

To study whether major weight loss causes sustained improvement in blood lipids and haemostatic profile in obese subjects, and to compare the influence of two different slimming and maintenance regimens.

DESIGN

Two-stranded randomized intervention study.

SETTING

University Department.

SUBJECTS

Thirty-six out of 43 obese patients recruited from out-patient waiting list completed the study.

INTERVENTIONS

Weight loss was achieved by very low energy formula diet (2 MJ/d for 8 weeks, n=18), or low-energy conventional diet (5 MJ/d for 17 weeks, n=18), both combined with anorectic compound. Participants were re-randomized to consume low fat diet ad libitum (n=16), or energy-restricted diet (n=20) for weight maintenance during 24 weeks.

MAIN OUTCOME MEASURES

Plasma lipids, fibrinogen, factor VII coagulant activity (FVIIc), and plasminogen activator inhibitor type 1 (PAI-1) antigen.

RESULTS

Weight loss averaged 13.6 kg (95% CI: 12.3-14.9 kg). After 24 weeks' weight maintenance, plasma total cholesterol was 9% lower, high density lipoprotein cholesterol 5% higher, triglycerides 30% lower, FVIIc 12% lower, fibrinogen 6% lower, and PAI-1 antigen 34% lower than at baseline (all changes highly significant). There were no significant differences between slimming or maintenance regimens.

CONCLUSIONS

Major weight loss is associated with sustained and marked improvements in blood lipids and hemostatic profile, irrespective of the tested slimming and maintenance regimens.