Background/Objectives: Long-term (≥12 months) weight loss maintenance (WLM) is a major challenge in the treatment of overweight and obesity. Some individuals with overweight or obesity may have a relatively healthy metabolic profile, termed ‘metabolically healthy overweight or obesity’ (MHO), resulting in a decreased risk of developing conditions such as cardiovascular disease and type 2 diabetes. This is compared to those with a less healthy metabolic profile, termed ‘metabolically unhealthy overweight or obesity’ (MUO). Such differences have also been observed among individuals with normal weight. An individual’s metabolic profile can be characterised via testing for the presence of several cardiometabolic risk factors which, when occurring together, constitute metabolic syndrome (Met-S). The aim of the present analysis was to investigate whether baseline metabolic profile has any influence on long-term WLM to gauge the potential of risk stratification according to metabolic profile as a strategy to improve future WLM interventions.
Subjects/Methods: This analysis included 879 participants from the Navigating to a Healthy Weight (NoHoW) trial. At baseline, 568 participants had MHO, 151 had MUO, 104 had normal weight and zero risk factors for Met-S and 56 had normal weight and ≥1 risk factors for Met-S. Multiple linear regression models were used to compare changes in body weight, waist circumference, fat mass, and fat-free mass from baseline to 18 months between individuals with MHO vs MUO and between individuals with normal weight and zero risk factors for Met-S vs normal weight and ≥1 risk factors for Met-S.
Results: No statistically significant differences in change in body weight or body composition from baseline to 18 months were found.
Conclusions: Baseline metabolic profile may not be the strongest predictor of long-term WLM. Thus, all individuals should continue to have access to the highest quality WLM support possible to ensure equitable and effective health outcomes.