Long-Term Effect of Weight Regain Following Behavioral Weight Management Programs on Cardiometabolic Disease Incidence

Temps de lecture
4 min

This article investigates the long-term effects of weight regain on cardiometabolic disease incidence and risk following the completion of behavioral weight management programs.

We discuss various factors that contribute to weight regain, the relationship between weight regain and cardiometabolic disease risk, and the importance of maintaining weight loss after completing behavioral weight management programs.

Additionally, we explore the current literature on strategies to prevent weight regain and improve long-term outcomes. Finally, we list the key references used in this article at the end.

Obesity is a global health concern that has been linked to numerous health complications, including cardiometabolic diseases such as type 2 diabetes, hypertension, and cardiovascular disease (1).

Behavioral weight management programs (BWMPs) have emerged as an effective approach to addressing obesity by promoting weight loss through lifestyle modifications, including dietary changes, increased physical activity, and behavior modification techniques (2).

However, weight regain following the completion of BWMPs is a common issue, which may undermine the long-term benefits of weight loss on cardiometabolic disease risk (3).

In this article, we examine the long-term effects of weight regain on cardiometabolic disease incidence and risk and discuss strategies to prevent weight regain following BWMPs.

An obese woman sitting on a chair

Factors Contributing to Weight Regain

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Weight regain is a multifactorial phenomenon, with several factors contributing to the difficulty of maintaining weight loss achieved through BWMPs (4).

These factors include:

  • Physiological factors: Hormonal changes, such as decreased levels of leptin and increased levels of ghrelin, can lead to increased appetite and reduced energy expenditure following weight loss (5).
  • Environmental factors: Exposure to an obesogenic environment, characterized by an abundance of high-calorie, palatable foods, and limited opportunities for physical activity, can make it challenging for individuals to maintain weight loss (6).
  • Psychological factors: Emotional eating, stress, and lack of social support can contribute to weight regain after the completion of BWMPs (7).

Weight Regain and Cardiometabolic Disease Risk

Weight regain following BWMPs has been associated with an increased risk of cardiometabolic diseases (8).

The relationship between weight regain and cardiometabolic disease risk can be explained through several mechanisms:

  • Increased adiposity: Weight regain leads to increased adipose tissue, which can contribute to insulin resistance and inflammation, increasing the risk of type 2 diabetes and cardiovascular disease (9).
  • Elevated blood pressure: Weight regain has been associated with increased blood pressure, which is a significant risk factor for cardiovascular disease (10).
  • Altered lipid profile: Weight regain can lead to an unfavorable lipid profile, characterized by increased levels of low-density lipoprotein cholesterol (LDL-C) and triglycerides, and decreased levels of high-density lipoprotein cholesterol (HDL-C) (11).

Strategies to Prevent Weight Regain

Several strategies have been proposed to minimize weight regain and improve long-term outcomes following BWMPs:

Extended care programs: Providing ongoing support and follow-up after the completion of BWMPs can help individuals maintain weight loss and prevent weight regain (12).

Physical activity: Engaging in regular physical activity has been shown to be an effective strategy for maintaining weight loss and preventing weight regain (13).

Mindfulness-based approaches: Incorporating mindfulness techniques, such as mindful eating and stress reduction, can help individuals better manage emotional eating and prevent weight regain (14).

The Role of Diet in Preventing Weight Regain

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Dietary modifications play a crucial role in preventing weight regain following BWMPs (15).

Several dietary strategies can help individuals maintain weight loss:

  • Caloric restriction: Consuming fewer calories than expended can help maintain weight loss (16). Individuals should work with healthcare professionals to determine the appropriate caloric intake for their needs.
  • Macronutrient composition: A diet rich in protein, fiber, and healthy fats may promote satiety and help prevent weight regain (17). Additionally, reducing the intake of refined carbohydrates and added sugars can be beneficial.
  • Meal timing and frequency: Eating regular, balanced meals and avoiding long periods of fasting can help regulate appetite and prevent overeating (18).
  • Portion control: Being mindful of portion sizes can help prevent weight regain by avoiding excessive caloric intake (19).

The Importance of Social Support

Social support can play a significant role in preventing weight regain following BWMPs (20).

Individuals who have strong social support systems are more likely to maintain weight loss and adopt healthier lifestyles (21).

Strategies to enhance social support include: Joining support groups or online communities for individuals who have completed BWMPs.

Engaging friends and family members in healthy lifestyle changes, such as participating in physical activities together or sharing healthy meal planning tips.

Working with healthcare professionals, such as dietitians and exercise physiologists, who can provide ongoing guidance and support.

The Role of Sleep and Stress Management

Adequate sleep and effective stress management are essential for maintaining weight loss and preventing weight regain (22).

Sleep deprivation has been linked to increased appetite and poorer dietary choices, while chronic stress can lead to emotional eating and weight gain (23).

Strategies for improving sleep and managing stress include:

  • Establishing a consistent sleep schedule and creating a sleep-friendly environment.
  • Practicing relaxation techniques, such as deep breathing, progressive muscle relaxation, or meditation.
  • Engaging in regular physical activity, which has been shown to improve sleep quality and reduce stress levels (24).

The Potential Role of Pharmacotherapy and Bariatric Surgery

In some cases, pharmacotherapy or bariatric surgery may be considered as adjunct treatments to help individuals maintain weight loss and prevent weight regain (25).

However, these options should be carefully evaluated on a case-by-case basis and should not replace the need for lifestyle modifications.

Pharmacotherapy: Several weight loss medications have been approved for long-term use in individuals with obesity (26).

These medications can help promote weight loss and prevent weight regain by suppressing appetite, increasing feelings of fullness, or altering nutrient absorption.

Bariatric surgery: Bariatric surgery is a surgical intervention that can result in significant weight loss for individuals with severe obesity (27).

The surgery can also improve or resolve obesity-related comorbidities, such as type 2 diabetes and hypertension (28).

However, it is important to note that bariatric surgery is not a cure for obesity and requires a lifelong commitment to lifestyle modifications to maintain weight loss.


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In conclusion, weight regain following the completion of behavioral weight management programs is a significant concern that can increase the risk of cardiometabolic diseases.

Healthcare professionals and individuals who have participated in these programs should consider adopting a comprehensive approach that incorporates dietary modifications, regular physical activity, mindfulness-based techniques, social support, adequate sleep, and stress management to prevent weight regain and reduce cardiometabolic disease risk.

In some cases, pharmacotherapy or bariatric surgery may be considered as adjunct treatments to support long-term weight loss maintenance.

Future Directions for Research and Practice

Future research should focus on identifying the most effective strategies to prevent weight regain and reduce cardiometabolic disease risk following BWMPs.

Longitudinal studies with larger and more diverse samples are needed to better understand the factors contributing to weight regain and the most effective interventions for maintaining weight loss.

Additionally, research should investigate the potential synergistic effects of combining multiple strategies, such as extended care programs, physical activity, and dietary modifications, to optimize long-term outcomes.

Healthcare professionals should be aware of the challenges associated with weight regain following BWMPs and incorporate evidence-based strategies into their practice to support individuals in maintaining weight loss.

This includes providing ongoing education and support, promoting regular physical activity, encouraging a healthy diet, fostering social support, and addressing sleep and stress management issues.

By adopting a comprehensive approach to weight loss maintenance, healthcare professionals can help individuals achieve lasting health improvements and reduce their risk of cardiometabolic diseases.

What are the long-term effects of weight regain on cardiometabolic disease incidence and risk?


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