Obesity in older adults: Effect of degree of weight loss on cardiovascular markers and medications
Abstract
Summary: Obesity worsens the age‐related tendency towards cardiovascular disease and diabetes. Older adults are vulnerable to medication adverse effects. Intentional weight loss in older adults with obesity has been shown to improve cardiovascular and glycaemic markers. The effect of rapid weight loss induced by very‐low‐calorie diets (VLCDs) on these markers has not been evaluated in this group. In this 12‐week study, participants were randomized to one of healthy eating, hypocaloric diet or VLCD, all combined with three times weekly exercise (Ex/HE, Ex/Diet, Ex/VLCD, respectively). The effects of these interventions on weight, blood pressure, lipids, glucose and HbA 1c, inflammatory markers and cardiovascular and diabetes medication changes were measured. Weight loss was 3.7%, 5.1% and 11.1% in Ex/HE, Ex/Diet and Ex/VLCD, respectively. There were significant improvements in HbA 1c in all groups, but by the greatest degree in Ex/VLCD (0.18 ± 0.07%, 0.18 ± 0.06% and 0.59 ± 0.13%, respectively). Similar patterns were seen in total cholesterol (0.13 ± 0.15, 0.21 ± 0.11 and 0.53 ± 0.13 mmol/L, respectively, P = .047), triglycerides (0.35 ± 0.13, 0.20 ± 0.10 and 0.51 ± 0.09 mmol/L, respectively, P = .011) and systolic blood pressure (9 ± 2, 2 ± 3 and 14 ± 3 mmHg respectively, P = .025). There were no between‐group differences in fasting glucose, high‐density lipoprotein (HDL) cholesterol, LDL‐C and inflammatory markers. Reductions in anti‐hypertensive or diabetes medication were made in 4/29, 7/36 and 16/37 participants in Ex/HE, Ex/Diet and Ex/VLCD, respectively (P = .017). Significant weight loss achieved with a VLCD gave rise to improvements in multiple cardiovascular risk markers, despite reduction in medication. Weight loss is an under‐utilized method of cardiovascular risk management in this group.
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Across clinical trials, weight regain was typically observed when AOM treatment was stopped.
“Across clinical trials, weight regain was typically observed when AOM treatment was stopped [23,40,41].”
From Nutritional considerations with antiobesity medications (2024) · cites this paper as [41]
Blood pressure falls with weight loss, and postural hypotension, common in older people and those with diabetes, is aggravated during rapid weight loss if diuretic or antihypertensive drugs are taken concurrently.
“Blood pressure falls with weight loss, and postural hypotension, common in older people and those with diabetes, is aggravated during rapid weight loss if diuretic or antihypertensive drugs are taken concurrently [73].”
Another trial found that all diets improved cardiometabolic risk markers and reduced the number of people requiring type 2 diabetes and cardiovascular disease prevention medication, especially with very-low energy diets.
“Another trial randomised older adults to healthy eating, hypocaloric diet, or very-low energy diet (VLED) groups, found that all diets improved cardiometabolic risk markers and reduced the number of people requiring T2D and CVD prevention medication, especially with VLEDs [62].”
From Obesity pharmacotherapy in older adults: a narrative review of evidence (2025) · cites this paper as [62]
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Obesity pharmacotherapy in older adults: a narrative review of evidence
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- Authors
- Haywood, C. J., Prendergast, L. A., Lim, R., Lappas, M., Lim, W. K., & Proietto, J.
- Affiliations
- The University of Melbourne (AU)
- La Trobe University (AU)
- The Royal Melbourne Hospital (AU)
- Corresponding author
- Haywood, Cilla J.
- Venue
- Clinical Obesity
- Publisher
- Wiley
- Published
- 2019-06-17
- Volume
- 9
- Issue
- 4
- Pages
- e12316-e12316
- ISSN
- 1758-8103 (ISSN-L)
- 1758-8111
- OpenAlex
- W2952670397
- Cited by
- 19
- References
- 3
- Citations by year
- 2026: 1 · 2025: 7 · 2024: 3 · 2022: 5 · 2021: 2 · 2020: 1
- FWCI
- 1.62
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Obesity (publishedVersion)
- PubMed (publishedVersion)
- Minerva Access (University of Melbourne) (submittedVersion)
- Funders
- National Health and Medical Research Council (APP1044334)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Physiology › Diet and metabolism studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Keywords
- obesity in older adults, very low calorie diet, weight loss, cardiovascular risk markers, glycemic control, HbA1c, blood pressure, lipids, diabetes medication reduction, antihypertensive drugs, physical activity, hypocaloric diet, inflammatory markers
- MeSH terms
- Aged, Aged, 80 and over, Antihypertensive Agents, Blood Pressure, Cardiovascular Diseases, Diabetes Mellitus, Diet, Reducing, Female, Glycated Hemoglobin, Humans, Hypoglycemic Agents, Cholesterol, HDL, Male, Obesity, Triglycerides, Biomarkers, Weight Loss, Body Mass Index
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