Weight loss and serum lipids in overweight and obese adults: A systematic review and meta-analysis
Open accessAbstract
Background: Excess adipose tissue is associated with an abnormal lipid profile that may improve with weight reduction. In this meta-analysis, we aimed to estimate the magnitude of change in lipid parameters associated with weight loss in adults who are overweight or obese. Methods: We searched MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, and Scopus from 2013 to September, 2018. We included randomized controlled trials (RCTs) that evaluated interventions to treat adult obesity (lifestyle, pharmacologic and surgical) with follow-up of 6 months or more. Results: We included 73 RCTs with moderate-to-low risk of bias, enrolling 32 496 patients (mean age, 48.1 years; weight, 101.6 kg; and body mass index [BMI], 36.3 kg/m2). Lifestyle interventions (diet, exercise, or both), pharmacotherapy, and bariatric surgery were associated with reduced triglyceride (TG) and low-density lipoprotein cholesterol (LDL-C) concentrations and increased high-density lipoprotein cholesterol (HDL-C) at 6 and 12 months. The following data are for changes in lipid parameters after 12 months of the intervention with 95% CI. Following lifestyle interventions, per 1 kg of weight lost, TGs were reduced by –4.0 mg/dL (95% CI, –5.24 to –2.77 mg/dL), LDL-C was reduced by –1.28 mg/dL (95% CI, –2.19 to –0.37 mg/dL), and HDL-C increased by 0.46 mg/dL (95% CI, 0.20 to 0.71 mg/dL). Following pharmacologic interventions, per 1 kg of weight lost, TGs were reduced by –1.25 mg/dL (95% CI, –2.94 to 0.43 mg/dL), LDL-C was reduced by –1.67 mg/dL (95% CI, –2.28 to –1.06 mg/dL), and HDL-C increased by 0.37 mg/dL (95% CI, 0.23 to 0.52 mg/dL). Following bariatric surgery, per 1 kg of weight lost, TGs were reduced by –2.47 mg/dL (95% CI, –3.14 to –1.80 mg/dL), LDL-C was reduced by –0.33 mg/dL (95% CI, –0.77 to 0.10 mg/dL), and HDL-C increased by 0.42 mg/dL (95% CI, 0.37 to 0.47 mg/dL). Low-carbohydrate diets resulted in reductions in TGs and increases in HDL-C, whereas low-fat diets resulted in reductions in TGs and LDL-C and increases in HDL-C. Results were consistent across malabsorptive and restrictive surgery. Conclusions: Weight loss in adults is associated with statistically significant changes in serum lipids. The reported magnitude of improvement can help in setting expectations, inform shared decision making, and facilitate counseling.
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Some studies have observed an increase in LDL cholesterol concentration with KD.
“Some studies have observed an increase in LDL cholesterol concentration [135]”
From Dietary and Behavioral Strategies for Weight Loss and Weight Loss Maintenance: A Narrative Review (2025) · cites this paper as [135]
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- Authors
- Hasan, B., Nayfeh, T., Alzuabi, M., Wang, Z., Kuchkuntla, A. R., Prokop, L. J., Newman, C. B., Murad, M. H., & Rajjo, T. I.
- Affiliations
- Mayo Clinic (US)
- NYU Langone Health (US)
- Corresponding author
- Murad, Mohammad Hassan
- ORCID
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2020-09-21
- Volume
- 105
- Issue
- 12
- Pages
- 3695-3703
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W3087550284
- Cited by
- 126
- References
- 40
- Citations by year
- 2026: 37 · 2025: 31 · 2024: 24 · 2023: 13 · 2022: 13 · 2021: 6 · 2020: 2
- FWCI
- 1.30
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Endocrine Society
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Keywords
- weight loss, serum lipids, obesity, overweight adults, triglycerides, LDL cholesterol, HDL cholesterol, lifestyle intervention, pharmacotherapy, bariatric surgery, weight loss interventions, body mass index, diet and exercise, obesity pharmacotherapy, obesity surgery outcomes
- MeSH terms
- Adult, Exercise Therapy, Female, Humans, Lipids, Male, Middle Aged, Obesity, Weight Loss, Diet, Fat-Restricted, Bariatric Surgery, Overweight, Diet, Carbohydrate-Restricted
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