Effects of Weight Loss, Weight Cycling, and Weight Loss Maintenance on Diabetes Incidence and Change in Cardiometabolic Traits in the Diabetes Prevention Program

Delahanty, Linda M.; Pan, Qing; Jablonski, Kathleen A.; Aroda, Vanita R.; Watson, Karol E.; Bray, George A.; Kahn, Steven E.; Florez, Jose C.; Perreault, Leigh; Franks, Paul W.; for the Diabetes Prevention Program Research Group

doi:10.2337/dc14-0018

Cited by 126Diabetes, Cardiovascular Risks, and LipoproteinsObesity, Physical Activity, DietBariatric Surgery and Outcomes

Effects of Weight Loss, Weight Cycling, and Weight Loss Maintenance on Diabetes Incidence and Change in Cardiometabolic Traits in the Diabetes Prevention Program

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Delahanty, Linda M., Pan, Qing, Jablonski, Kathleen A., Aroda, Vanita R., Watson, Karol E., Bray, George A., Kahn, Steven E., Florez, Jose C. +3 more·2014·Diabetes Care

DOI 10.2337/dc14-0018PMC PMC4170126

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Abstract

OBJECTIVE: This study examined specific measures of weight loss in relation to incident diabetes and improvement in cardiometabolic risk factors. RESEARCH DESIGN AND METHODS: This prospective, observational study analyzed nine weight measures, characterizing baseline weight, short- versus long-term weight loss, short- versus long-term weight regain, and weight cycling, within the Diabetes Prevention Program (DPP) lifestyle intervention arm (n = 1,000) for predictors of incident diabetes and improvement in cardiometabolic risk factors over 2 years. RESULTS: Although weight loss in the first 6 months was protective of diabetes (hazard ratio [HR] 0.94 per kg, 95% CI 0.90, 0.98; P < 0.01) and cardiometabolic risk factors (P < 0.01), weight loss from 0 to 2 years was the strongest predictor of reduced diabetes incidence (HR 0.90 per kg, 95% CI 0.87, 0.93; P < 0.01) and cardiometabolic risk factor improvement (e.g., fasting glucose: β = −0.57 mg/dL per kg, 95% CI −0.66, −0.48; P < 0.01). Weight cycling (defined as number of 5-lb [2.25-kg] weight cycles) ranged 0–6 times per participant and was positively associated with incident diabetes (HR 1.33, 95% CI 1.12, 1.58; P < 0.01), fasting glucose (β = 0.91 mg/dL per cycle; P = 0.02), HOMA-IR (β = 0.25 units per cycle; P = 0.04), and systolic blood pressure (β = 0.94 mmHg per cycle; P = 0.01). After adjustment for baseline weight, the effect of weight cycling remained statistically significant for diabetes risk (HR 1.22, 95% CI 1.02, 1.47; P = 0.03) but not for cardiometabolic traits. CONCLUSIONS: Two-year weight loss was the strongest predictor of reduced diabetes risk and improvements in cardiometabolic traits.

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In the Diabetes Prevention Program, associations between weight cycling and cardiometabolic risk factors were no longer significant after adjustment for baseline weight or 2-year weight change.
“these associations were no longer significant after adjustment for baseline weight or 2-year weight change”
From Weight maintenance after discontinuation of GLP-1 therapies (2026) · cites this paper as [26]
In the Diabetes Prevention Program, weight cycling was initially associated with adverse cardiometabolic risk factors, including higher fasting glucose, insulin resistance, and systolic blood pressure.
“weight cycling was initially associated with adverse cardiometabolic risk factors, including higher fasting glucose, insulin resistance, and systolic blood pressure”
From Weight maintenance after discontinuation of GLP-1 therapies (2026) · cites this paper as [26]

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Diabetes Care 2014;37:2738–2745 | DOI: 10.2337/dc14-0018
(2016)
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Self-citation
Early Response to Preventive Strategies in the Diabetes Prevention Program
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Self-citation
CARDIOVASCULAR DISEASE AND DIABETES
Vanderwood, K. K., Hall, T. O., Harwell, T. S., Butcher, M. K., & Helgerson, S. D. (2013)

Authors: Delahanty, L. M., Pan, Q., Jablonski, K. A., Aroda, V. R., Watson, K. E., Bray, G. A., Kahn, S. E., Florez, J. C., Perreault, L., Franks, P. W., & for the Diabetes Prevention Program Research Group
Affiliations: Harvard University (US)
George Washington University (US)
Georgetown University (US)
University of California, Los Angeles (US)
Pennington Biomedical Research Center (US)
University of Washington (US)
Diabetes Research Center, Massachusetts General Hospital, Boston, MA
University of Colorado Anschutz (US)
Corresponding author: Delahanty, Linda M.
ORCID: Delahanty, Linda M.
Pan, Qing
Aroda, Vanita R.
Watson, Karol E.
Bray, George A.
Kahn, Steven E.
Perreault, Leigh
Franks, Paul W.
Venue: Diabetes Care
Publisher: American Diabetes Association
Published: 2014-09-10
Volume: 37
Issue: 10
Pages: 2738-2745
ISSN: 0149-5992 (ISSN-L)
1935-5548
DOI: 10.2337/dc14-0018
PMC: PMC4170126
OpenAlex: W2158399663
Cited by: 125
References: 19
Citations by year: 2026: 5 · 2025: 7 · 2024: 11 · 2023: 15 · 2022: 13 · 2021: 7 · 2020: 10 · 2019: 9 · 2018: 14 · 2017: 10 · 2016: 14 · 2015: 7 · 2014: 1
FWCI: 8.58
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: Diabetes Care (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Lund University Publications (Lund University) (submittedVersion)
Funders: Novo Nordisk Fonden (NNF13OC0005781)
National Institutes of Health
National Institute of Diabetes and Digestive and Kidney Diseases (R01DK072041, R01-DK072014, U01DK048489, P30DK017047)
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 › Bariatric Surgery and Outcomes
Keywords: weight loss, weight cycling, weight regain, weight loss maintenance, type 2 diabetes prevention, new-onset diabetes, cardiometabolic risk factors, fasting blood glucose, insulin resistance, HOMA-IR, systolic blood pressure, lifestyle intervention, Diabetes Prevention Program
MeSH terms: Adult, Blood Glucose, Body Weight, Cardiovascular Diseases, Diabetes Mellitus, Female, Humans, Life Style, Male, Metabolic Diseases, Middle Aged, Prospective Studies, Risk Factors, Weight Loss, Incidence, Weight Reduction Programs

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Effects of Weight Loss, Weight Cycling, and Weight Loss Maintenance on Diabetes Incidence and Change in Cardiometabolic Traits in the Diabetes Prevention Program

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