Academic Editors: Fabio Angeli and Brian Tomlinson
Cardiometabolic diseases, including cardiovascular disease (CVD) and type 2
diabetes (T2D), are the leading cause of death globally. Because T2D and obesity
are strongly associated, weight loss is the cornerstone of treatment. However,
weight loss is rarely sustained, which may lead to weight cycling, which is
associated with increased mortality risk in patients with T2D. Meta-analyses show
that weight loss is not generally associated with reduced mortality risk in T2D,
whereas weight cycling is associated with increased all-cause and CVD mortality.
This may be attributable in part to increased variability in CVD risk factors
that often accompany weight cycling, which studies show is consistently
associated with adverse CVD outcomes in patients with T2D. The inconsistent
associations between weight loss and mortality risk in T2D, and consistent
findings of elevated mortality risk associated with weight cycling, present a
conundrum for a weight-loss focused T2D prevention and treatment strategy. This
is further complicated by the findings that among patients with T2D, mortality
risk is lowest in the body mass index (BMI) range of ~25–35
kg/m