Exercise and Diet Improve Cardiometabolic Risk in Overweight and Obese Individuals Without Weight Loss

Weight loss is routinely recommended for overweight and obese individuals for purposes of reducing morbidity and mortality risk, especially from cardiovascular disease (CVD) and type 2 diabetes (T2D). However, sustained weight loss presents a daunting challenge, and most individuals who lose weight eventually regain most, if not all, of their lost weight. Repeated efforts to lose weight may not be benign, as weight fluctuation has been associated with a number of CVD risk markers. We propose a non-weight-loss-centered approach to treating "obesity-related" health problems. Increasing physical activity and improving quality of diet have multiple health benefits for overweight and obese men and women, including skeletal muscle adaptations that improve fat and glucose metabolism and insulin action, reductions in blood pressure and pro-inflammatory markers, improved endothelial function, and favorable changes in blood lipids and lipoproteins. A large body of evidence demonstrates that these lifestyle-induced adaptations occur independently of changes in body weight or body fat. Consequently, we suggest that overweight and obese men and women, who are at increased risk for CVD and T2D due to sedentary lifestyle, poor diet, and excess body weight, should be encouraged to become more physically active and consume more nutrient-dense foods, even if the healthier lifestyle does not produce desired weight loss.