October 23, 2018
Midsection Of Woman Smiling While Adjusting Weight Scale
Be Well

Weight Loss: Every Little Bit Counts

by John Swartzberg, M.D.  

Taking off pounds is a losing proposition, as the old joke goes. The frustrating part is that if you’re overweight by 20 or 30 pounds or more, losing them may loom as an impossible task. It’s hard enough simply not to gain more weight, let alone slim down.

But here’s good news: If you’re overweight or even obese, dropping just a little weight is a big step forward. I know this from my own practice as a physician. “You can’t imagine how much better you’ll feel,” I can hear myself saying to patients when I was in practice, “if you could lose just 10 pounds—and how much that would improve your overall health.” And I saw the results when they succeeded.

That advice wasn’t just guesswork. Over the years many studies have demonstrated that even modest weight loss—5 percent of your total body weight, about 10 pounds if you weigh 200—can pay substantial health dividends. For starters, it can improve blood cholesterol and triglyceride levels. In addition, modest weight loss has been shown to improve blood sugar levels and reduce the risk of diabetes in studies involving obese people. Recently, in an interesting small study in Cell Metabolism, obese participants with insulin resistance were put on a calorie-restricted diet in order to lose 5, 10, and then 15 percent of their body weight. Big improvements in insulin sensitivity, abdominal fat, and other risk factors for heart disease and diabetes came from losing just 5 percent of weight; further weight loss produced smaller additional improvement. “You get the biggest bang for your buck with 5 percent weight loss,” said the lead author.

Just as clearly, modest weight loss can result in “clinically significant, long-term reductions in blood pressure,” according to a landmark study of people with prehypertension published in the Annals of Internal Medicine back in 2001. Other research shows that for every 2 pounds of weight loss, systolic blood pressure goes down 1 point, on average. If you lose 10 pounds, that may bring your blood pressure close to the “normal” range. It might mean not having to take blood pressure medication, or at least needing less of it. Even more important, it might mean avoiding a heart attack or stroke.

Some icing on the (diet) cake: Losing even a little weight can reduce the pain of knee arthritis or help prevent it in the first place. And in people with sleep apnea, it can decrease episodes of sleep-disordered breathing. The potential benefits go on and on.

Easier said than done, you may say. Start with small steps. Try cutting just 200 calories a day (16 ounces of soda, say, or a little more than an ounce of chips)—that way you may lose a couple of pounds in a month, especially if you add in a daily walk or other physical activity. For more advice, consult our recent article 18 Keys to Healthy Weight Loss. As the Chinese aphorism says, “a journey of 1,000 miles begins with a single step.”