Five Percent Weight Loss More Likely Than BMI Reduction in Patients With High BMI

A 5% weight reduction is more likely than a decrease in BMI in patients who are overweight or have obesity.

Weight loss of 5% or greater is more likely in overweight and obese patients than achieving a BMI of a healthy weight category, according to findings published in JAMA Network Open.

Researchers aimed to determine the likelihood of achieving weight loss by 5% or more, weight loss by 10% or more, and BMI reduction to a healthy weight in patients who were overweight or had obesity.  

The researchers extracted data from the IQVIA AEMR database on patients aged 17 years or older who had BMI data for at least 3 years ranging from January 2009 to February 2022. Exclusion criteria consisted of individuals with BMI lower than 12 or higher than 110, aged older than 70 years, and who were pregnant.

The primary outcomes were weight loss of greater than 5% and reduction of body weight to a healthy BMI (18.5-24.9). Additional outcomes included weight reduction of greater than 10% and BMI reduction to a lower category.

Data on 18,461,623 individuals were included in the final analysis (56.7% women; 43.3% men). At initial visit, 72.5% of the cohort were in the overweight or obesity category.

Five percent weight loss was achieved by 33.4% of those who were initially overweight and 41.8% of those with obesity. Additionally, reduction to a healthy BMI category  was achieved in 23.2% of persons with overweight and 2.0% of persons with obesity. Median time to achievement of 5% or greater weight loss and to the healthy weight category was 2.4 (1.4-4.0) and 2.6 (1.5-4.4) years, respectively.

Clinicians and public health efforts can focus on messaging and referrals to interventions that are aimed at clinically meaningful weight loss (5% or greater) for those at any level of excess weight.

The annual probability of 5% or greater reduction in weight loss was found to be 1 in 10. Notably, a higher initial BMI was associated with a higher likelihood of achieving an annual 5% weight reduction (1 in 12 in overweight vs 1 in 6 in BMI ≥45).

Conversely, the probability of achieving a healthy BMI category was more likely in those at a lower initial BMI; 1 in 19 individuals classified as overweight and 1 in 1667 with an initial BMI of 45 or higher were able to obtain a healthy BMI classification.

Supplemental analysis on annual probability of 10% or greater weight loss was found to be 1 in 24 individuals, with achievement found in 1 in 32 individuals with initial overweight, and 1 in 11 individuals with a BMI of 45 or higher. The annual probability of achieving BMI to a lower-than-initial category was found to be 1 in 13 individuals, which ranged from 1 in 19 individuals with overweight and 1 in 8 individuals with initial BMI 45 or higher.

Notably, 76.5% of those who achieved 5% or greater weight loss had stable weight loss and higher initial BMIs increased the percentage. However, a sizable amount of those who reduced BMI to a healthy weight or moved to a lower BMI category gained back the weight lost (42.8% and 43.0%, respectively).

As this was study conducted in a clinical setting, the lack of generalizability was cited as a potential limitation as it did not account for the population of US adults that are not seeking healthcare related weight loss.

 “…5% or greater weight loss was more likely than BMI reduction to the healthy weight category, especially for individuals with the highest initial BMI,” the study authors wrote. “Clinicians and public health efforts can focus on messaging and referrals to interventions that are aimed at clinically meaningful weight loss (5% or greater) for those at any level of excess weight.”.

This article originally appeared on Endocrinology Advisor


Kompaniyets L, Freedman DS, Belay B, et al. Probability of 5% or greater weight loss or BMI reduction to healthy weight among adults with overweight or obesity. JAMA Netw Open. Published online August 7, 2023. doi:10.1001/jamanetworkopen.2023.27358