Official recommendations for obese patients with type-2 diabetes is to lose weight.

But this might not be the best advice and doctors should change their treatment guidelines, say health researchers from University of Copenhagen and University of Southern Denmark.

In a new study of obese patients with type-2 diabetes, they have discovered that patients who reached their planned weight loss target did not have a lower risk of developing heart disease and did not live longer than patients who hadn’t lost weight.

"We blindly strive for weight loss [for diabetic patients], but in fact we have no evidence that it’s healthy. Our study suggests that, at best, it has no effect," says lead-author Rasmus Køster-Rasmussen from the Research Unit for General Practice, University of Copenhagen.

"We should shift our focus from weight loss to other things that we know [have a beneficial effect on patient] survival and cardiovascular disease. For example, physical activity and a Mediterranean diet with vegetables, fish, a glass of wine, fruit, and lots of olive oil and nuts--without weight loss in mind," he says.

The new research is published in the journal PLOS ONE, after a two-year struggle to get the paper accepted for publication. Køster-Rasmussen attributes this delay to the nature of the controversial results.

"The study is absolutely solid"

The new study is a cohort study that began 25 years ago, tracking the progress of type-2 diabetes patients in Denmark.

761 patients were monitored during the first six years after receiving their diabetes diagnosis. Patients were seen by their GP once every three months, where they were weighed and advised to lose weight before the next appointment.

Køster-Rasmussen and colleagues checked their progress again, 13 years later, in the Danish national registers to see which patients had survived and which diseases they had contracted.

They discovered that patients who tried and failed to lose weight lived just as long as those who achieved their weight loss target.

"The study is very robust," says diabetes researcher Henning Beck-Nielsen, who is a professor at the University of Southern Denmark. He was not involved in the new study.

"It confirms what other studies have previously shown. It suggests that weight loss doesn’t have as big an effect on cardiovascular disease as was once thought,’ says Beck-Nielsen.

Expert: Weight loss has other positive effects

Three years ago a groups of American researchers reached the same conclusion after conducting a large randomised trial.

But even though the two studies point in the same direction, this is not a green light to put on weight, stresses Beck-Nielsen.

"I still believe that [doctors] should recommend that [patients] lose weight, because it has other positive effects."

"What matters is that you live a good life. When patients lose weight, they have a better life because weight loss is essential to stabilise their diabetes and thereby avoid eye problems and kidney disease," says Beck-Nielsen.

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Read the Danish version of this story on Videnskab.dk



Translated by: Catherine Jex

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