Weight Loss Goals for Health- How much is needed to be ‘clinically meaningful’?

When people think about losing weight, we often have a lofty goal in mind. The reason many people want to lose weight is to look better and wear a smaller clothing size. However, what is more important is achieving improved health and preventing disease that can shorten your life. So, how much weight does one need to lose to be ‘clinically meaningful’? To reduce risk of or improve obesity related co-morbidities such as heart disease, diabetes, knee arthritis, hypertension, hyperlipidemia, sleep apnea? Studies show, even 2.5% total body weight loss will improve diabetes and help prevent the development of diabetes in those with impaired glucose tolerance or prediabetes. Triglycerides also go down and in women with polycystic ovarian syndrome (PCOS) and infertility, they have improved ovulation and pregnancy with 2.5% body weight loss. For someone 220 lbs, this would be only a 5.5 lbs weight loss!

Now, studies also show that modest weight loss, say 5-10% will increase HDL (good) cholesterol, decrease pain of knee osteoarthritis, decrease risk of depression, decrease high blood pressure, improve urinary incontinence and overall improve quality of life. For the same 220 lbs person, this is 11-22 lbs. To improve obstructive sleep apnea, improve metabolic associated steatohepatitis in the liver (MASH) and decrease risk of cardiovascular events, we need 10% or more. To decrease risk of mortality (death from all causes), more like 15% body weight loss has been shown to be necessary. So, a little bit of weight loss starts improving health but more weight loss has even more health benefits.

When evaluating medications for treating obesity, the FDA considers 5% body weight loss to be clinically meaningful because of the previously described health benefits. In 2013 an expert panel formed by the NIH agreed weight loss of 3-5% was clinically meaningful to improve health but because 10% provides even greater health benefits, this was their recommendation for an initial weight loss goal.

So, when you are thinking of losing weight, try not to think about getting back to what you weighed in high school as the only weight that will matter. Give yourself some grace, be realistic and think about 5-10% body weight loss as being a fantastic health goal to get started!