Personalized Weight-Loss Targets for Metabolic Syndrome Reversal: A BMI-Normalization Achievement Rate-Based Cohort...

Area of Science:

• Metabolic Syndrome Research
• Obesity and Weight Management
• Cardiovascular Health

Background:

• Metabolic syndrome (MetS) affects a significant portion of the adult population, increasing cardiovascular disease risk.
• Achieving a normal Body Mass Index (BMI) is often a goal for MetS management, but personalized targets are needed.
• Current weight-loss recommendations for MetS may not account for individual baseline BMI and progress.

Purpose of the Study:

• To introduce and evaluate the BMI-normalization achievement rate (BMI-NAR) as a novel metric for personalized weight-loss targets in MetS.
• To explore the dose-response relationship between BMI-NAR and the likelihood of MetS reversal.
• To identify potential minimum effective weight-loss thresholds for MetS reversal based on BMI-NAR.

Main Methods:

• A longitudinal cohort of 7340 adults with overweight/obesity and MetS from the ChinaHEART project was analyzed.
• BMI-NAR was calculated as the percentage of progress toward a normal BMI (<24 kg/m²).
• Logistic regression and restricted cubic splines were used to assess the association between BMI-NAR and MetS reversal.

Main Results:

• Each 50% increase in BMI-NAR was significantly associated with MetS reversal (OR=1.10).
• Exploratory minimum effective thresholds for MetS reversal were identified: 37% for the overall population, 53% for overweight, and 22% for obesity.
• Personalized minimum weight-loss targets ranged from 2%-8% for overweight individuals and 3%-9% for those with obesity.

Conclusions:

• Metabolic syndrome reversal is achievable without reaching a normal BMI.
• BMI-NAR offers a quantifiable framework for establishing personalized, effective minimum weight-loss goals for individuals with MetS.
• External validation is necessary to confirm these findings before widespread clinical application.