Weight reduction
The lever with the broadest reach: it moves blood lipids and insulin resistance at the same time. Also the one with the greatest effort and the longest time to effect.
Order of magnitude
Five to ten percent of the starting weight, sustained for at least six months.
The ranges below apply to sustained weight loss, not to the low point of a diet. HDL often falls during the loss phase and only rises once weight is stable. There is no pooled effect size for uric acid: weight loss is recommended in gout, but urate can rise transiently with very rapid loss or after bariatric surgery. There is therefore no offset row.
Effects in detail
Each row is a directed edge from our database, with range, latency, evidence grade and the condition under which it applies at all.
| Marker | Effect | Latency | Mode of action | Outcome | Evidence | Condition | Sources |
|---|---|---|---|---|---|---|---|
| Apolipoprotein B | helps. Lowers Direction known, size not established the larger fall is a BMI change of 3.5 kg/m2 and the smaller 1.5, which the row takes to be 10 and 5 % of body weight. The two slopes behind them differ by sex as well as by amount lost, and the source is observational Only one observational dataset (Dansinger 2019, industry-funded). The direct ApoB change is smaller than the LDL-C proxy range above. Order of magnitude, not an RCT meta-analysis. | not specified | chronic | unclear | Evidence grade C | applies regardless of the starting value | |
| LDL cholesterol | helps. Lowers Direction known, size not established the larger fall is 10 kg lost and the smaller 5 kg; use per_kg_coefficient instead LDL-C from lifestyle trials, not direct ApoB. The reduction is reported mainly for low-fat weight-loss diets; Look AHEAD found no association with LDL-C in type 2 diabetes. ApoB and LDL can disagree. Trial proxy: ldl_c. | 26–26 weeks | chronic | unclear | Evidence grade B | applies regardless of the starting value | |
| HOMA-IR | helps. Lowers -0.97 HOMA-IR units confidence interval of the estimate, not the range one person can expect Wide confidence interval from 17 small RCTs (Tran 2026, mean −6.3 kg). Percentage refers to an assumed baseline of 3.0. HOMA-IR has never been a hard-outcome trial endpoint. | not specified | chronic | no | Evidence grade B | applies regardless of the starting value | |
| Alanine aminotransferase | helps. Lowers -25.9 U/L confidence interval of the estimate, not the range one person can expect A network meta-analysis of 19 randomised trials in fatty liver disease found aerobic exercise plus diet lowered ALT by 25.85 units (95 % CI -43.90 to -7.80). The intervention in these trials was diet plus exercise producing weight loss in people who already had fatty liver, not a defined 5 to 10 % loss in a general population. | not specified | chronic | unclear | Evidence grade B | applies regardless of the starting value | |
| Diastolic blood pressure | helps. Lowers -3.36 mmHg confidence interval of the estimate, not the range one person can expect Thirty-five studies in 3219 patients give clinic systolic -5.79 mmHg (95 % CI 3.54 to 8.05) and diastolic -3.36 mmHg (1.93 to 4.75) after a mean BMI reduction of 2.27 kg/m2. Read against the BPLTTC scale, a 5.8 mmHg systolic fall corresponds to roughly a 12 % lower rate of major cardiovascular events if blood pressure lowered this way behaves like blood pressure lowered by drugs, which has not been shown directly. | 12–12 weeks | chronic | unclear | Evidence grade A | applies regardless of the starting value | |
| Systolic blood pressure | helps. Lowers -5.79 mmHg confidence interval of the estimate, not the range one person can expect Thirty-five studies in 3219 patients give clinic systolic -5.79 mmHg (95 % CI 3.54 to 8.05) and diastolic -3.36 mmHg (1.93 to 4.75) after a mean BMI reduction of 2.27 kg/m2. Read against the BPLTTC scale, a 5.8 mmHg systolic fall corresponds to roughly a 12 % lower rate of major cardiovascular events if blood pressure lowered this way behaves like blood pressure lowered by drugs, which has not been shown directly. | 12–12 weeks | chronic | unclear | Evidence grade A | applies regardless of the starting value | |
| HbA1c | helps. Lowers Direction known, size not established the larger fall is 8.5 kg lost and the smaller 4.25 kg, being 0.1 percentage points per kilogram applied to 10 and 5 % of an 85 kg body weight; use per_kg_coefficient instead A systematic review of 58 trials in 17,204 people with type 2 diabetes modelled a mean HbA1c reduction of 0.1 percentage points per kilogram lost, so a 5 to 10 % weight loss maps to 0.43 to 0.85 percentage points at an 85 kg starting weight, or proportionally more or less at another. Grade B, not A: this is a group-level regression across published trial arms, not a pooled within-person effect, and it was derived entirely in people who already have type 2 diabetes. | 12–12 weeks | chronic | unclear | Evidence grade B | applies regardless of the starting value | |
| Triglycerides | helps. Lowers Direction known, size not established the larger fall is 10 kg lost and the smaller 5 kg; per_kg_coefficient carries the slope, so the app should compute from the person's own weight instead Derived from about −4 mg/dL per kilogram lost at a baseline of 200 mg/dL. At higher triglycerides the absolute fall is larger. Tran 2026 found no lipid change with caloric restriction alone. | 26–26 weeks | chronic | unclear | Evidence grade A | TG at or above 150 mg/dL | |
| Uric acid | helps. Lowers Direction known, size not established A systematic review of 10 mostly observational studies found serum urate changes ranging from -168 to +30 µmol/L with 3 to 34 kg weight loss and fewer gout flares in 6 of 8 studies; heterogeneity prevented a pooled estimate, so no effect size is entered. Both gout guidelines recommend weight loss as part of management (partial outcome evidence via gout flares, none for cardiovascular outcomes). | not specified | chronic | unclear | Evidence grade C | applies regardless of the starting value |
What this measure costs
Counteracting effects of the same measure.
No counteracting effect is on file for this measure. That does not mean there is none, only that we found no defensible edge.
Moves without implying progress
Informational or no established effect: the marker moves or was checked, and that is not progress.
| Marker | Effect | Latency | Mode of action | Outcome | Evidence | Condition | Sources |
|---|---|---|---|---|---|---|---|
| HDL cholesterol | moves, and does not count. Raises Direction known, size not established the larger rise is 10 kg lost and the smaller 5 kg; use per_kg_coefficient instead HDL only rises once the weight is held. During the loss phase it often falls at first (Dattilo 1992). The rise is not a treatment goal: HDL is not causal for fewer heart attacks. | 26–26 weeks | chronic | no | Evidence grade A | applies regardless of the starting value | |
| high-sensitivity CRP | moves, and does not count. Lowers -0.22 mg/L confidence interval of the estimate, not the range one person can expect Calorie restriction lowered CRP by a mean difference of -0.22 (95 % CI -0.40 to -0.04) in a meta-analysis of randomised trials in obesity. The unit is the weak point. | 12–12 weeks | chronic | unclear | Evidence grade B | applies regardless of the starting value |
Sources
Full details of every study the rows above rely on.
Weight Loss and Serum Lipids in Overweight and Obese Adults: A Systematic Review and Meta-Analysis
Hasan et al. · Journal of Clinical Endocrinology & Metabolism · 2020 · Meta-analysis
2020 American College of Rheumatology Guideline for the Management of Gout
FitzGerald et al. · Arthritis Care & Research · 2020 · Guideline
2016 updated EULAR evidence-based recommendations for the management of gout
Richette et al. · Annals of the Rheumatic Diseases · 2017 · Guideline
Effect of monotherapeutic caloric restriction diet on cardiometabolic parameters in adults with overweight or obesity: Insights from meta-analyses of randomized controlled trials
Tran et al. · Journal of Investigative Medicine · 2026 · Meta-analysis
Benefits of modest weight loss in improving cardiovascular risk factors in overweight and obese individuals with type 2 diabetes
Wing et al. (Look AHEAD Research Group) · Diabetes Care · 2011 · Cohort study
Interventions that cause weight loss and the impact on cardiovascular risk factors: a systematic review and meta-analysis
Zomer et al. · Obesity Reviews · 2016 · Meta-analysis
Effects of weight change on apolipoprotein B-containing emerging atherosclerotic cardiovascular disease (ASCVD) risk factors
Dansinger et al. · Lipids in Health and Disease · 2019 · Cohort study
Effects of weight reduction on blood lipids and lipoproteins: a meta-analysis
Dattilo & Kris-Etherton · American Journal of Clinical Nutrition · 1992 · Meta-analysis
Weight loss for overweight and obese individuals with gout: a systematic review of longitudinal studies
Nielsen et al. · Annals of the Rheumatic Diseases · 2017 · Review
Effect of intensive glucose lowering treatment on all cause mortality, cardiovascular death, and microvascular events in type 2 diabetes: meta-analysis of randomised controlled trials
Boussageon et al. · BMJ · 2011 · Meta-analysis
Pharmacological blood pressure lowering for primary and secondary prevention of cardiovascular disease across different levels of blood pressure: an individual participant-level data meta-analysis
Blood Pressure Lowering Treatment Trialists' Collaboration · Lancet · 2021 · Meta-analysis
Effect of exercise training on C reactive protein: a systematic review and meta-analysis of randomised and non-randomised controlled trials
Fedewa et al. · British Journal of Sports Medicine · 2017 · Meta-analysis
Effect of weight reduction on glycated haemoglobin in weight loss trials in patients with type 2 diabetes
Gummesson et al. · Diabetes, Obesity and Metabolism · 2017 · Review
Dietary Interventions in Patients With Non-alcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis
Houttu et al. · Frontiers in Nutrition · 2021 · Meta-analysis
Effect of calorie restriction diet on levels of C reactive protein (CRP) in obesity: A systematic review and meta-analysis of randomized controlled trials
Kemalasari et al. · Diabetes & Metabolic Syndrome · 2022 · Meta-analysis
Effect of weight loss on blood pressure changes in overweight patients: a systematic review and meta-analysis
Yang et al. · Journal of Clinical Hypertension · 2023 · Meta-analysis
Lifestyle interventions for patients with nonalcoholic fatty liver disease: a network meta-analysis
Zou et al. · European Journal of Gastroenterology & Hepatology · 2018 · Meta-analysis