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Men and Women Have Different Responses to Rapid Weight Loss

Sep 8, 2018
 

PREVIEW intervention study reveals men and woman with pre-diabetes respond differently to low energy diets and rapid weight loss.

The PREVIEW intervention study (PREVention of diabetes through lifestyle Intervention and population studies in Europe and around the World) is the largest one of its kind. The multinational study aims to prevent type 2 diabetes in patients who have excessive weight and prediabetes by using diet and exercise. Adult participants who were eligible for the study started by following an 8-week, low-energy diet (LED). The goal was to motivate individuals to lose at least 8% body weight in order to be included in the randomized intervention that focuses on long-term weight loss.

Women are the majority of individuals who use weight loss programs, including surgery. It is important to differentiate outcomes between men and woman in order to produce gender-specific treatments, when required. Previously, studies have shown that men lose more weight and excess fat than woman. This study aimed to compare the effects of an 8-week LED-induced weight loss program on metabolic outcomes in a large group of men and women ages 25-70 years who were enrolled in the PREVIEW diabetes intervention.

More than 2,000 participants were enrolled in the study from August 2013 to March 2015 at eight different sites worldwide. Men and women who had excess weight and were diagnosed with prediabetes were eligible for inclusion. There were two intervention phases in the PREVIEW study. After successful weight loss of ≥ 8%, phase 2 consisted of a 148-week lifestyle intervention that focused mainly on diet, physical activity, and behavior for maintenance weight loss.

Outcomes showed participants were able to cut body weight by an average of 11% and had significant improvements in insulin resistance after an 8-week LED. There were differences in weight loss between men and women. Men lost significantly more body weight and had higher reductions in metabolic Z-score, C-peptide, FM, and heart rate than women. Women had increased reductions in hip circumference and pulse pressure than men. All of these findings were after adjusting for differences in weight loss (%). These findings are clinically important when preparing gender-specific weight loss programs between men and woman.

“Despite adjusting for the differences in weight loss, it appears that men benefited more from the intervention than women. Whether differences between genders persist in the long term and whether we will need to design different interventions depending on gender will be interesting to follow,” explained lead author Dr. Pia Christensen, of the University of Copenhagen. “However, the 8-week low-energy diet in individuals with pre-diabetes did result in the initial 10% weight loss needed to achieve major metabolic improvement in the first phase of a diabetes prevention program.”

Practice Pearls:

  • This study aimed to compare the effects of an 8-week LED-induced weight loss on metabolic outcomes in a large group of men and women ages 25-70 years who were enrolled in the  PREVIEW (PREVention of diabetes through lifestyle Intervention and population studies in Europe and around the World) diabetes intervention
  • Participants in the study lost an average of 11% of their weight using the 8-week low-energy diet. Men lost significantly more body fat than women and had higher reductions in, metabolic Z-score, C-peptide, FM and heart rate than women. Women had increased reductions in hip circumference and pulse pressure than men.
  • These findings may be clinically significant when preparing gender-specific weight loss programs in order to achieve major metabolic improvement in patients with excess weight who have prediabetes.

References:

Christensen P, Meinert Larsen T, Westerterp‐Plantenga M, et al. Men and women respond differently to rapid weight loss: Metabolic outcomes of a multi‐centre intervention study after a low‐energy diet in 2500 overweight, individuals with pre‐diabetes (PREVIEW). Diabetes Obes Metab. 2018;1–12. https://doi-org.ezproxy.hsc.usf.edu/10.1111/dom.13466

Wiley. “Women and men experience different benefits from low-calorie diets.” ScienceDaily. ScienceDaily, 8 August 2018. <www.sciencedaily.com/releases/2018/08/180808075419.htm>.

Melissa Bailey, Pharm.D. Candidate, USF College of Pharmacy