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Health benefits of weight loss

Last updated 31-07-2025

Even a small amount of weight loss can reduce many of the adverse health effects associated with obesity. This page details the known benefits of weight loss for various medical conditions including type 2 diabetes, cardiovascular events and cancer. Changes in lifestyle and behaviour can also lead to improvements in many of the complications caused by excess weight, even if minimal weight loss occurs.

Key Evidence

01

In people with pre-diabetes, weight loss can prevent progression to type 2 diabetes

02

Moderate weight loss is beneficial for treating obstructive sleep apnoea

03

Even low-level weight loss (less than 5% of body weight) can lead to various health benefits and reductions in chronic disease risk

The health benefits of weight loss can vary depending on the individual and the amount of weight lost, often reported as a proportion of body weight.1 Health benefits are seen with low-level weight loss of less than 5% of body weight.12 However, generally more improvements are seen with greater weight loss. Modest weight loss of 5-10% of body weight is generally considered clinically significant to reduce risk factors.1 For some conditions, such as obstructive sleep apnoea, weight loss of 10-15% of body weight may be needed for improvement.1 The table below summarises the evidence for weight loss in different conditions.1

Maintaining weight loss long-term is challenging.3 Ongoing treatment and support assists with weight maintenance and setting realistic weight loss expectations (for both the health professional and patient) and implementing treatment that is sustainable.3 Weight loss goals should be individually planned between the health professional and patient, keeping in mind that the aim of treatment is to improve health and quality of life, and is not just about a number on the scale.14

The following information on health benefits summarises some common conditions, however, it is not an exhaustive list.

Table 1: Relationship with amount of weight loss and various comorbidities

Ryan DH, Yockey SR. Weight Loss and Improvement in Comorbidity: Differences at 5%, 10%, 15%, and Over. Curr Obes Rep. 2017 Jun;6(2):187-194.

Condition Amount of weight loss needed to effect improvement
Glycaemic Improvement–Diabetes prevention in impaired glucose tolerance 2.5% weight loss or more; maximal impact at 10%
Glycaemic improvement–Type 2 diabetes 2.5% to >15%; greater weight loss associated with greater glycaemic improvement; true for all BMI classes
Triglyceride reduction 2.5% to >15%; greater weight loss associated with greater glycaemic improvement; true for all BMI classes;
HDL increase 5% to >15%; greater weight loss associated with greater glycaemic improvement; not true for BMI >40 kg/m2
Apnoea Hypopnea Index Improvement in Obstructive Sleep Apnoea 10%+ weight loss required for significant improvement
Knee pain and function in persons with osteoarthritis 5–10% improves knee functionality, speed, walk distance and pain; 10%+ required to improve IL-6 and CRP levels; knee MRI and X-ray findings do not change
Emergent knee pain prevalence 5–10% weight loss, with persistent maintenance required to prevent knee pain in individuals with obesity
Hepatic steatosis reduction 5–15%+; greater weight loss associated with greater improvement
Non-alcoholic steatotic hepatitis activity score 10%+ weight loss required for significant improvement
Impact of Weight on Quality of Life score 5%–15%+; greater weight loss associated with greater improvement
Depression 5–10% may reduce risk for emergent depression; individuals with depression lose as much weight as non-depressed individuals.
Mobility 5–10% loss attenuates mobility decline with aging
Urinary Incontinence 5–10% improves symptoms in men and women
Sexual Function 5–10% improves erectile function in men and sexual dysfunction in women
Polycystic Ovarian Syndrome and infertility Improvement in ovulatory cycles and subsequent pregnancy with 2–5% weight loss, with more weight loss producing more robust effect.
Health care costs In persons with diabetes 5–10% weight loss associated with reduction in hospitalization and medication costs, but not outpatient costs.
Mortality 16% weight loss (vertical banded gastrectomy) associated with reduction in all cause and cardiovascular mortality. 5–10% weight loss with lifestyle intervention had no effect on major cardiovascular outcomes, but in those with 10%+ weight loss, there was a reduction in those outcomes.

Type 2 diabetes

Evidence shows weight loss is beneficial in the management and prevention of type 2 diabetes (T2D) as the condition has pathophysiological mechanisms in common with obesity.5 Weight loss can reverse the metabolic abnormalities related to T2D and improve glucose control.5 Weight loss of 15% or more of body weight can have beneficial results for people with T2D that are not seen from other glucose-lowering interventions.5 Additional benefits are seen with reductions in cardiometabolic risk factors and improved quality of life.5

Several large studies in people with pre-diabetes have shown that weight loss of 5-7% induced by changes in nutrition and physical activity, can reduce progression to T2D by nearly 60% over 3 to 4 years.67 Every kilogram of weight lost was associated with an estimated 16% reduction in risk of development of T2D.8 Weight loss of 5% in insulin resistant adults with obesity improves insulin sensitivity in fat, liver and muscle, and insulin production from the pancreas,9 and these parameters improve progressively with additional weight loss.

Numerous studies have found benefits of modest weight loss for people with established T2D. In a study of over 5,000 people with T2D, improvements in glycaemic control were seen with as little as 2-5% weight loss,10 while greater weight loss brought about progressive benefits in fasting glucose and HbA1c (a measure of average blood glucose).11 Similarly, in adults with overweight or obesity with a recent (<6 years) diagnosis of T2D, an intensive lifestyle intervention program comprising a low-energy diet with meal replacement products for 3–5 months followed by stepped food reintroduction and structured support over 12 months resulted in T2D remission in nearly half (46%) of participants in the intervention group, compared with 4% of participants in the control group (average weight loss 10 kg vs 1 kg).12 Remission of T2D was related to the amount of weight lost, ranging from 7% of participants who lost 0-5kg to 86% of participants who lost more than 15kg, and no remission in participants who gained weight.12 The durability of T2D remission was linked to the extent of sustained weight loss.13

Bariatric surgery is recommended as a treatment option to support weight loss for treatment of T2D.1415 A randomised study of people with obesity and T2D were treated with intensive medical therapy with or without bariatric surgery (Roux-en-Y gastric bypass [RYGB] or sleeve gastrectomy [SG]).16 Both types of surgery were superior to intensive medical therapy alone in achieving excellent glycaemic control and reducing the use of glucose-, lipid- and blood pressure-lowering medications after 5 years.16 The beneficial effects of RYGB and SG on glycaemic control appear to be related not only to weight loss but to additional metabolic effects.16

Non-alcoholic fatty liver disease (NAFLD)

Weight loss can lead to clinical improvements in NAFLD such as improved liver biochemical tests, liver histology, serum insulin levels, and quality of life.17 Additionally, healthy lifestyle changes without weight loss, such as healthy eating, increased physical activity and smoking/alcohol cessation can support management of NAFLD.17

Cardiovascular risk factors and events

A meta-analysis of 83 weight loss intervention studies found that any weight loss significantly reduced blood pressure and triglycerides over 2 years.18 A graded improvement with progressive weight loss has been found in these parameters, starting with as little as 2-5% weight loss (for systolic blood pressure and triglycerides) and 5-10% weight loss (diastolic blood pressure and high-density lipoprotein cholesterol).11

Although an improvement in cardiovascular risk factors has been consistently shown, it is not clear whether small amounts of weight loss are sufficient to improve cardiovascular outcomes. A randomised trial of over 5,000 adults with T2D aged 45-76 years who were overweight or had obesity showed no difference in the occurrence of cardiovascular events between people randomly assigned to an intensive lifestyle-based weight loss intervention compared with diabetes support and education over 10 years’ follow-up.19 However, a subsequent analysis of the data suggests an association between magnitude of weight loss and cardiovascular events, as people who lost ≥10% of their body weight in the first year of the study had a 21% lower risk of cardiovascular events and mortality compared with individuals with stable weight or weight gain.20 A meta-analysis of lifestyle interventions in adults with obesity did not find a significant effect of weight loss on the development of new cardiovascular events or on cardiovascular mortality, but did demonstrate a reduction in all-cause mortality (34 trials, 685 events; risk ratio 0.82, 95% confidence interval 0.71 to 0.95) for weight loss, equating to six fewer deaths per 1,000 participants.21 Another meta-analysis in patients with established coronary artery disease reported a 37% reduction in a composite outcome of all-cause mortality, cardiovascular mortality, and major adverse cardiac events with intentional weight loss.22

Pharmacological treatments for obesity can also benefit cardiovascular disease. The SELECT trial assessed the effectiveness of semaglutide on cardiovascular outcomes in people with preexisting cardiovascular disease and overweight or obesity, without diabetes.23 The intervention reduced major adverse cardiovascular events by 20%,23 and an average weight loss of 10% of body weight.24

Although individual studies have not shown a mortality benefit with modest weight loss, a meta-analysis of randomised controlled trials involving over 17,000 adults with obesity reported a 15% reduction in all-cause mortality with intentional weight loss of 5.5 kg.25 Furthermore, cohort studies have shown a mortality benefit with greater weight loss after bariatric surgery. For example, Swedish Obese Subjects study, in which bariatric surgery produced an average of 16-18% weight loss, found a 29% reduction in overall mortality after 10-20 years, compared with a matched unoperated control group that did not lose weight.26

Obstructive sleep apnoea

Clinical trials indicate that moderate weight loss of >10 kg or >10% of body weight in people with obesity is beneficial in the treatment of obstructive sleep apnoea (OSA), with improvements in nocturnal respiratory disturbances (apnoea-hypopnoea index) and symptoms (Epworth Sleepiness Score) related to the degree of weight loss.1272829

Osteoarthritis

Obesity has a multifaceted role in osteoarthritis pain including inflammation and immune dysfunction.3031 Weight loss of 10% of body weight or more is associated with a lower risk of osteoarthritis.32 Weight loss is commonly recommended in clinical guidelines for management of hip and knee osteoarthritis in people with overweight or obesity, although evidence suggests only a modest effect on symptoms.33 A systematic review found there was inconsistent evidence of positive effects from weight loss on imaging of the hip or knee joint.34 In older adults with knee osteoarthritis, a combined nutrition and physical activity intervention that resulted in weight loss of 5.7% produced better overall improvements in self-reported and objectively measured physical function, as well as knee pain, compared to a control group (weight loss 1.2%).35 Functional benefits were limited in participants who received either the nutrition or physical activity intervention alone.35 Weight loss of at least 6% of body weight may be needed for a significant reduction in pain.36

Cancer

Obesity is a risk factor for 13 cancers: prostate, thyroid, breast (postmenopausal women), endometrial, kidney (renal cell), oesophageal, bowel, liver, ovarian, stomach, pancreas, multiple myeloma and gallbladder.37383940 Excess body weight increases insulin resistance, which leads to the pancreas producing more insulin. Elevated levels of insulin-like growth factor 1 can promote the growth of cancer cells. Excess body weight can also increase sex steroid hormones, which are linked to endometrial and post-menopause breast cancer.

Given unintentional weight loss can be a symptom of cancer, it is difficult to study the impact of weight loss on reversing cancer risk for people with obesity.41 For people with cancer, obesity was associated with greater mortality overall, however, for some cancers, people with obesity had greater survivorship than people without obesity (known as the obesity paradox).42 This highlights the need for tailored treatment plans and advice regarding weight loss and further research to understand the impact of weight loss. Breast cancer survivors with overweight and obesity have an increased risk of recurrence, however there’s a lack of evidence on the effectiveness of weight loss to reduce risk.43

An observational study of postmenopausal women found intentional weight loss was associated with reduced obesity-related cancer risk.44 A meta-analysis of randomised controlled trials of various non-surgical weight loss interventions in people with obesity did not find a significant reduction in cancer incidence or mortality after modest weight loss (overall mean 3.4 kg at 1 year).21 However, greater weight losses may be beneficial: larger cohort studies in people with obesity have reported a decreased incidence of all cancers and obesity-related cancers in women who intentionally lost at least 9 kg in adulthood,4546 but not men.47

In the SPLENDID matched cohort study, they found bariatric surgery was associated with a significantly lower incidence of obesity-related cancer and obesity-related mortality than nonsurgical care.48 Meta-analyses of controlled cohort and population-based studies have also demonstrated a 28-58% reduction in overall incidence of cancer, as well as specific reductions in the incidence of obesity-related cancer and breast cancer following bariatric surgery.4950 Although multiple observational studies suggest weight loss reduces risk for obesity-related cancer, further studies are needed to understand the mechanism of risk reduction.51

Reproductive and genitourinary conditions

Weight gain and obesity are common in women with Polycystic Ovary Syndrome (PCOS).52 International PCOS treatment guidelines recommend a lifelong health plan that includes a focus on healthy lifestyle and weight management including weight loss as appropriate.53 A systematic review of lifestyle approaches for weight loss in women with PCOS found no single approach more effective than others, findings reinforced the challenges of weight loss, and recommended a multidisciplinary team should be involved to support individualised care.54 In women with PCOS, lifestyle interventions can improve clinical and biochemical hyperandrogenism (excess male hormone levels), even if minimal weight loss is achieved.55 Greater weight loss after bariatric surgery has been shown to bring about a six-fold reduction in the incidence of PCOS, as well as attenuation of symptoms, including menstrual irregularity and excess hair growth.56

Overweight and obesity can have a negative impact on fertility in men and women.57 Lifestyle interventions (diet and physical activity) aimed to reduce weight in men and women with overweight or obesity experiencing infertility can improve pregnancy outcomes compared to control groups, with no difference seen in assisted reproductive outcomes.58 A systematic review also found weight loss prior to vitro fertilization (IVF) did not improve pregnancy outcomes.59

Weight loss of 5-10% in men and women with obesity has been shown to improve urinary stress incontinence and sexual dysfunction.60616263

Mental health and quality of life

Treatment of obesity is generally associated with improvements in mental health and quality of life.4 Weight loss intervention studies have generally reported a reduction in symptoms and prevalence of depression.6465 However, after bariatric surgery, there’s an increased risk of depression, self-harm and suicide, the cause for which has not been clearly identified.666768 Despite reports of suicide ideation from semaglutide treatment, current evidence does not show an increased risk.69 All treatments for obesity, particularly bariatric surgery, are consistently shown to be associated with an improvement in physical domains of health-related quality of life, but outcomes have been mixed for psychological aspects quality of life.46770

Lifestyle intervention without weight loss

For most people, it is difficult to achieve sustained weight loss.3 Fortunately, lifestyle changes can lead to improvements in many of the complications of obesity, even if minimal weight loss occurs.2 For example, exercise training even without weight loss leads to improvements in endothelial function,71 visceral adiposity,72 liver fat,73 inflammation,74 and quality of life.75 In part, such benefits may occur due to changes in body composition such as a reduction in visceral fat even when there is little or no overall weight loss.6576

Risks associated with weight loss

Although there are considerable benefits to weight loss for people with overweight and obesity, it can increase the risk of certain conditions and nutritional deficiencies.4 An individual’s overall health and potential risks from weight loss should be assessed and prevented, monitored and treated as necessary. Risks and side effects vary depending on the weight loss intervention and the extent of weight loss, such as greater risks with bariatric surgery.4 Risks include micronutrient deficiencies, bone density changes, gallstones and psychological effects.4

Information on risks of medication and surgery are mentioned here and lifestyle interventions here.

Content for this page was updated by Josephine Marshall at the at the Global Centre for Preventive Health and Nutrition at Deakin University. For more information about the approach to content on the site please see About | Obesity Evidence Hub.

References

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