Few overweight people trim down after heart attack

By Anne Harding

NEW YORK (Reuters Health) - Overweight people lose virtually no weight after suffering a heart attack, according to the first study to evaluate factors associated with post-heart attack weight changes.

"On average less than a half of a percent change in body weight occurred, and that's really small," Dr. John A. Spertus of the Mid America Heart Institute of Saint Luke's Hospital in Kansas City, Missouri, one of the study's authors, told Reuters Health. People need to lose at least 5 percent of their body weight to significantly improve their heart health, he added.

Spertus and his team followed up with 1,253 overweight or obese individuals one year after they had experienced a heart attack. On average, they had lost 0.2 percent of their body weight. Overweight people actually gained an average of 0.4 percent of their body weight, while obese people lost 0.5 percent and morbidly obese individuals lost nearly 4 percent.

People who were depressed put on more weight, as did people who quit smoking after their heart attack. Individuals without health insurance were also more likely to put on pounds.

"People who stopped smoking tended to increase their weight by about 2.5 to 3 percent," Spertus noted. "That's a challenge because you want people to both stop smoking and lose weight."

Just 18 percent to 25 percent of the study patients participated in a certified cardiac rehabilitation program in the first month after their heart attack, Spertus noted in an interview. These programs, which focus on helping people increase activity, eat better, quit smoking and make other lifestyle changes to improve cardiovascular health, are considered the gold standard of post-heart attack care, he added, but not everyone has access to them.

When this is the case, Spertus said, "doctors and office staff need to fill the role" of encouraging patients to lose weight and quit smoking. When certified cardiac rehabilitation programs are available, he added, they're often underused. "We aren't doing as well as we need to be doing."

SOURCE: American Heart Journal, October 2007.