Effect of Clinically Significant Weight Loss on Remission of Metabolic Complications: A Rapid Review and Meta‐Analysis of Comparative Controlled Studies

The strength of the association between achieving clinically significant weight loss and remission of metabolic complications remains unclear. This rapid review aimed to investigate the effect of weight loss on remission of metabolic risk factors. We searched Embase, Medline, Web of Science, and Google Scholar databases (up to June 2025) for studies comparing the effects of ≥ 5% versus < 5% total weight loss (%TWL) for at least 12 months. Mean differences (MD) and risk ratios (RR) with 95% confidence intervals (95% CI) were calculated for the meta-analysis. A total of 43 comparative studies were reviewed. Compared to < 5%TWL, ≥ 5%TWL had a higher RR of type 2 diabetes remission (RR = 7.88: 95% CI = 5.00, 12.43; I² = 75.2%), hypertension remission (RR = 2.23: 95% CI = 1.06,4.68; I² = 70.5%), and metabolic syndrome remission (RR = 5.61: 95% CI = 1.62,19.49; I² = 70.2%). Compared to < 5%TWL, ≥ 5%TWL participants achieved significant MDs in HbA1c (MD = -1.06: 95% CI = -1.40, -0.71), fasting plasma glucose (MD = -1.13: 95% CI = -1.84, -0.43), systolic blood pressure (MD = -3.65: 95% CI = -5.56, -1.74), diastolic blood pressure (MD = -3.26: 95% CI = -6.31, -0.20), triglycerides (MD = -0.26: 95% CI = -0.45, -0.06), and HDL-cholesterol (MD = 0.09: 95% CI = 0.04, 0.14). Remission of metabolic complications and improvements in HbA1c, blood pressure, lipids, and fasting insulin were observed following ≥ 5%TWL in people with obesity in a dose-response manner. Factors like the %TWL achieved (particularly ≥ 15%), bariatric surgery, and duration of follow-up predict these outcomes.