Longitudinal weight trajectories and predictors of weight gain in treated patients with Graves’ disease: A prospective observational study

ABSTRACT Background: Weight gain after the correction of thyrotoxicosis is well recognized. However, in a substantial subset of patients, it exceeds premorbid levels and may predispose to obesity and cardiometabolic risk. Indian data on the magnitude, temporal pattern, and predictors of posttreatment weight gain in Graves’ disease are lacking. Aim: To evaluate weight trajectories during the 1 st year of antithyroid drug therapy in patients with GD and to identify the clinical predictors of excessive weight gain. Materials and Methods: In this prospective observational study from a tertiary endocrine center, 70 patients with newly diagnosed GD were followed for 12 months. Weight, body mass index (BMI), and thyroid function tests were assessed at baseline and at 3-month intervals. Multivariable linear regression was performed to identify the predictors of weight gain at 12 months. Results: Seventy patients (mean age 40.36 ± 10.49 years) completed the follow-up. Mean baseline weight was 52.59 ± 11.59 kg compared with a premorbid weight of 58.27 ± 11.36 kg. Weight and BMI increased progressively over the follow-up ( P < 0.0001). At 12 months, 77.14% of patients had gained weight relative to premorbid values (mean +2.82 kg), and obesity prevalence rose from 22.86% at baseline to 52.86%. Weight gain at 9 months was the only independent predictor of total gain at 12 months (β = 1.393; P < 0.001). Conclusion: ATD-treated GD patients experience significant and sustained weight gain, surpassing premorbid levels by 9 months. The early weight trajectory especially by month nine is strongly associated with excess weight gain. Incorporating weight management and lifestyle counseling early in treatment may mitigate long-term adiposity.