Personalized Weight‐Loss Targets for Metabolic Syndrome Reversal: A
BMI
‐Normalization Achievement Rate‐Based Cohort Study
Junfeng Qi, Longzhu Xiong, Chuansha Wu, Xiaojie Sun, Junlin Li, Likun Ren, Chaoliang Yi, Yuqin Shi, Ling Zhang, Xiongfei Pan, Ting Zhou, Shuzhen Zhu ABSTRACT
Objective
This study aimed to explore personalized weight‐loss targets for metabolic syndrome (MetS) reversal by introducing the BMI‐normalization achievement rate (BMI‐NAR), a novel baseline‐BMI‐scaled metric.
Methods
In a longitudinal cohort of 7340 adults with overweight/obesity and MetS from the ChinaHEART project, BMI‐NAR was defined as the percentage of progress toward a normal BMI (< 24 kg/m 2 ). Logistic regression and restricted cubic splines assessed the dose–response relationship between BMI‐NAR and MetS reversal.
Results
Each 50% increase in BMI‐NAR was significantly associated with MetS reversal (overall: OR = 1.10, 95% CI: 1.07–1.12; overweight: OR = 1.08, 95% CI: 1.06–1.11; obesity: OR = 2.36, 95% CI: 2.00–2.80). The probability of reversal increased steeply beyond exploratory minimum effective thresholds (37% BMI‐NAR for overall; 53% for overweight; 22% for obesity), with benefits observed up to ~165% in the total population, beyond which data were sparse. No clear upper plateau was identified in populations with overweight and obesity. These exploratory thresholds translate into personalized weight‐loss targets: a minimum reduction of 2%–8% for typical overweight (baseline BMI 25–27.99 kg/m 2 ) and 3%–9% for obesity.
Conclusions
MetS reversal does not require full BMI normalization. BMI‐NAR provides a hypothesis‐generating, quantifiable framework for exploring personalized minimum effective weight‐loss goals in this high‐risk population. However, external validation is required before clinical application.