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High BMI polygenic risk score linked to faster weight regain in postmenopausal European American womenGenetic risk score linked to faster weight regain in some postmenopausal women after weight loss

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Key Takeaway
Interpret high BMI polygenic risk score findings cautiously; validation in diverse populations is needed.

This secondary analysis of the Women's Health Initiative Dietary Modification Trial examined whether a polygenic risk score (PRS) for BMI modifies long-term weight trajectories following modest weight loss. The study included 9,897 postmenopausal women (6,132 European American; 3,749 African American) who were followed for 7 years. The intervention was a PRS derived from a trans-ancestry GWAS, comparing women with high genetic risk (≥95th percentile) to those with average risk.

In European American women who lost ≥5% of initial weight by year 1, those in the ≥95th percentile of PRS regained nearly twice as much weight per year compared to those with average risk (0.94 vs. 0.48 kg/year, p = 0.0016). The PRS × randomization × time interaction approached significance at the 95th percentile (p = 0.052) and 85th percentile (p = 0.07) in European Americans. No such interaction was observed in African American women.

Safety and tolerability data were not reported. A key limitation is that further validation is required in a diverse population. The study demonstrates an association, not causation, between high genetic risk and faster weight regain in one population subset. While these findings suggest genetics may eventually inform targeted weight management strategies, the evidence remains preliminary and requires confirmation in broader populations before considering clinical application.

Researchers wanted to see if a person's genetic makeup, measured by a 'polygenic risk score' for body weight, affects how much weight they regain after losing some. They studied 9,897 postmenopausal women who had taken part in a large dietary trial. The women were followed for seven years after they had lost a modest amount of weight.

In European American women who lost at least 5% of their weight, those with a very high genetic risk score regained weight nearly twice as fast per year (0.94 kg) compared to women with an average score (0.48 kg). However, this pattern was not seen in the African American women in the study. The researchers noted that the statistical link in the full European American group was close to, but did not quite reach, the usual threshold for scientific significance.

No safety issues were reported, as the study only looked at weight changes and did not test a new treatment. The main reason to be careful is that this is a single, observational finding from a specific group of women. It does not prove that genes cause weight regain, and the results may not apply to men, younger women, or people from other backgrounds. Readers should see this as an early step in understanding how genetics might play a role in long-term weight management, not as a tool for personal prediction or a reason to give up on healthy habits.

What this means for you:
Early research suggests genetics may influence weight regain in some women, but more studies in diverse groups are needed.

Study Details

Study typeRct
EvidenceLevel 2
PublishedApr 2026
View Original Abstract ↓
OBJECTIVE: Long-term weight regain limits the population-level benefits of obesity interventions. We tested whether the polygenic risk score of BMI (PRS) modifies weight trajectories following modest weight loss. METHODS: The analytic sample included 9897 postmenopausal women from the Women's Health Initiative Dietary Modification Trial (6132 European American; 3749 African American). PRS was derived from a trans-ancestry GWAS of ~2 million participants. Longitudinal weight change (7 years) was modeled using weighted GEE. RESULTS: In European Americans, the PRS × randomization × time interactions approached significance at the 95th percentile (p = 0.052) and 85th percentile (p = 0.07). No interaction was observed in African Americans. In analyses restricted to European Americans who lost ≥ 5% of initial weight by year 1 (20%; n = 1273), women in the ≥ 95th percentile of PRS regained nearly twice as much per year as those with average risk (0.94 vs. 0.48 kg/year, p = 0.0016). CONCLUSIONS: A high PRS was associated with faster weight regain following modest weight loss in European American women. While further validation is required in a diverse population, these results suggest the potential for genetics to inform targeted strategies for sustaining long-term weight management. TRIAL REGISTRATION: ClinicalTrials.gov identifier: 75N92021D00001, 75N92021D00002, 75N92021D00003, 75N92021D00004, and 75N92021D00005.
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