Personalized Weight‐Loss Targets for Metabolic Syndrome Reversal: A <scp>BMI</scp> ‐Normalization Achievement Rate‐Based Cohort Study

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. image