Prospective Study of Intentional Weight Loss and Mortality in Overweight White Men Aged 40-64 Years

Abstract

Although 25% of US men indicate that they are trying to lose weight, the association between intentional weight loss and longevity in men is unknown. The authors analyzed prospective data from 49,337 overweight (initial body mass index > or =27) white men aged 40-64 years who, in 1959-1960, answered questions on weight change direction, amount, time interval, and intent. Vital status was determined in 1972. Proportional hazards regression estimated mortality rate ratios for men who intentionally lost weight compared with men with no weight change. Analyses were stratified by health status and adjusted for age, initial body mass index, smoking status, alcohol intake, education, physical activity, health history, and physical symptoms. Among men with no reported health conditions (n = 36,280), intentional weight loss was not associated with total, cardiovascular (CVD), or cancer mortality, but diabetes-associated mortality was increased 48% (95% confidence interval (CI) -7% to +133%) among those who lost 20 pounds (9.1 kg) or more; this increase was largely related to non-CVD mortality. Among men with reported health conditions (n = 13,057), intentional weight loss had no association with total or CVD mortality, but cancer mortality increased 25% (95% confidence interval -4% to +63%) among those who lost 20 pounds or more. Diabetes-associated mortality was reduced 32% (95% confidence interval -52% to -5%) among those who lost less than 20 pounds and 36% (95% confidence interval -49% to -20%) among those who lost more than 20 pounds. These results and those from our earlier study in women (Williamson et al., Am J Epidemiol 1995;141:1128-41) suggest that intentional weight loss may reduce the risk of dying from diabetes, but not from CVD. In observational studies, however, it is difficult to separate intentional weight loss from unintentional weight loss due to undiagnosed, underlying disease. Well-designed observational studies, as well as randomized controlled trials, are needed to determine whether intentional weight loss reduces CVD mortality.

Systematic review of long-term weight loss studies in obese adults: clinical significance and applicability to clinical practice

“…94,95 The impact of weight loss on cardiovascular risk factors is greatest in subjects with impaired glucose tolerance, type 2 diabetes, or hypertension, because changes in risk factors are more likely in subjects with abnormal baseline levels, and this is consistent with findings from observational studies that intentional weight loss is associated with increased longevity but only in people with pre-existing disease. 96,97 We found, however, that these improvements may be intervention specific. Orlistat therapy was associated with a 5-10% decrease in LDL levels, which is comparable to a cholesterol-lowering diet.…”

Lipid peroxides in obese patients and effects of weight loss with orlistat on lipid peroxides levels

“…20 A weight loss in the order of 5-10% is associated with clinically meaningful reductions with respect to all comorbidities. 21 Diet and exercise have been the cornerstone of weight management therapy. Vasankari et al 22 investigated the effect of weight reduction with diet and exercise on LDL oxidation in obese premenopausal women.…”

Effects of moderate weight loss on anginal symptoms and indices of coagulation and fibrinolysis in overweight patients with angina pectoris

“…All improve with loss of 5 -10% or 5 -10 kg body weight (Goldstein, 1992). Life expectancy is increased with intentional weight loss in overweight people who have obesity-related complications, particularly diabetes (Lean et al, 1990;Williamson et al, 1995Williamson et al, ,1999.…”