Weight loss causes increased mortality: cons

Yang, Dongyan; Fontaine, Kevin R.; Wang, C.; Allison, David B.

doi:10.1046/j.1467-789x.2003.00092.x

Cited by 73 publications

(75 citation statements)

References 36 publications

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“…Nutrition Research Reviews relative risk (RR) of all-cause mortality (13,14) . Methodological problems have also been identified, for example, the method by which the weight loss was achieved has usually not been reported (although dietary energy restriction is likely to have been a major factor), while weight changes before and after the recording periods have usually not been determined (12 -16) .…”

Section: Introductionmentioning

confidence: 99%

A review and meta-analysis of the effect of weight loss on all-cause mortality risk

Harrington¹,

Gibson²,

Cottrell³

2009

Nutr. Res. Rev.

211

152

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Overweight and obesity are associated with increased morbidity and mortality, although the range of body weights that is optimal for health is controversial. It is less clear whether weight loss benefits longevity and hence whether weight reduction is justified as a prime goal for all individuals who are overweight (normally defined as BMI . 25 kg/m 2 ). The purpose of the present review was to examine the evidence base for recommending weight loss by diet and lifestyle change as a means of prolonging life. An electronic search identified twenty-six eligible prospective studies that monitored subsequent mortality risk following weight loss by lifestyle change, published up to 2008. Data were extracted and further analysed by meta-analysis, giving particular attention to the influence of confounders. Moderator variables such as reason for weight loss (intentional, unintentional), baseline health status (healthy, unhealthy), baseline BMI (normal, overweight, obese), method used to estimate weight loss (measured weight loss, reported weight loss) and whether models adjusted for physical activity (adjusted data, unadjusted data) were used to classify subgroups for separate analysis. Intentional weight loss per se had a neutral effect on all-cause mortality (relative risk (RR) 1·01; P ¼ 0·89), while weight loss which was unintentional or ill-defined was associated with excess risk of 22 to 39 %. Intentional weight loss had a small benefit for individuals classified as unhealthy (with obesity-related risk factors) (RR 0·87 (95 % CI 0·77, 0·99); P ¼ 0·028), especially unhealthy obese (RR 0·84 (95 % CI 0·73, 0·97); P ¼ 0·018), but appeared to be associated with slightly increased mortality for healthy individuals (RR 1·11 (95 % CI 1·00, 1·22); P ¼ 0·05), and for those who were overweight but not obese (RR 1·09 (95 % CI 1·02, 1·17); P ¼ 0·008). There was no evidence for weight loss conferring either benefit or risk among healthy obese. In conclusion, the available evidence does not support solely advising overweight or obese individuals who are otherwise healthy to lose weight as a means of prolonging life. Other aspects of a healthy lifestyle, especially exercise and dietary quality, should be considered. However, well-designed intervention studies are needed clearly to disentangle the influence of physical activity, diet strategy and body composition, in order to define appropriate advice to those populations that might be expected to benefit.

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Section: Introductionmentioning

confidence: 99%

A review and meta-analysis of the effect of weight loss on all-cause mortality risk

Harrington¹,

Gibson²,

Cottrell³

2009

Nutr. Res. Rev.

211

152

View full text Add to dashboard Cite

show abstract

“…[8][9][10][11][12][13][14][15] However, the results are not consistent. 16,17 Variations in occurrence of pre-existing disease, sub-clinical disease, smoking, changes in body composition or fat distribution have been suggested to explain, in part, the elevated risk among those who lose weight. 10,11,18,19 Although studies have shown that even after careful confounder control and exclusion of subjects with preexisting disease, weight loss still seems an independent risk factor for premature death.…”

Section: Introductionmentioning

confidence: 99%

Combined effects of weight loss and physical activity on all-cause mortality of overweight men and women

et al. 2010

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“…The primary limitation of the observational literature on weight change and mortality is the lack of information about weight loss intention (10,11). The weightlosing population includes an admixture of individuals losing weight on purpose and those who lose weight unintentionally.…”

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confidence: 99%

Trying to Lose Weight, Losing Weight, and 9-Year Mortality in Overweight U.S. Adults With Diabetes

et al. 2004

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OBJECTIVE -The aim of this study was to examine the relationships between intention to lose weight, actual weight loss, and all-cause mortality among overweight individuals with diabetes.RESEARCH DESIGN AND METHODS -We performed a prospective analysis among 1,401 overweight diabetic adults aged Ն35 years sampled in the National Health Interview Survey. The previous year intention to lose weight and weight change were assessed by selfreport. Nine-year mortality rates were examined according to intent to lose weight and weight loss, which were adjusted for age, sex, education, ethnicity, smoking, initial body weight, and diabetes complications.RESULTS -Individuals trying to lose weight had a 23% lower mortality rate (hazard rate ratio [HRR] 0.77, 95% CI 0.61-0.99) than those who reported not trying to lose weight. This association was as strong for those who failed to lose weight (0.72, 0.55-0.96) as for those who succeeded in losing weight (0.83, 0.63-1.08). Trying to lose weight was beneficial for overweight (BMI 25-30 kg/m 2 ) individuals (0.62, 0.46 -0.83) but not for obese (BMI Ͼ30) individuals (1.17, 0.72-1.92). Overall weight loss, without regard to intent, was associated with an increase of 22% (1.22, 0.99 -1.50) in the mortality rate. This increase was largely explained by unintentional weight loss, which was associated with a 58% (1.58, 1.08 -2.31) higher mortality rate.CONCLUSIONS -Overweight diabetic adults trying to lose weight have a reduced risk of all-cause mortality, independent of whether they lose weight. Actual weight loss is associated with increased mortality only if the weight loss is unintentional.

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Weight loss causes increased mortality: cons

Cited by 73 publications

References 36 publications

A review and meta-analysis of the effect of weight loss on all-cause mortality risk

A review and meta-analysis of the effect of weight loss on all-cause mortality risk

Combined effects of weight loss and physical activity on all-cause mortality of overweight men and women

Trying to Lose Weight, Losing Weight, and 9-Year Mortality in Overweight U.S. Adults With Diabetes

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