American Journal of Epidemiology Vol. 141, No. 12: 1128-1141
Copyright © 1995 by The Johns Hopkins University School of Hygiene and Public Health
research-article |
Prospective Study of Intentional Weight Loss and Mortality in Never-Smoking Overweight US White Women Aged 40–64 Years
1National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention Atlanta, GA
2National Center for Health Statistics, Centers for Disease Control and Prevention Hyattsville, MD
3Department of Epidemiology and statistics, American Cancer Society Atlanta, GA
4School of Public Health, Emory University Atlanta, GA
Reprint requests to Dr. David F. Williamson, Division of Diabetes Translation (K-10), Centers for Disease Control and Prevention, 4770 Buford Highway NE, Atlanta, GA 30341-3724.
Although 40% of US women indicate they are currently trying to lose weight, the association between intentional weight loss and longevity is unknown. The authors analyzed prospective data from 43,457 overweight, never-smoking US white women aged 40–64 years who in 1959–1960 completed a questionnaire that included questions on weight change direction, amount, time interval, and intentionallty. Vital status was determined in 1972. Proportional hazards regression was used to estimate mortality rate ratios for women who intentionally lost weight compared with women who had no change in weight. Women who died within the first 3 years of follow-up were excluded. Analyses were stratified by preexisting illness and adjusted for age, beginning body mass index, alcohol intake, education, physical activity, and health conditions. In women with obesity-related health conditions (n = 15,069), intentional weight loss of any amount was associated with a 20% reduction in all-cause mortality, primarily due to a 40–50% reduction in mortality from obesity-related cancers; diabetes-associated mortality was also reduced by 30–40% in those who intentionally lost weight. In women with no preexisting illness {n = 28,388), intentional weight loss of 
20 Ib (9.1 kg) that occurred within the previous year was associated with about a 25% reduction in all-cause, cardiovascular, and cancer mortality; however, loss of <20 Ib (<9.1 kg) or loss that occurred over an interval of 1 year was generally associated with small to modest increases in mortality. The association between intentional weight loss and longevity in middle-aged overweight women appears to depend on their health status. Intentional weight loss among women with obesity-related conditions is generally associated with decreased premature mortality, whereas among women with no preexisting illness, the association is equivocal.
cardiovascular diseases; diabetes mellitus; mortality; neoplasms; obesity; weight loss
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