X-Message-Number: 12384
Date: Tue, 7 Sep 1999 08:52:28 -0700 (PDT)
From: Doug Skrecky <>
Subject: weight loss: beneficial or detrimental?

Med Sci Sports Exerc 1999 Aug:31(8): 1118-28

Thinness and weight loss: beneficial or detrimental to longevity?

Gaesser GA
Exercise Physiology Laboratory, University of Virginia

  This review examined the hypotheses that 1) low body mass index (BMI) 
is optimal for longevity and 2) weight loss reduces mortality rates. 
The preponderance of epidemiological evidence fails to support either 
of these hypotheses. Indeed, a number of studies show that thiness and
weight loss (regardless of initial BMI) are associated with increased
mortality rates. These findings cannot be attributed to smoking status or
to weight loss resulting from subclinical disease. The effect of
intentional weight loss on mortality rates depends upon health status. For
overweight individuals in good health, there is no compelling evidence to
show that mortality rates are reduced with weight loss. Even among
overweight persons with one or more obesity-related health conditions,
specific weight loss recommendations may be unnecessary: 1) the reduction
in mortality rate associated with intentional weight loss is independant
of the amount of weight loss, 2) the reductions in all-cause mortality
rate associated with increased physical activity and fitness (23-44%),
independant of changes in body weight,are greater than that reported 
for intentional weight loss (approximately 20%), and 3) many
obesity-related health conditions (e.g., hypertension, dyslipidemias,
insulin resistance, glucose intolerance) can be ameliorated independantly
of weight loss. In view of the potential risks associated with weight loss
and weight cycling, it is suggested that public health may be better
served by placing greater emphasis on lifestyle changes and less attention
to weight loss per se.

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