Abstract
OBJECTIVE: In epidemiological studies, weight loss is usually associated with increased mortality rate. Contrarily, among obese people, weight loss reduces other risk factors for disease and death. We hypothesised that this paradox could exist because weight is used as an implicit adiposity index. No study has considered the independent effects of weight loss and fat loss on mortality rate. We studied mortality rate as a function of weight loss and fat loss.
DESIGN: Analysis of âtime to deathâ in two prospective population-based cohort studies, the Tecumseh Community Health Study (1890 subjects; 321 deaths within 16â y of follow-up) and the Framingham Heart Study (2731 subjects; 507 deaths within 8â y of follow-up), in which weight and fat (via skinfolds) loss were assessable.
RESULTS: In both studies, regardless of the statistical approach, weight loss was associated with an increased, and fat loss with a decreased, mortality rate (P<0.05). Each standard deviation (s.d.) of weight loss (4.6â kg in Tecumseh, 6.7â kg in Framingham) was estimated to increase the hazard rate by 29% (95% confidence interval CI), (14%, 47%, respectively) and 39% (95% CI, 25%, 54% respectively), in the two samples. Contrarily, each s.d. of fat loss (10.0â mm in Tecumseh, 4.8â mm in Framingham) was estimated to reduce the hazard rate 15% (95% CI, 4%, 25%) and 17% (95% CI, 8%, 25%) in Tecumseh and Framingham, respectively. Generalisability of these results to severely (that is, body mass index BMI) â¥34) obese individuals is unclear.
CONCLUSIONS: Among individuals that are not severely obese, weight loss is associated with increased mortality rate and fat loss with decreased mortality rate.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Buy this article
- Purchase on SpringerLink
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Allison, D., Zannolli, R., Faith, M. et al. Weight loss increases and fat loss decreases all-cause mortality rate: results from two independent cohort studies. Int J Obes 23, 603â611 (1999). https://doi.org/10.1038/sj.ijo.0800875
Published:
Issue Date:
DOI: https://doi.org/10.1038/sj.ijo.0800875
Keywords
This article is cited by
-
Levels and changes in body mass index decomposed into fat and fat-free mass index: relation to long-term all-cause mortality in the general population
International Journal of Obesity (2020)
-
The Effect of Low-Volume High-Intensity Interval Training on Body Composition and Cardiorespiratory Fitness: A Systematic Review and Meta-Analysis
Sports Medicine (2019)
-
Management of cardiovascular diseases in patients with obesity
Nature Reviews Cardiology (2018)
-
Association between weight change and mortality in community living older people followed for up to 14 years. The Hordaland Health Study (HUSK)
The Journal of nutrition, health and aging (2017)
-
Reducing Heart Failure Risks in Obese Patients
Current Cardiovascular Risk Reports (2016)