Re: Study Says Weight Loss May Raise Risk of Death

[Guest guest]

We have previously discussed about fat-soluble toxins released into

the bloodstream from fatty tissue during weight reduction. (BT120YD

pp. 78-80). I don't think that the Finland study took this into

consideration.

Tony

> Overweight people who are otherwise healthy may increase their

risk of

> dying by intentionally losing weight, according to provocative new

research.

>

> A study of 2,957 twins in Finland found that those who were

overweight who

> lost weight on purpose were about 86 percent more likely to die for

any

> reason over the next 18 years compared with those whose weight

remained

> stable.

>

[Guest guest]

Thanks, my favorite subject.

Notice full text:

HR = hazard ratio

http://medicine.plosjournals.org/perlserv/?request=get-document & doi=10.1371/journal.pmed.0020171

PLoS Med. 2005 Jun;2(6):e171. Epub 2005 Jun 28.

Intention to Lose Weight, Weight Changes, and 18-y Mortality in Overweight Individuals without Co-Morbidities.Sorensen TI, Rissanen A, Korkeila M, Kaprio J.Danish Epidemiology Science Centre, Institute of Preventive Medicine, Copenhagen University Hospital, Copenhagen, Denmark.BACKGROUND: Weight loss in the obese improves risk factors for cardiovascular diseases and diabetes. However, several studies have shown inconsistent long-term effects of weight loss on mortality. We investigated the influence on mortality of intention to lose weight and subsequent weight changes among overweight individuals without known co-morbidities. METHODS AND FINDINGS: In 1975, a cohort of individuals reported height, weight, and current attempts (defined as "intention") to lose weight, and in 1981, they reported current weight. Mortality of the 2,957 participants with body mass index >/= 25 kg/m(2) in 1975 and without pre-existing or current diseases was followed from 1982 through 1999, and 268 participants died. The association of intention to lose weight in 1975 and actual weight change until 1981 with mortality was analysed while controlling for behavioural and psychosocial risk factors and hypertension as possible confounders. Compared with the group not intending to lose and able to maintain stable weight, the hazard ratios (with 95% confidence intervals) in the group intending to lose weight were 0.84 (0.49-1.48) for those with stable weight, 1.86 (1.22-2.87) for those losing weight, and 0.93 (0.55-1.56) for those gaining weight. In the group not intending to lose weight, hazard ratios were 1.17 (0.82-1.66) for those who did lose weight, and 1.57 (1.08-2.30) for those gaining weight. CONCLUSION: Deliberate weight loss in overweight individuals without known co-morbidities may be hazardous in the long term. The health effects of weight loss are complex, possibly composed of oppositely acting processes, and need more research.PMID: 15971946

However, several prospective, long-term population-based studies have shown that weight loss, compared with stable weight in overweight or obese participants, is associated with future excess or unchanged mortality [10–13].

Lee IM, Paffenbarger RS (1992) Change in body weight and longevity. JAMA 268: 2045–2049. Find this article online Andres R, Muller DC, Sorkin JD (1993) Long-term effects of change in body weight on all-cause mortality. Ann Int Med 119: 737–743. Find this article online Yaari S, Goldburt U (1998) Voluntary and involuntary weight loss: Associations with long term mortality in 9,228 middle-aged and elderly men. Am J Epidemiol 148: 546–555. Find this article online Mikkelsen KL, Heitmann BL, Keiding N, Sørensen TIA (1999) Independent effects of stable and changing body weight on total mortality. Epidemiology 10: 671–678. Find this article online

The present analysis included only the participants who in 1975 were overweight or obese, defined as BMI = 25 kg/m2, forming a total of 4,466 out of the 19,993 participants.

Within this group, the median BMI was 26.7 kg/m2, the maximum BMI was 47.0 kg/m2, and 313 (9.9%) were obese (BMI = 30 kg/m2).

There was significant excess mortality only in the group intending to lose weight in 1975 and who lost weight by 1981, and in the group not intending to lose weight and then gaining weight.

YES

LOSS

42

YES

STABLE

17

YES

GAIN

22

NO

LOSS

73

NO

STABLE

54

NO

GAIN

60

{Those intending to lose were lower in each category (of Total deaths).}

{That might imply a level of restriction?}

{TOL, So how much did they lose?}

When exercise was used as the method, the HR for those who lost weight compared with those who maintained weight was increased but not statistically significant....Our finding that the excess mortality was worse in the group reporting using dieting than in the group reporting using exercise, is consistent with the possibly hazardous effects of loss of fat-free body mass.

{However, in the weight loss group, the HR of diet alone was 2.46, verus 1.84 diet alone.

How about diet AND exercise?}

The analysis of the causes of death did not indicate any single disease as responsible for all the excess mortality.

We may assume that intentional weight loss as induced by deliberate calorie restriction has multiple biological effects—some potentially beneficial, some potentially harmful. The net effects on the health of participants may depend on their current condition.

{What I don't see is the weight gain after the 5 yr period.

----- Original Message -----

FromA: Francesca Skelton

support group

Sent: Tauesday, June 28, 2005 9:18 AM

Subject: [ ] Study Says Weight Loss May Raise Risk of Death

By Rob Stein Overweight people who are otherwise healthy may increase their risk ofdying by intentionally losing weight, according to provocative new research.A study of 2,957 twins in Finland found that those who were overweight wholost weight on purpose were about 86 percent more likely to die for anyreason over the next 18 years compared with those whose weight remainedstable.The researchers cautioned, however, that only 268 people in the study died,a number too small to justify any firm recommendations about whetheroverweight people should try to lose weight.Skeptics who think health authorities have exaggerated the risks of beingoverweight said the findings offer fresh support. Other researchers,however, said that the study's weaknesses undercut the findings, and thatthere is overwhelming evidence that being overweight increases the risk of ahost of health problems.The researchers who conducted the study said they hope the results willstimulate more research into the relative risks and benefits of losingweight."We think that our findings are scientifically significant because theyclearly demonstrate that the relation between intentional weight loss andsubsequent health effects is complex and needs much more research," saidThorkild I.A. Sorensen of Copenhagen University Hospital.Many previous studies have found that people who lost weight appeared tohave an increased risk of dying over the long term, but the prevailingwisdom has been that the weight loss in these studies was the result ofillness, because people who are ill often lose weight. Still, some evidencehave suggested that intentional weight loss may be unhealthy for otherwisehealthy people, perhaps, for example, because losing muscle could havedetrimental effects on vital organs.To try to tease that out, Sorensen and his colleagues studied twins who hadundergone detailed questioning in 1975 about various health issues,including whether they intended to try to lose weight. Over the next 18years, those who were overweight and lost weight on purpose ended up beingmore likely to die than those who did not slim down, and the risk increasedwith the amount of weight lost, the study found. The increased risk heldtrue even after the researchers took into consideration factors such as howmuch the subjects exercised, what they ate and whether they had any healthproblems."We cannot say that they should not lose weight, only that we, due to ourfindings, are in doubt about the possible adverse long-term effects,"Sorensen said in an e-mail.The study was published in the Public Library of Science journal PLoSMedicine, one of a new set of scientific journals that are free to thepublic. Sorensen said his team previously tried to publish the study inother journals, including the New England Journal of Medicine and theJournal of the American Medical Association."We were left with the impression that they perhaps did not like todistribute such [a] message," Sorensen wrote.Other researchers praised the study for exploring the provocative question."It is one of the few studies that addresses this issue," said Flegal of the federal Centers for Disease Control and Prevention, whoignited a controversy in April when she published a study that concludedthat her agency had overestimated the negative effects of obesity. "Itsuggests there may be more to this than people think."The findings should counter blanket recommendations that weight loss isalways beneficial, other researchers said."There is such a cultural assumption that weight loss is necessary that weignore the evidence," said Bacon of the University of California at. "This is an important study that adds to the body of evidence that weneed to question the concept of encouraging weight loss."But other researchers said the study has a number of weaknesses. Theresearchers , for example, failed to fully account for the possibility thatillness may have gone undetected."I don't think this study is in any way definitive -- far from it," said of the University of Alabama at Birmingham.There is overwhelming evidence that losing weight reduces the risk of ahost of serious health problems, including heart disease, cancer anddiabetes."If you put it all together, you can say with certainty that weight loss inobese people is warranted and likely to be beneficial, and weight loss inoverweight people is probably also healthy as long as it is accomplished bymedically sound ways," said.Some researchers worried that the findings might discourage people fromtrying to lose weight."There are so many people who are struggling to lose weight, and if yougive them any indication that it's harmful, that's certainly going to sapmotivation," said Lawrence J. Cheskin, director of the s Hopkins WeightManagement Center in Baltimore.

[Guest guest]

So the real answer is not to become overweight in the first place.

Duh. (And not the case already for a great many of us.)

Iris

[Guest guest]

Hi folks:

I do not have a view on this issue. I do not have enough data to

justify one. But I do have a point to raise.

The majority of the populations of industrialized countries are over

weight and trying to lose weight. But overwhelmingly the majority of

those trying to lose weight do no succeed. EVERYONE seems to agree

that losing weight is incredibly difficult. One supposedly serious

(university) authority recently said that it is realistically

impossible to lose weight, seemingly implying that even bothering to

make the attempt is a waste of effort.

So perhaps we ought to ask a question about the people in these

studies who succeeded in losing weight. Why were a few successful

while the vast majority never are?

Possibly, for many of those who succeeded in losing weight there was

a reason beyond just 'rugged determination'. And that reason,

whatever it was, may also be the reason for the increased incidence

of death in the weight loss group.

We are not talking large numbers of people here. Of the 2957 total

people studied, 268 died - or 9.1%. These were divided among six

groups (both 'intending to lose' and 'intending to be stable' were

each divided into 'actually increased', 'actually stable',

and 'actually lost').

So the explanation may be that of the people 'intending to lose' who

succeeded in losing weight - just one of the six groups - (the

abstract does not tell us how many there were but suppose 65% of the

2957 were intending to lose, and 10% of them succeeded in losing

weight, then we are talking about 192 people in this group) perhaps

20 to 25 of them died.

Now ask yourself, is it too extreme to suppose that, say, fifteen to

twenty of those 20 to 25 had underlying sickness that CAUSED them

both to succeed in losing weight and eventually to die? While the

other five to ten did it by 'rugged determination' and remained alive

at the end of the study?

If 65% that were trying to lose weight among the 2957 being studied

the total number of those trying to lose weight was 1922. Fifteen to

twenty out of 1922 is not a large number.

And remember, Clinton's coronary artery was 90% occluded before he

noticed symptons notable enough to visit his doctor. So I really

doubt the study's authors were able to weed out all cases where the

people would eventually lose weight some time in the next twenty

years, just because they were sick). And **ALL** cases of weight-

loss-sickness among the 1922 will fall into the 'succeeded in losing

weight' category.

If we believe the propaganda, we know that, for almost everyone,

losing weight is simply beyond their capabilities. Pretty much the

only people who can lose weight are those who have a poor appetite.

And the reason for the poor appetite that enables them to succeed in

losing weight is ................ ?????

This is simply a question. Without access to much more data than I

currently have I cannot have a strong view about this.

But PERHAPS the headline should have read: " Study Says Weight Loss

Is Dead Easy. All That is Needed is to Be Sick Before Yer Start " .

If the above does explain the data these studies found, then the

conclusions do not apply to healthy people.

Rodney.

--- In , " jwwright " <jwwright@e...>

wrote:

> Recognize that this group is me - probably 95% were hypertensives -

the one disease not excluded. If they had, they wouldn't have had

many subjects.

> It does provide 5 refs

>

> 1.. Lee IM, Paffenbarger RS (1992) Change in body weight and

longevity. JAMA 268: 2045-2049. Find this article online

> 2.. Andres R, Muller DC, Sorkin JD (1993) Long-term effects of

change in body weight on all-cause mortality. Ann Int Med 119: 737-

743. Find this article online

> 3.. Yaari S, Goldburt U (1998) Voluntary and involuntary weight

loss: Associations with long term mortality in 9,228 middle-aged and

elderly men. Am J Epidemiol 148: 546-555. Find this article online

> 4.. Mikkelsen KL, Heitmann BL, Keiding N, Sørensen TIA (1999)

Independent effects of stable and changing body weight on total

mortality. Epidemiology 10: 671-678. Find this article online

> that may provide more insight.

>

> Regards.

[Guest guest]

Message: 3

Date: Wed, 29 Jun 2005 13:24:30 -0500

From: " jwwright " <jwwright@...>

Subject: Re: Re: Study Says Weight Loss May Raise Risk of Death

more data:

Reasons for intentional weight loss, unintentional weight loss, and mortality in

older men.

Arch Intern Med. 2005 May 9;165(9):1035-40.

PMID: 15883243

<snip>

Results: Unintentional but not intentional weight loss was associated with a

significant

increase in risk of all-cause mortality compared with men who reported no weight

change, even after adjustment for lifestyle characteristics and preexisting

disease

(adjusted relative risk [RR], 1.71; 95% confidence interval [CI], 1.33-2.19; and

RR, 1.00; 95% CI, 0.91-1.10, respectively). Men who lost weight intentionally as

a result of personal choice showed significant benefit in all-cause mortality

(RR,

0.59; 95% CI, 0.34-1.00; P = .05), which was largely owing to a significant

reduction in mortality from non-CVD causes (RR, 0.36; 95% CI, 0.15-0.87). The

benefit

in these men was most apparent in markedly overweight men (BMI [calculated as

weight

in kilograms divided by the square of height in meters] >=28) and in younger

men (age <65 years). Men who lost weight intentionally owing to ill health or

physician's advice showed an increased risk of all-cause mortality (RR, 1.37;

95%

CI, 0.96-1.94). No harm or benefit was seen for CVD mortality, irrespective of

reasons

for intentional weight loss.

Conclusion: Intentional weight loss carried out for personal reasons is

associated

with a significant reduction in all-cause mortality in markedly overweight men,

and the data suggest that the earlier the intervention, the greater the chance

of

benefit.

--Heh. Good to hear, may it all be true. In the last 1.5 years I've CRawled my

way down from 234 to 205, fifteen of those pounds since the beginning of this

year and whittled my BMI down from too-close-to-30 to 26-something while

increasing my lean body mass, which I suspect is all good stuff.

Maco