LONG-TERM EFFECTS OF CHANGE IN BODY-WEIGHT ON ALL-CAUSE MORTALITY - AREVIEW

Objective: To summarize published studies analyzing the effects of lon g-term change in body weight on all-cause mortality and have not been reported elsewhere in these proceedings. Data Sources: Thirteen report s from 11 diverse population studies, 7 from the United States and 4 f rom Europe. Study Selection: All studies included a weight change peri od of 4 or more years, followed by a mortality assessment period of 8 or more years. All weight changes occurred in persons 17 years or olde r. Data Extraction: Data from individual studies are presented as numb er of participants, number of deaths, ages at initial and final weight measurements, duration of the mortality follow-up period, considerati on of cigarette smoking and other potential confounders, exclusion cri teria, temporal separation between the weight change and mortality fol low-up periods, and the association between weight change and all-caus e mortality. Data Synthesis: Results are summarized by weight change a ssociated with the lowest mortality rate and by the effects of long-te rm weight loss on mortality rate. Conclusions: Despite the diversity o f the populations studied, the degree of ''clinical clean-up'' at entr y, the techniques used to assess weight change, and the differences in analytic techniques (including consideration of potentially confoundi ng variables), certain conclusions may be drawn. Evidence suggests tha t the highest mortality rates occur in adults who either have lost wei ght or have gained excessive weight. The lowest mortality rates are ge nerally associated with modest weight gains.