Intentional weight loss and mortality among overweight individuals with diabetes

OBJECTIVE - To estimate the effect of intentional weight loss on mortality in overweight individuals with diabetes. RESEARCH DESIGN AND METHODS - We performed a prospective analysis with a 12 -year mortality follow-up (1959-1972) of 4,970 overweight individuals with diabetes, 40-64 years of age, who were enrolled in the American Cancer Soci ety's Cancer Prevention Study I. Rate ratios (RRs) were calculated, compari ng overall death rates, and death from cardiovascular disease (CVD) or diab etes in individuals with and without reported intentional weight loss. RESULTS - Intentional weight loss was reported by 34% of the cohort. After adjustment for initial BMI, sociodemographic factors, health status, and ph ysical activity, intentional weight loss was associated with a 25% reductio n in total mortality (RR = 0.75; 95% CI 0.67-0.84), and a 28% reduction in CVD and diabetes mortality (RR = 0.72; 0.63-0.82). intentional weight loss of 20-29 lb was associated with the largest reductions in mortality (simila r to 33%). Weight loss >70 Ib was associated with small increases in mortal ity. CONCLUSIONS - Intentional weight loss was associated with substantial reduc tions in mortality in this observational study of overweight individuals wi th diabetes.