N John Bosomworth1. 1. Department of Family Practice, University of British Columbia, Vancouver, BC, Canada. john.bosomworth@interiorhealth.ca
Abstract
OBJECTIVE: To explore the reasons why long-term weight loss is seldom achieved and to evaluate the consequences of various weight trajectories, including stability, loss, and gain. QUALITY OF EVIDENCE: Studies evaluating population weight metrics were mainly observational. Level I evidence was available to evaluate the influence of weight interventions on mortality and quality of life. MAIN MESSAGE: Sustained weight loss is achieved by a small percentage of those intending to lose weight. Mortality is lowest in the high-normal and overweight range. The safest body-size trajectory is stable weight with optimization of physical and metabolic fitness. With weight loss there is evidence for lower mortality in those with obesity-related comorbidities. There is also evidence for improved health-related quality of life in obese individuals who lose weight. Weight loss in the healthy obese, however, is associated with increased mortality. CONCLUSION: Weight loss is advisable only for those with obesity-related comorbidities. Healthy obese people wishing to lose weight should be informed that there might be associated risks. A strategy that leads to a stable body mass index with optimized physical and metabolic fitness at any size is the safest weight intervention option.
OBJECTIVE: To explore the reasons why long-term weight loss is seldom achieved and to evaluate the consequences of various weight trajectories, including stability, loss, and gain. QUALITY OF EVIDENCE: Studies evaluating population weight metrics were mainly observational. Level I evidence was available to evaluate the influence of weight interventions on mortality and quality of life. MAIN MESSAGE: Sustained weight loss is achieved by a small percentage of those intending to lose weight. Mortality is lowest in the high-normal and overweight range. The safest body-size trajectory is stable weight with optimization of physical and metabolic fitness. With weight loss there is evidence for lower mortality in those with obesity-related comorbidities. There is also evidence for improved health-related quality of life in obese individuals who lose weight. Weight loss in the healthy obese, however, is associated with increased mortality. CONCLUSION:Weight loss is advisable only for those with obesity-related comorbidities. Healthy obesepeople wishing to lose weight should be informed that there might be associated risks. A strategy that leads to a stable body mass index with optimized physical and metabolic fitness at any size is the safest weight intervention option.
Authors: Rochelle E Garner; David H Feeny; Amanda Thompson; Julie Bernier; Bentson H McFarland; Nathalie Huguet; Mark S Kaplan; Heather Orpana; Nancy A Ross; Chris Blanchard Journal: Qual Life Res Date: 2011-08-13 Impact factor: 4.147