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Can Fam Physician. 2012 May;58(5):517-23.

The downside of weight loss: realistic intervention in body-weight trajectory.

Author information

  • 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.

PMID:
22586192
[PubMed - indexed for MEDLINE]
PMCID:
PMC3352786
Free PMC Article

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