Obesity is a known risk factor for COVID-19. As we think more broadly about obesity prevention strategies, does when you lose weight across the lifespan matter related to all-cause mortality?
A new paper by Wubin Xie and colleagues from Boston University in JAMA Open examines the role of weight loss in early adulthood and subsequent all-cause mortality in later life. The authors leveraged the National Health and Nutritional Examination Survey III (NHANES) dataset sampling the 1988-1994 data collection with continuous data updates in two-year cycles through 2014. Weight history was assessed by self-report at baseline where participants were asked to recall their weight as 25-year-olds, and weight was measured at mid-life (mean age of 44 years of age). The sample included 24,205 participants of individuals aged 40-74 years in the last survey timeframe. The participant sample was 49% female, and 76.9% non-Hispanic white. The mean BMI at baseline was 29, and at a ten-year follow-up, 5846 of the participants had died.
Data patterns show that participants who moved from having obesity to having overweight in early adulthood showed a 54% reduction in all-cause mortality relative to those who remained in the obese category. The authors suggest that 3.2% of the sample’s early deaths could have been avoided if they lost weight and moved from having obesity to having overweight. Persistent obesity points to higher mortality risk.
This paper is an addition to our learning. From a population management perspective, addressing weight loss in early adulthood points toward less premature deaths from obesity-related comorbidities. The dataset does have limitations that are important to consider. Self-reported weights have been a controversial area in the obesity literature; recall of weight at age 25 may have been inaccurate, putting participants into an incorrect BMI category from the outset. As with much of the literature in obesity, this sample consisted of predominately white females. Findings aren’t generalizable to other diverse groups. The subsequent analysis did account for these issues. Still, it showed an overall risk reduction of those who moved down weight classes, so early adulthood is a likely intervention timeframe for weight-loss interventions. It is also a time when people move away from home, have children, and begin their adulthood. Addressing weight gain and weight-loss interventions in the part of the lifespan seem prudent.
Thanks for reading – Trina
(Opinions are my own)
Xie W, Lundberg DJ, Collins JM, et al. Association of Weight Loss Between Early Adulthood and Midlife With All-Cause Mortality Risk in the US. JAMA Netw Open. 2020;3(8):e2013448. doi:10.1001/jamanetworkopen.2020.13448