Weight change, weight cycling and mortality in the ERFORT Male Cohort Study

Eur J Epidemiol. 2007;22(10):665-73. doi: 10.1007/s10654-007-9167-5. Epub 2007 Aug 4.


Objective: To investigate the effect of weight change and weight fluctuations on all-cause-mortality in men.

Methods: Within a prospective population-based cohort of 1,160 men aged 40-59 years at recruitment, complete weight change patterns from baseline and three follow-up examinations during a period of 15 years of follow-up was used to categorize the 505 men into stable obese, stable non-obese, weight gain, weight loss and weight fluctuation groups. For these men (age range: 55-74 years at start time of survival analysis) further survival was analyzed during the subsequent 15 years.

Results: Overall, 183 deaths were observed among the 505 men. Only weight fluctuations had a clear significant impact on all-cause mortality. Adjusted hazard rate ratio (HRR (95%-CI)) was 1.86 (1.31-2.66) after adjustment for age group, pre-existing cardiovascular disease or diabetes mellitus, smoking and socio-economic status. The risk rate due to weight loss was borderline significant (HRR = 1.81 (0.99-3.31)). Risk of death due to weight gain (HRR = 1.15 (0.70-1.88)) or stable obesity (HRR = 1.16 (0.69-1.94)), however, were not significantly increased compared to men staying non-obese for the first 15 years after cohort recruitment.

Conclusion: Weight fluctuations are a major risk factor for all-cause mortality in middle aged men. Moreover, stable obesity does not increase further mortality in men aged 55-74 years in long-term follow-up.

MeSH terms

  • Aged
  • Body Weight / physiology
  • Cause of Death
  • Cohort Studies
  • Germany / epidemiology
  • Health Behavior
  • Humans
  • Male
  • Middle Aged
  • Mortality / trends*
  • Obesity / complications*
  • Prospective Studies
  • Risk Factors
  • Weight Gain* / physiology
  • Weight Loss* / physiology