Effect of Weight Loss in Adults on Estimation of Risk Due to Adiposity in a Cohort Study

Obesity (Silver Spring). 2012 Jan;20(1):206-13. doi: 10.1038/oby.2011.281. Epub 2011 Sep 22.


The effect of overweight and obesity on the risk of fatal disease tends to attenuate with age. To evaluate whether this effect is partly attributable to disease-related weight loss, we examined the prebaseline history of weight loss and diseases associated with weight loss among adults enrolled in a cohort study. We conducted an analysis of 7,855 adult cohort members of the Adventist Health Study (AHS) I who had provided anthropometric data on surveys at baseline and 17 years prior to baseline. Among adults in the recommended range of BMI (19-25 kg/m(2)) at baseline we found that: (i) the prevalence of prebaseline weight loss of 5 kg/m(2) from an overweight or obese state was 20.4% and increased with age (12.6% for <65 years; 27.7% for 65-84 years; 36.7% for >85 years) and (ii) prebaseline weight loss of 5 kg/m(2) from an overweight or obese state was associated with diabetes (odds ratio (OR) = 2.91 95% confidence interval (CI) = (2.16, 3.93)), coronary heart disease (OR = 1.84 95% CI = (1.42, 2.40)), and high blood pressure (OR = 1.51 95% CI = (1.26, s1.82)). During 12 years of follow-up, we found evidence that hazard ratios for adiposity can be confounded by disease-related weight loss. Our findings raise the possibility that prebaseline weight loss can confound the estimation of risk due to adiposity at baseline in a cohort study.

MeSH terms

  • Adult
  • Body Weight*
  • Cohort Studies
  • Comorbidity
  • Diabetes Mellitus / epidemiology
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Obesity / epidemiology*
  • Odds Ratio
  • Prevalence
  • Prospective Studies
  • Risk Factors
  • United States / epidemiology
  • Weight Loss*