Living ~400lbs

… and believe me I am still alive

Expectations (and Risks) of Weight Loss

Lots of folks have been quoting the new paper in the International Journal of Obesity

Weight loss of 15% or more from maximum body weight is associated with increased risk of death from all causes among overweight men and among women regardless of maximum BMI.

“Associate”, here, appears to mean “correlate”.   The 15% piqued my interest because it echoed this bit* from The Practical Guide: Identification, Evaluation, and Treatment of Overweight and Obesity in Adults, from the US National Institutes of Health (NIH) guidelines on “obesity treatment”:

Obese individuals typically want to lose 2 to 3 times the 8 to 15 percent often observed and are disappointed when they do not.  (p32)**

Correlation does not necessarily mean causation, but this leads me to wonder whether, on average, a more than 15% loss requires more extensive changes to diet and exercise, that in turn can result in more muscle loss and other damage?    Nobody knows.  It’s not clear whether the correlation is a strong one (3000% more likely?) or a weak one (100% more likely?) or if it will actually mean anything in the end.   But I do think we should focus more on health than on weight.

I also note they did find one group where weight loss reduced risk of cardiovascular disease:  obese men who lost between 5% and 15% of their max weight.  I also note that reducing risk of cardiovascular disease can be done by increasing exercise and other such changes, without focusing on weight loss.

*Posted about here.

**For convenience, I’m using PDF page numbers, which can be entered into the PDF viewer to go directly to the page in question.  These do not map to the printed page numbering.

10 responses to “Expectations (and Risks) of Weight Loss”

  1. Has anyone heard these research findings reported on any of the mainstream media outlets? I don’t watch a whole lot of news programs (I tend to read my news on the internet), so I would be curious to know if this is being screamed from the rooftops as loudly as the OMFG!!!THEOBESEAREKILLINGUSALLLLLRUNFORYOURLIVES!!! news.

    Nevertheless, I have been ruminating this information since I first read about it yesterday. The logical response as to why this research produced these findings is that losing that much percentage of weight does not mean strictly body fat. It stands to reason that a 15% weight loss HAS to include not only fat cell reduction, but muscle reduction as well. The most important muscle of all being the heart. It makes sense that if the heart muscle breaks down there will be a “weakening” of the systems supported by the efficacy of the heart. Weaken the heart muscle’s ability to pump blood throughout the body and you could be depriving vital organs of the necessary oxygen, cell repair, and other life support they need.

    Additionally, I wonder if there is a possibility that the byproduct of fat cell reduction and losing weight could be releasing negative elements into the bloodstream that would have otherwise remained dormant in the fat cell? I know that we can store hormones in our fat cells, so is it possible that these can have a negative side effect on the body’s organs and ability to protect itself?

    Those are the main thoughts I have about the “why” of the research, but I am not a medical professional by any means. I DO know that regular exercise can and will increase and strengthen muscle mass, which may be the reason behind the positive cardiovascular effect the weight loss had for obese men over 50.

    It’s hard to decipher how this will play out amongst the medical community. I’m sure some will dismiss it as flawed science, as the general public probably will as well. It is just too HARD for many to believe that fat can have a protective effect for the body. Not only does it cushion the bones during a fall, it also provides necessary energy for help in healing, cell repair, and supporting the fight for recovery from surgeries and certain treatments.

    As an aside……I am starting to believe that the increase in health care costs attributed to the obese may be due to more doctors LOOKING for something to be wrong with the obese, and thus ordering more tests, scans, and surgeries. I know I’ve had my share of tests based on the ASSumption there MUST be something wrong with my because I’m oh-so-FAT! Including several expensive tests by eye doctors because I have sudden blurry vision in one eye. We’re talking University of Washington eye scans, retinal, and corneal testing….all of which I am still paying for. The findings of which state that I just have old eyes….macular degeneration you would find in a 60 year old…..and it’s genetic! *rim shot*

    Anyway….just my thoughts.

  2. The rule of thumb seems to be that the range between “couch potato and doesn’t eat well” and “does some exercise and eats well” is very, very roughly 10% of body weight. (Lots of variation, it goes without saying – some people’s weight doesn’t move no matter what they do or don’t do, others’ changes more. Men seem to have a greater range than women, in general. But call it 10%.)

    From which it follows as the night the day that losing more than (very approximately) 10% of your body weight necessarily involves either great athleticism or unhealthy practices (restriction, dieting behaviors, exercise bulimia, disordered eating in general) or both, or else doing something even more unnatural to yourself such as bariatric surgery.

    It would help explain this result. It doesn’t mean that fat is either healthy or unhealthy by itself; it means that weight loss beyond one’s natural range cannot be achieved in a healthy way, and the anchor of that natural range is determined by your actual weight, not by the number on a chart saying what a person your height is “supposed to” weigh.

  3. The short version of the article doesn’t seem to make any distinction between intentional and unintentional weight loss, which makes me wonder whether some of the correlation could be due to people losing weight through illness or aging. Perhaps the full version goes into more detail? I’m not arguing that weight-loss diets are innocent, just curious about whether the study explicitly implicates dieting in raising the risk of death.

    Regardless, it’s an interesting set of results, and if anyone is able to prove that deliberate weight loss of 15% *is* harmful in and of itself, the ramifications could be big.

    1. The article says they adjusted for age, race, smoking, health status, and preexisting illnesses. I assume that means they controlled for intentional/unintentional weight loss, as much as possible.

      1. Thanks for clearing that up for me, Becka (and Living 400lbs, below).

    2. The abstract doesn’t discuss intentional vs unintentional weight loss, but it does state they adjusted for “age, race, smoking, health status, and preexisting illness”.

  4. I have to agree the distinction between spontaneous and weight loss dieting might be important.

    I also think it’s important to note that we are talking about weight loss via weight loss dieting; not simply weight loss in itself.

    1. That was a really interesting link. I wonder if there’s any connection between the effect they described and with stress combining with seeming inability to gain weight, leading on to other more serious stress relief such as alcohol or drugs, etc

      It’s like the stress re-routes itself when it cannot invoke metabolic adjustment.

      You can sometimes see this in reverse when people manage to maintain weight loss for a little while and develop similar problems.

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Former software tester, now retired heart patient having fun and working on building endurance and strength. See also About page.

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