A decades-long study has revealed that losing excess weight in midlife, without the aid of medication or surgery, can significantly reduce the risk of serious illness and increase life expectancy. Published in JAMA Network Open, the study followed over 23,000 adults over several decades to explore the long-term benefits of sustained weight loss during midlife.
The research focused on adults aged 40 to 50, tracking their body mass index (BMI) changes over 12 to 35 years. The participants were from three large cohort studies: the 1985-1988 Whitehall II study (WHII), the 1964-1973 Helsinki Businessmen Study (HBS), and the 2000 Finnish Public Sector study (FPS). Participants were categorized into four groups: those with a stable BMI under 25 (healthy weight), those who lost weight to a healthy BMI, those who gained weight, and those who maintained an overweight BMI (25 or higher).
The findings show that individuals who successfully lost weight and maintained a healthy weight had a lower risk of chronic diseases compared to those who remained overweight. This benefit was independent of the reduction in diabetes risk.
In the WHII and HBS cohorts, those who either lost weight or maintained a healthy weight had a 50% lower risk of developing chronic diseases over a median follow-up period of 23 years and 35 years, respectively. In the FPS cohort, participants who lost weight had a 60% reduction in the risk of chronic disease over a median of 12 years. Additionally, participants from the HBS cohort who lost weight experienced a 20% lower risk of death, with a median age of survival of 91 years at the end of the study.
The research also found that individuals who gained weight from a healthy weight to an overweight BMI had a higher risk of chronic disease compared to those who maintained a healthy weight, though the risk was lower than those with persistent overweight.
By excluding participants who unintentionally lost weight due to disease or frailty, the study ensured that the observed weight loss was intentional and linked to lifestyle changes. Previous studies have shown that intentional weight loss reduces the risk of diabetes, and this research extends that understanding to other chronic conditions, such as cardiovascular disease and mortality.
The study highlights that the long-term benefits of weight loss may not be immediately apparent, especially when the follow-up periods are too short to detect these effects. Furthermore, the results may not be directly applicable to individuals with morbid obesity, as they are more likely to undergo bariatric surgery or use weight-loss medications, which may have different health implications due to the loss of lean mass (such as muscle).
While the study used self-reported BMI data for the FPS cohort, which has limitations compared to measured data, it infers that the weight loss was likely intentional due to the participants’ age and health status.
In conclusion, this study provides strong evidence that losing weight and maintaining a healthy weight during midlife, without the use of medication or surgery, offers significant long-term health benefits. These include a reduced risk of chronic diseases and, in some cases, a lower risk of death. Although achieving sustained weight loss through lifestyle changes can be challenging, the findings underscore its potential to improve long-term health outcomes when initiated in midlife.
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