Authors

Kannel, D'Agostino, & Cobb (1996)²²

Conclusions

*Literature review supports weight reduction for BMIs >22. 6.
*Review showed a positive relationship between obesity & hypertension, insulin resistance, & the ratio of total to HDL cholesterol.

Concerns

*Study limitations are not acknowledged & the disparity between "desirable" BMIs & findings showing no significant risk for BMIs <27-30 is troubling.
*Selective overemphasis on the role of BMI in predicting health risk.

Authors

Kassirer & Angell (1998)²³, Wolf & Colditz (1996)²⁴ , NIH (1992)²⁵, & Borkan, Sparrow, Wisniewski, & Vokonas (1986)²⁶

Conclusions

*BMIs >30 affect health & longevity because they are associated with elevated cholesterol, hypertension, & type 2 diabetes.
*Excessive weight increases the risk for gallbladder disease, gout, CHD, & cancer & may lead to osteoarthritis of the weight-bearing joints.
*Benefits of weight loss for otherwise healthy mildly/moderately heavy people is unknown, but, hyperglycemia, hyperlipidemia, & hypertension are improved by a loss of 10-15% of body weight.
*A causal relationship between high BMI & increased morbidity/mortality is accepted with claims that obesity raised health care costs by 6.8% in 1990.

Concerns

*Many studies in the above reviews make no attempt to control the effects of cholesterol levels, diet, activity, or weight cycling. Without evidence refuting a statistically significant role for each of these potentially confounding variables, causal assumptions about the dangers of weight are impossible.
*Summarizing the research in the above manner implies that large people are inherently unhealthy due to their weight, while weight loss is possible & leads to lasting improved health, but statistical support for these implications is not provided.
*The logical conclusion that health benefits will be short term because most weight loss attempts fail is ignored & the available evidence on the adverse physical, emotional, & social effects of weight loss is not provided.

Authors

Kassirer & Angell (1998)²⁷, Fraser (1997)²⁸, Gaesser (1997)²⁹, Robison (1997)³⁰, Robison, Hoerr, Petersmarck, & Anderson (1995)³¹, Troiano, Frongillo, Sobal, & Levitsky (1994)³² & Garner & Wooley (1991)³³

Conclusions

*Reevaluation of BMI recommendations is needed.
*BMI defined as moderately overweight is not related to increased mortality.
*BMI at or below that recommended is associated with increased mortality.
*The possibility of long-term weight loss is unproven & evidence that weight loss may be harmful exists.

Concerns

*Additional studies are needed to determine the exact role of weight in health.