- Maximum BMI over the years tracks with mortality risk.
- People with stable BMI in normal or overweight categories had no risk difference and had the lowest mortality risk in this Framingham Heart Study analysis.
Why this matters
- Asking about weight history rather than relying on a snapshot in time might add to the clinical picture.
- Editorial notes the “story of BMI history and mortality is far from straightforward” and says the “bottom line is weight gain prevention.”
- Overall: 21.9% increased risk with each 5-unit increase in maximum BMI.
- Mortality risk did not differ between people who remained stably normal-weight or overweight (HR, 1.04; 95% CI, 0.94-1.14).
- Mortality risk increased with obesity:
- Obese 1: BMI 30 to 2; HR, 1.27 (95% CI, 1.14-1.41).
- Obese 2: BMI 35 to kg/m2; HR, 1.93 (1.68-2.20).
- Former overweight/obesity in normal-weight tied to mortality of 47.48 and 66.67/1000 person-years, respectively, vs sustained normal weight: 27.93/1000 person-years.
- Of note: those with weight loss more likely had history of CVD or cancer.
- n=6197 from Framingham Heart Study cohorts (3478 deaths; mean follow-up, 17 years).
- Outcomes: maximum BMI over time, all-cause/cause-specific mortality.
- Funding: NIH.
- Reasons for weight changes unknown; reverse causality possible.
- True BMI maximum possible missed.