Does Losing Weight Always Make You Feel Better?

How do weight changes affect our personal perceptions about our own health? Does losing weight always lead to a better perception? Can attitudes about personal health predict weight gain or weight loss? With these questions in mind, researchers publishing in BMC Women's Health surveyed a large group of Danish women, in order to analyze the association between weight changes and self-rated health (SRH). Numerous studies have shown that maintaining a normal weight is associated with better health, while being overweight is considered a factor in poor health-related outcomes. Other studies, however, challenge these findings by reporting that in some cases weight loss can actually increase the risk of death. The study included 13,684 female nurses, who completed a baseline survey in 1993, and a follow-up in 1999. The authors of the study wanted to examine the association between weight change and change in SRH over a six-year period. They hypothesized that going from overweight at baseline to a normal weight during the study period would result in higher SRH. They also hypothesized that those who reported a poor SRH would be less likely to gain weight due to an underlying disease condition. As it turned out, follow-up responses were not quite what these researchers had anticipated.

Between 1993 and 1999, 57.7% of the women maintained a normal weight, 16.9% gained weight, and 4.4% lost weight. Almost 80% of the women remained in the same body mass index (BMI) category, while 20% reported a change in BMI category, after six years. At baseline, 85% rated their health as very good or good. In 1999, no change in SRH was reported by 59% of the respondents. At baseline, more women who reported low SRH were smokers, and did less exercise than women who reported very good SRH ratings. Ninety percent of women who were normal weight in 1993, but overweight in 1999, gave themselves a lower rating in 1999. Women who went from being underweight at baseline to a normal weight, reported a higher SRH in 1999, while those who remained underweight still reported low SRH. Although the authors expected to find that women who went from being overweight in 1993 to a normal weight 1999 would report higher SRH, results showed that weight loss had no effect on SRH. They also expected to find that poor SRH in 1993 would make it less likely that a woman would gain weight. Instead they found that poor health at baseline increased the odds of later weight gain.

Two assumptions regarding weight and SRH were essentially debunked by the results of the Danish nurse study. Although being overweight is associated with poor health, losing weight does not always result in an improved perception of health, and poor SRH may actually predict weight gain, even when no disease condition is present. The authors propose more research, and they invite more questions. What health consequences are associated with weight changes? In an overweight person, is trying to lose weight always a better choice than maintaining a stable weight? The answers will have to wait, for future studies.

Reference

Simonsen, M., Hundrup, Y., Gronbaek, M.,Heitmann, B.

A Prospective study of the association between weight changes and self-rated health

http://www.biomedcentral.com/1472-6874/8/13