title: Intentional weight loss and mortality among overweight individuals with diabetes.
abstract: OBJECTIVE
  To estimate the effect of intentional weight loss on mortality in overweight individuals with diabetes.
  
  
  METHODS
  We performed a prospective analysis with a 12-year mortality follow-up (1959-1972) of 4,970 overweight individuals with diabetes, 40-64 years of age, who were enrolled in the American Cancer Society's Cancer Prevention Study I. Rate ratios (RRs) were calculated, comparing overall death rates, and death from cardiovascular disease (CVD) or diabetes in individuals with and without reported intentional weight loss.
  
  
  RESULTS
  Intentional weight loss was reported by 34% of the cohort. After adjustment for initial BMI, sociodemographic factors, health status, and physical activity, intentional weight loss was associated with a 25% reduction in total mortality (RR = 0.75; 95% CI 0.67-0.84), and a 28% reduction in CVD and diabetes mortality (RR = 0.72; 0.63-0.82). Intentional weight loss of 20-29 lb was associated with the largest reductions in mortality (approximately 33%). Weight loss >70 lb was associated with small increases in mortality
  
  
  CONCLUSIONS
  Intentional weight loss was associated with substantial reductions in mortality in this observational study of overweight individuals with diabetes.
authors.affiliation: Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia 30341-3717, USA. drw1@cdc.gov
authors.forename: D F
authors.initials: DF
authors.lastname: Williamson
authors.forename: T J
authors.initials: TJ
authors.lastname: Thompson
authors.forename: M
authors.initials: M
authors.lastname: Thun
authors.forename: D
authors.initials: D
authors.lastname: Flanders
authors.forename: E
authors.initials: E
authors.lastname: Pamuk
authors.forename: T
authors.initials: T
authors.lastname: Byers
mesh_terms: D000328:Adult; D000570:American Cancer Society; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000401:mortality; D015331:Cohort Studies; D003920:Diabetes Mellitus / Q000178:diet therapy* / Q000401:mortality / Q000503:physiopathology; D004038:Diet, Reducing; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000517:prevention & control; D009765:Obesity; D011446:Prospective Studies; D044469:Racial Groups; D014481:United States; D015430:Weight Gain; D015431:Weight Loss