title: Reasons for intentional weight loss, unintentional weight loss, and mortality in older men.
abstract: BACKGROUND
  We have examined the relationship between intentional and unintentional weight loss and the reasons underlying intention to lose weight and all-cause mortality and mortality due to cardiovascular disease (CVD) and non-CVD causes in older men.
  
  
  METHODS
  Prospective study of 4869 men aged 56 to 75 years drawn from general practices in 24 British towns, who in 1996 completed questionnaires about intentional and unintentional weight loss over the preceding 4 years and were followed up for a subsequent 7 years.
  
  
  RESULTS
  Unintentional but not intentional weight loss was associated with a significant increase in risk of all-cause mortality compared with men who reported no weight change, even after adjustment for lifestyle characteristics and preexisting disease (adjusted relative risk [RR], 1.71; 95% confidence interval [CI], 1.33-2.19; and RR, 1.00; 95% CI, 0.91-1.10, respectively). Men who lost weight intentionally as a result of personal choice showed significant benefit in all-cause mortality (RR, 0.59; 95% CI, 0.34-1.00; P = .05), which was largely owing to a significant reduction in mortality from non-CVD causes (RR, 0.36; 95% CI, 0.15-0.87). The benefit in these men was most apparent in markedly overweight men (BMI [calculated as weight in kilograms divided by the square of height in meters] > or = 28) and in younger men (age < 65 years). Men who lost weight intentionally owing to ill health or physician's advice showed an increased risk of all-cause mortality (RR, 1.37; 95% CI, 0.96-1.94). No harm or benefit was seen for CVD mortality, irrespective of reasons for intentional weight loss.
  
  
  CONCLUSIONS
  Intentional weight loss carried out for personal reasons is associated with a significant reduction in all-cause mortality in markedly overweight men, and the data suggest that the earlier the intervention, the greater the chance of benefit.
authors.affiliation: Department of Primary Care and Population Sciences, Royal Free and University College Medical School, London, England. goya@pcps.ucl.ac.uk
authors.forename: S Goya
authors.initials: SG
authors.lastname: Wannamethee
authors.forename: A Gerald
authors.initials: AG
authors.lastname: Shaper
authors.forename: Lucy
authors.initials: L
authors.lastname: Lennon
mesh_terms: D000367:Age Factors; D000368:Aged; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000401:mortality*; D005500:Follow-Up Studies; D015438:Health Behavior; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D033182:Intention; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015431:Weight Loss