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Mid-Life Obesity Predicts Women's Later Health Woes

Women, want to enjoy good health in your golden years?

Lose weight. Now.

A study published online last night in the British Medical Journal shows that women who are overweight in midlife are at increased risk of various health problems, from chronic diseases to cognitive impairment, once they pass age 70.

Conversely, the study found, women who were lean at midlife were most likely to be healthy after 70.

Researchers at the Harvard School of Public Health and Brigham and Women's Hospital (both in Boston) analyzed data for more than 17,000 women collected through the ongoing Nurses' Health Study, which started in 1976. Just under 10 percent of the women in the study who had lived to age 70 or beyond (their mean age was 50 when the Nurses' Health Study began) reported being free of the 11 major chronic diseases the researchers tracked, maintaining good mental health and cognitive and physical function.

The likelihood of making it into that elite group decreased as BMI (body mass index) increased. Obese women were nearly 80 percent less likely to be healthy after age 70 than lean women. The least likely of all to remain healthy in later years were women who were overweight at age 18 and who gained more than 22 pounds by the time they turned 50. And whether they were lean, overweight or obese at age 18, women who gained weight by midlife had less chance of being healthy over 70 than those whose weight remained steady.

The study controlled for socioeconomic status and for smoking, diet and other lifestyle behaviors that could affect physical and mental health. One caveat: Most of the women studied were white, so researchers aren't sure their findings extend broadly across the general population.

Still, the study adds new fodder to the often-heated debate about how closely body weight correlates to health. While the common wisdom is that being overweight puts people at increased risk of life-shortening diseases such as cancer, diabetes and cardiovascular disease, others say no such cause-and-effect relationship has been scientifically established and that people can be very healthy even if they're overweight or even obese. The new research is the first, according to its authors, to examine the role of overweight and obesity in overall health among women who survive to older ages.

Your thoughts?

By Jennifer LaRue Huget  |  September 30, 2009; 7:00 AM ET
Categories:  Nutrition and Fitness , Obesity  
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I suspect these same findings apply to men as well.

We've seen several studies recently that indicate that your situation in your 40s makes a difference 30-40 years later. The one before this found that people with even slightly raised blood lipids mid-life had a greater instance of dementia later on.

It's not fair because at mid-life many of us are dealing with high-stress jobs, young or aging family members and a zillion other things that don't leave a lot of time for attention to health.

You just can't wait until the time is right to lose those pounds or control your diet.

Posted by: RedBird27 | September 30, 2009 7:12 AM | Report abuse

You know, the thing that frustrates the bejeebers out of me with these epidemiological studies is that they raise really interesting questions that they can't answer, because we still don't know which way the causation runs. I mean, the obvious conclusion is that increased weight = bad diet + less exercise = bad health risk. So you look at this and go, aha! It's what we always suspected!

But the first thing that popped into my mind is that a number of women -- more women than men -- tend to run into chronic diseases in their 30s and 40s, which can be correlated with weight gain or unhealthy lifestyle habits. For ex., hypothyroid can really pack on the pounds; other diseases, like Lupus, MS, Lyme disease, and various other autoimmune diseases can sap the energy that you need to maintain a healthy lifestyle. And a lot of autoimmune diseases are correlated with other autoimmune diseases, which may also be risk factors in various other health issues (for ex., I have an autoimmune blood factor that is correlated with heart disease, even though I am perfectly healthy now and have no symptoms).

What interests me in terms of this study is that a lot of these diseases can remain undiagnosed for years -- and are most frequently diagnosed in the 30s and 40s. So a healthy, skinny woman at 20 may develop thyroid disease at 28, start putting on weight despite her best efforts, but still not be diagnosed until 35 or 40. So at 20, she seems perfectly healthy and normal, and 30 years later she's overweight, with all of these "new" risk factors (which were there all along, but which were never noticed until they did all the blood tests to diagnose the thyroid problem). Yeah, ok, that interests me because it's me. :-)

That makes me wonder which way the cause and effect really runs. Does weight gain itself between 20 and 50 cause disease at 70? Or is weight gain between 20 and 50 a symptom of an underlying disease that may not be diagnosed until 40, 50, or 60? I suspect a little of both. The fact that the highest risks were associated with women who were overweight at 18 and then gained the most weight thereafter seems to imply that it's the weight, not some later onset of disease. On the other hand, the fact that even women who were skinny at 18 had higher risks if they gained weight before 50 could indicate that maybe it's not just the overall weight itself, but whatever it is that triggers the weight gain.

Posted by: laura33 | September 30, 2009 9:43 AM | Report abuse

Turn off the television and the computer,Get off the couch, take a walk and don't eat the Snickers Bar

Posted by: dc2008 | September 30, 2009 10:42 AM | Report abuse

Laura33 makes a number of good points in her comments above. One way of summarizing this would be to say that correlation, in and of itself, can never establish causation or it's direction. It could just as easily be the case that factors which put you at risk for certain diseases in your later years also predispose you to put on weight in your middle years. The correlation could just as easily reflect a third factor (e.g., stress) that causes both the weight gain and the increased probability of disease later on.

Having said that, there's a lot to be said for watching what you eat and being active; you'll be happier and feel better no matter how old you are.

Posted by: jwillner1 | September 30, 2009 12:11 PM | Report abuse

It has been known for quite some time that obesity is a risk factor for many diseases. The excess weight makes our internal organs work harder, especially the heart.

Inflammation is also being linked as a factor in the development of many diseases. This is why aspirin is recommended to prevent strokes and heart attacks. It is an anti-inflammatory. Both obesity and past injuries help to accelerate inflammation and may even cause it. It may also be a factor in dementia.

For longevity, substitute olive or avocado oil for other fats when cooking. Avoid corn oil and high fructose corn syrup. Use stevia as a sugar substitute. Take a daily aspirin and a vitamin D supplement. Drink fruits and fruit juices in smoothies made in your blender as occasional meal substitutes. With some exceptions - you can't be too rich or too thin.

Posted by: alance | September 30, 2009 1:51 PM | Report abuse

Yes, we know it would be healthy to lose weight.
Yes, we are stereotyped, discriminated against, and nagged to add to our motivation to lose weight.
But the technology for the control of appetite is not available.
It's like telling us that we'd be better off if we were two inches taller.
It's true, but how do we get there from here?

Posted by: Racje | October 1, 2009 6:57 PM | Report abuse

Xenical works as a lipase inhibitor in the body. It helps to disable the fat digesting lipase enzymes in the intestine. This action reduces around 30 percent of the fat absorbing process in the body. The fats make a smooth passage through the digestive system and weight loss is the result. More results on Xenical is availabel on

Posted by: Katie448 | October 2, 2009 7:12 AM | Report abuse

Find out if you are fat or not:

Posted by: karlito1 | October 2, 2009 9:20 AM | Report abuse

You say "The likelihood of making it into that elite group decreased as BMI (body mass index) increased."

But we don't really know if this is true, because to get into that elite group, you need to survive until age 70. The authors did not report the relation between midlife BMI and survival to age 70, although they do report a secondary analysis where they lump women who died before age 70 into the usual survivors group. Other than that, they only reported results among women who had all already survived until age 70. They also conspicuously did not report the current BMI among the two groups of healthy and unhealthy survivors, but only the midlife BMI. Similarly their weight change analyses only looked at weight change from age 18 up to midlife, and not at weight change after midlife, which would have been interesting to see.

It is striking how unhealthy these nurses appear to be, if fewer than 10% are healthy at age 70. Midlife BMI may be the least of these women's problems if they are so unhealthy.

Posted by: Luciana1 | October 4, 2009 2:55 PM | Report abuse

The subjects of the study were all white females? How scientific is that? It just underlines the fact 9again)that they don't really put research or time into the health of non-whites at a time when the country is increasingly of color. Sad, but not a surprise.

Posted by: cab50151 | October 5, 2009 9:56 AM | Report abuse

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