ORIGINAL ARTICLE Weight Change, Initial BMI, and Mortality Among Middle- and Older-aged Adults

Background: It is not known how the relationship between weight change and mortality is influenced by initial body mass index (BMI) or the magnitude of weight change. Methods: We use the nationally representative Health and Retire-ment Study (n 13,104; follow-up 1992–2006) and Cox regression analysis to estimate relative mortality risks for 2-year weight change by initial BMI among 50- to-70-year-old Americans. We defined small weight loss or gain as a change of 1–2.9 BMI units and large weight loss or gain as a change of 3–5 BMI units. Results: Large and small weight losses were associated with excess mortality for all initial BMI levels below 32 kg/m2 (eg, hazard ratio [HR] for large weight loss from BMI of 30 1.61 [95 % confidence interval 1.31–1.98]; HR for small weight loss from BMI of 30 1.19 [1.06–1.28]). Large weight gains were associated with excess mortality only at high BMIs (eg, HR for large weight gain fro