Response to Invited Commentary Adams et al. Respond to “Body Mass Index and Mortality”

We appreciate Dr. Allman-Farinelli’s thoughtful com-ments (1) on our study (2). We believe that our study contrib-utes to the public health debate by providing detailed results characterizing the combined influence of body mass index (BMI; weight (kg)/height (m)2) and weight change in speci-fied periods and intervals of adulthood on relative mortality. One key point raised in the commentary that we would like to address is that we did not use standard BMI categories or a BMI of 18.5–24.9 as the referent group. Dr. Allman-Farinelli contrasts the BMI findings of our study with those of the large meta-analysis recently published by Flegal et al. (3). Although we do not believe that the referent groupwe used obscures com-parative interpretation as suggested byDr. Allman-Farinelli, we nonetheless provide risk estimates below based on standard BMI categories. The primary difference between our stud