LETTER
Weight Loss and Longevity
Michael E. J. Lean, MA, MD, FRCP, and
Paul Garthwaite
1 December 1995 | Volume 123 Issue 11 | Page 892
TO THE EDITOR:
In the Annals supplement on weight loss, Williamson and Pamuk [1] attempted to dismiss our conclusion [2] that overweight patients with non–insulin-dependent diabetes mellitus had a survival increase of approximately 3 to 4 months per kg of weight lost under physician advice during the first year of treatment. Williamson and Pamuk followed our analysis to the point at which 1 kg of weight lost increased survival by 0.036 years1/2. They then incorrectly interpreted an increase in 
survival of 0.036 as an increase in survival of 0.0362. However, (x + 0.036)2 – x2 does not equal 0.0362. For example, if a patient survives 12 years (3.42) and survival is increased by 0.036, then the patient survives (3.464 + 0.036)2 years (12.25 years), an increase of 3 months.
We recognize the need for better and prospective survival studies and indeed did our own research because the previous studies of the association between weight loss and increased survival were based on anecdotal and uncontrolled evidence. However, we are confident that the conclusions of our initial paper are correct and represent the only evidence for a therapeutic effect on life expectancy in overweight patients with noninsulin-dependent diabetes mellitus.
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Author and Article Information
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University of Glasgow; Glasgow, United Kingdom
1. Williamson DF, Pamuk ER. The association between weight loss and increased longevity. A review of the evidence. Ann Intern Med. 1993; 119(7 pt 2):731-6.
2. Lean ME, Powrie JK, Anderson AS, Garthwaite PH. Obesity, weight loss and prognosis in type 2 diabetes. Diabet Med. 1990; 7:228-33.
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