Weight Loss for the Obese: Panacea or Pound-Foolish?

Despite increasing prevalence of dieting, Americans continue to get fatter. Because traditional weight loss programs have poor long-term efficacy, a nonweight-centered paradigm might be more effective for improving the health of individuals considered overweight or obese. Many obesity-related health conditions can be ameliorated via physical activity and improved nutrition, independent of weight loss. Epidemiological evidence suggests that, compared to reported intentional weight loss, increasing physical activity or fitness, independent of body weight or changes in body weight, is associated with greater reductions in all-cause mortality rates. In view of the potential risks associated with calorie-restrictive dieting and weight fluctuation (yo-yoing), public health may be better served by placing greater emphasis on lifestyle changes and less importance to weight loss per se.