A Second Chance for Middle Agers

by Carole Jackson, Bottom Line Health

A large group of people now get another whack at having a healthier heart, according to findings from a new study. If you are between the ages of 31 and 64 and are currently overweight or obese — perhaps you’ve even been heavy for decades — you might think, if someone suggests that you lose weight, “What’s the point? The damage has been done.” But it turns out that, when it comes to cardiovascular risk, the number of years that you’ve been carrying excess pounds isn’t as important as whether you are overweight or obese during middle age. In fact, what we have just learned is that shedding extra weight in middle age can actually cancel out your increased risk for heart disease. If you’ve ever wished for a second chance — a real second chance — at good health, this is it.

Now, it’s important to note that being overweight or obese at any point in your life is still not advisable. Beyond raising your risk for heart disease, it raises your risk for a myriad of other health problems, such as osteoarthritis, breast and colon cancers and type 2 diabetes — many of which you may not be able to “cancel out” later. But since heart disease is the number-one cause of death in the US, getting rid of your risk for that particular health problem in middle age is still a big deal. And, believe it or not, no study until now had followed subjects over decades to explore whether losing weight in middle age would have this effect. To find out more about the study, which was published in the October 24, 2011 issue of Archives of Internal Medicine, I called the author, I-Min Lee, MD, MPH, ScD, an associate professor in the department of epidemiology at the Harvard School of Public Health.


For this analysis, nearly 19,000 male Harvard alumni were studied. The men were first measured with a college physical exam around age 18 and then were given a follow-up medical questionnaire when their ages ranged from 31 to 64. Researchers gathered health measurements that included body mass index (BMI) — a ratio of body weight to height that determines whether you’re “underweight,” “normal weight,” “overweight” or “obese” — and death certificates that recorded the causes of mortality for any alumni who died through 1998.

Results: Those who were overweight or obese teens but managed to attain a normal weight during middle age were not at any higher risk of dying from heart disease compared with those of normal weight in middle age who were a normal weight as students. Like I said, a second chance at good health!


I asked Dr. Lee why this amazing benefit occurs even as late as middle age. The reason, she said, is that being overweight or obese negatively affects all sorts of physiological processes in our bodies, including blood pressure, cholesterol and the ability to process glucose and insulin. “But if you lose weight, no matter when you lose it,” Dr. Lee said, “all of those parameters improve, because your body doesn’t have to work as hard.” The surprise is that the potentially cumulative effects of gaining weight over time before losing it doesn’t appear to leave behind any lingering effects — at least when it comes to cardiovascular risk. In other words, if you’re healthy in middle age — that’s what matters most. Talk about a myth buster! If you thought that it was too late to start eating healthier and exercising more because you are “over the hill,” then think again.

I asked Dr. Lee how this finding might apply to women, since only men were studied. She told me that she would expect the results to be very much the same for women because excess weight has essentially the same adverse physiological effects in women as it does in men.

My final question was whether this wonderful result was likely to hold true for people who wait until even later in life to achieve a normal weight — such in their 60s, 70s or even later. Dr. Lee said that it’s tough to predict, but prior studies have shown that taking up physical activity at any age is beneficial.

Again, keep in mind that this research looked only at the effect of weight loss in middle age on one aspect of overall health — cardiovascular risk — so it’s not a free pass to eat cheeseburgers and fries every day throughout your 20s and early 30s. Being overweight, even for just a few months or years, can still be detrimental to your health. But this sure is promising news for people who have made mistakes and are ready to correct them — don’t lose hope, lose pounds!


I-Min Lee, MD, MPH, ScD, associate professor in the department of medicine at Harvard Medical School and in the department of epidemiology at the Harvard School of Public Health, both in Boston. She is also an associate epidemiologist at Brigham and Women’s Hospital, Boston.