ABSTRACT
In the absence of major progress in the prevention of
obesity, voluntary weight loss is considered central to
the clinical and public health response to prevent over-
weight and obesity-related conditions. Yet ironically,
recommendations of weight loss as a clinical and public
health intervention remain controversial for several rea-
sons. First, weight loss is perceived as being relatively
ineffective due to the large proportion of persons who
regain weight, raising questions of whether the short-
term benefits are likely to influence long-term health
outcomes. This concern is compounded by the lack of
long-term intervention trials examining the effects of
weight loss on major causes of morbidity and mortality.
Second, weight loss remains controversial because of
epidemiological literature associating weight loss with
increased mortality. This latter concern may have been
spuriously affected by weaknesses in the methodology
of observational epidemiology. Finally, weight loss is
