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August 3, 2005

Underweight, Overweight, Obesity, and Excess Deaths—Reply

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2005;294(5):551-553. doi:10.1001/jama.294.5.552-c

In Reply: Dr Willett and colleagues assert that our analysis is flawed because it is based on the entire study sample rather than on a highly restricted subgroup. Their example of how to cull out a subgroup that is not subject to confounding by unhealthy lean study participants (“reverse causation”)1 was based on only 531 (11%) of the 4726 deaths that occurred in the cohort. This approach would not satisfy a central aim of our study, which was to describe the numbers of deaths associated with BMI values outside the reference range of 18.5 to less than 25 in the entire US population rather than in a small subgroup.

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