A new study published in JAMA Network Open sheds light on the critical role of intentional weight loss—especially when accompanied by reductions in waist circumference—in lowering mortality risk among postmenopausal women. With data from almost 59,000 people followed up on average for 18.6 years, the study questions the traditional use of body mass index (BMI) alone and instead calls for a more focused approach on visceral adiposity.

The study,  led by Michael Hendryx, PhD, and his colleagues, looked at whether losing weight and reducing waist circumference (WC) could be linked to lower rates of death from all causes, cancer, and heart disease. In an era when more than 2.6 billion people globally face issues related to overweight or obesity—and with the United States reporting obesity rates as high as 42% among adults and 44% among older women—the findings provide a timely public health message.

Researchers found that people who purposely lost at least 5 pounds had a lower chance of dying later from any cause—including cancer, heart disease, or other reasons—compared to those who kept the same weight. This shows that making healthy lifestyle changes to lose weight and shrink belly fat can really benefit your overall health.

Even more interesting, when people intentionally lost weight and also reduced their waist size, the benefits went beyond just a healthier heart. The study found that “intentional weight loss coupled with measured WC loss was associated with lower rates of all-cause mortality, cancer mortality, and cardiovascular mortality.” In contrast, those who only lost weight—without a noticeable decrease in waist size—mostly saw benefits related to heart health alone.

These findings strongly suggest that healthcare providers and policymakers should enhance their weight loss strategies for postmenopausal women. It is not enough to focus on overall weight loss; clinical interventions must prioritise the loss of visceral fat, which appears to have a more profound impact on reducing the risk of premature death. The study’s rigorous methodology, leveraging long-term data from the Women’s Health Initiative Observational Study, underpins its credibility and relevance in today’s battle against obesity-related diseases. While unintentional weight loss and increases in waist circumference were linked to higher mortality risks, the clear advantage of intentional lifestyle changes underscores the importance of comprehensive health programs tailored to the needs of older women.

The research thus reinforces a critical paradigm shift—from solely focusing on BMI to embracing a more nuanced understanding of body composition. In practice, these insights should encourage the integration of dietary counselling, exercise programs, and behavioural modifications aimed at reducing central obesity— ultimately paving the way for improved longevity and quality of life.