Weight and Mortality

To the Editor: In a recent article, Dr Hu states1 that the findings regarding weight and mortality in Flegal et al2 are “most likely” the result of “methodologic flaws,” namely the failure to exclude subjects on the basis of smoking and preexisting illness. In August 2005, we replied3 to a similar assertion by Willett, Hu, and colleagues.4 In that reply we stated, “To determine if reverse causation might be affecting our results, we performed extensive supplemental analyses of our data, stratifying by baseline health status and using multiple simultaneous exclusions for smoking, early deaths, and involuntary weight loss.2 The relative risks were little affected by such exclusions, and changes were often in the direction opposite to those anticipated by Willett et al.”3 Reference 2 in our reply provided the hyperlink to these supplemental analyses: http://www.cdc.gov/nchs/products/ pubs/pubd/hestats/excess\_deaths/excess\_deaths.htm. Exclusions based on …