Research

Mixed

The association between low BMI and increased mortality is likely caused by preclinical disease (weight loss preceding diagnosis) rather than low body weight itself.

If you are underweight, do not panic about mortality risk based on BMI alone. This risk is often driven by underlying undiagnosed health issues causing weight loss. Focus on medical check-ups rather than just trying to gain weight.

WeakRefutesHIGH confidence
The increased risk of mortality observed in underweight people could at least partly be caused by residual confounding from prediagnostic disease.
Dagfinn Aune et al. · BMJ · 2016

Why this rating

Supported by stratification by follow-up duration showing risk decreases with longer follow-up.

Source

BMI and all cause mortality: systematic review and non-linear dose-response meta-analysis of 230 cohort studies with 3.74 million deaths among 30.3 million participants

Dagfinn Aune et al. · BMJ · 2016

DOI 10.1136/bmj.i2156

Meta-analysis · 230 studiesCited 956×
Read the paper
DOI resolved against Crossref · corpus check 2026-06-10

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