Annual Deaths Attributable to Obesity in the United States

TLDR

Obesity is a growing medical problem affecting millions, with its burden measured by prevalence, economic cost, and links to risk factors and diseases. This study aims to calculate the annual number of deaths attributable to obesity in the United States, a metric previously lacking precise estimates. Using 1990 census and mortality data for 1991, the authors estimated deaths that would have been avoided if obese individuals had the same mortality risk as those with BMI just below the obesity threshold.

Abstract

BESITY IS A SERIOUS MEDIcal problem, increasing in prevalence, affecting millions, 1 and of great interest to the public.To articulate the burden of obesity, investigators have used indicators such as prevalence, 1,2 economic cost, 3 and association with risk factors and diseases. 4However, there is little published scientific information on the number of annual obesityattributable deaths in the United States.Mass media, 5-8 scholarly journals, 9-11 and pharmaceutical handouts 12 have cited 300 000 deaths per year in the United States as being attributable to obesity, a number that may have been adapted from an analysis of precursors of premature death in the United States for 1980, 13 attributing 289 502 deaths to "overnutrition."McGinnis and Foege 14 estimated that, of US deaths in 1990, 309 000 to 582 000 were associated with unhealthy diet and exercise patterns.However, neither study estimated deaths attributed specifically to obesity.We report a detailed analysis aimed at calculating the annual number of deaths attributable to obesity.It is important to clarify the quantity we are trying to estimate.If we choose a particular year, ie, 1991, we can say, "Of the people who were alive at the beginning of 1991, how many fewer would have died by the end of that year if all of the obese people alive at the beginning of the year had not been obese and if those people had the hazard of those with a BMI [body mass index] just below the cutoff for obesity (eg, BMI 23-25 kg/m 2 )."For simplicity, we refer to this quantity as "the annual number of deaths attributable to obesity." METHODSThe year 1991 was chosen for analysis because of the availability of population (1990 US census 15 ) and mortality statistics. 16Also, it was the midpoint of data collection for the Third National