06/05
Abstract
Deaths Associated
With Underweight, Overweight and Obesity
Prepared
by: Janice Hermann, Ph.D., R.D./L.D.
Nutrition Education Specialist
333
HES/NSCI
Cooperative
Extension Service
Stillwater,
OK 74078-6111
(405)
744-6824
Source:
K.M.
Flegal, B.I. Graubard, D.F. Williamson & M.H. Gail. Excess Deaths
Associated With Underweight, Overweight, and Obesity. JAMA, 293(15) 2005.
Associated Press and Washington Post. Obesity death toll was vastly inflated.2005.
http://seattletimes.nwsource.com/html/nationworld/2002246797_fat20.html.
IMPLICATIONS FOR COOPERATIVE EXTENSION. As the incidence of obesity increases in the United States,
concern over the relationship between body weight and excess death has also
increased. The following is an abstract of a recent study evaluating the
association of death rate and body weight and a newspaper editorial questioning
past CDC death rates in light of death rates reported in this article.
Article Abstract - Excess Deaths Associated
With Underweight, Overweight, and Obesity
Objective: To estimate deaths associated with
underweight, overweight, and obesity in the United States in 2000.
Design, Setting, and Participants: Estimated relative risk
of death associated with different body weights were calculated from the
National Health and Nutrition Examination Survey (NHANES) I (1971-1975) and NHANES
II (1976-1980), with follow-up through 1992, and from NHANES III (1988-1994), and
with follow-up through 2000.
Results: Relative to the normal weight, obesity
was associated with 111,909 excess deaths and underweight was associated with
33,746 excess deaths. Overweight was not associated with excess deaths. The
relative risks of death associated with obesity were lower in NHANES II and
NHANES III than in NHANES I.
Conclusions: Underweight and
obesity, particularly higher levels of obesity, were associated with increased death
rate compared to the normal weight category. The impact of obesity on death
rate may have decreased over time, perhaps because of improvements in public
health and medical care.
Editorial - Obesity death toll was vastly inflated
Being overweight ranks 7th instead of 2nd among the nation's preventable causes of death,
according to a new calculation from the Centers for Disease Control and
Prevention.
CDC researchers reported that being
overweight accounts for 25,814 deaths a year in the United
States. However, as recently as January, CDC
Deaths Associated
With Underweight, Overweight and Obesity (continued)
came up with an estimate 14 times higher: 365,000
deaths.
The latest calculations are being used
by some to support their beliefs that public-health authorities have created undue alarm
about obesity. Other experts and the researchers who conducted the new study,
however, say obesity still represents a major public-health
threat.
"This certainly shouldn't be interpreted to
mean obesity isn't a problem anymore," said Katherine Flegal of the
National Center for Health Statistics, who led the study in the Journal of the
American Medical Association. "Obesity certainly is still a problem."
Flegal attributed the difference in estimated
death estimates due to different body weights
to the fact that her group used more-recent and
more-complete data and was able to account better for more variables, such as
smoking, age and alcohol consumption. They also believe that improvements in medical care and lifestyles
may have begun to have a role in reducing death risk due to obesity.
The number of Americans who are overweight has steadily
increased in recent years. About two-thirds of Americans are
overweight, one-third of who are obese. Being overweight is believed to
increase risks for many health problems, including heart disease, cancer
and diabetes.
Last year the CDC estimated that being overweight caused
nearly 400,000 deaths each year, making it the 2nd
cause of preventable death. The CDC predicted that obesity would soon overtake tobacco as the leading cause of
preventable death, but it subsequently acknowledged that estimates involved a statistical error and lowered it.
In the new study, Flegal and her colleagues used
data collected by large federal surveys over three time periods from 1971 to 2000.
The new study attributes 111,909 deaths to obesity.
Surprisingly, they reported that people, who were merely overweight, as opposed to obese, suffered more than 86,000 fewer deaths than those
whose weight was in the normal weight range. The study subtracts those to arrive at a net figure
of 25,814 deaths blamed on excess weight.
Using the new calculations, excess weight would drop to the 7th
preventable cause of death, behind tobacco,
alcohol, germs, toxins/pollutants, car crashes and guns.
Researchers in this study believe that some of the difference in the two estimates
may be due to recent improvements in treating heart disease, a major cause of
death among people who are obese.
In addition, researchers in the study note that their study only looked at death rate and not at other negative effects that obesity has
on quality of life.
Other health authorities agreed, and said the
findings of the new study should not undermine efforts to fight obesity.
"Obesity prevalence is increasing in adults
and in the young, and we may not see that impact on cardiovascular disease and
death until the next three to four decades," said Robert Eckel of the
American Health Association.