Abstract
The objectives of this paper are to predict life years lost associated with obesity-related diseases (ORDs) for U.S. non-smoking adults, and to examine the relationship between those ORDs and mortality. Data from the National Health Interview Survey, 1997–2000, were used. We employed mixed proportional hazard models to estimate the association between those ORDs and mortality and used simulations to project life years lost associated with the ORDs. We found that obesity-attributable comorbidities are associated with large decreases in life years and increases in mortality rates. The life years lost associated with ORDs is more marked for younger adults than older adults, for blacks than whites, for males than females, and for the more obese than the less obese. Using U.S. non-smoking adults aged 40 to 49 years as an example to illustrate percentage of the life years lost associated with ORDs, we found that the mean life years lost associated with ORDs for U.S. non-smoking black males aged 40 to 49 years with a body mass index above 40 kg/m2 was 5.43 years, which translates to a 7.5% reduction in total life years. White males of the same age range and same degree of obesity lost 5.23 life years on average – a 6.8% reduction in total life years, followed by black females (5.04 years, a 6.5% reduction in life years), and white females (4.7 years, a 5.8% reduction in life years). Overall, ORDs increased chances of dying and lessened life years by 0.2 to 11.7 years depending on gender, race, BMI classification, and age.
Highlights
The increasing prevalence of overweight and obesity has caused an increased risk of obesity-related comorbidities
We considered BMI classifications based on the standards established by the World Health Organization [47]: underweight for people whose BMI is less than 18.5 kg/m2; normal if BMI M [18.5, 25); overweight if BMI M [25, 30); class I obese if BMI M [30, 35), class II obese if BMI M [35, 40), and class III obese if BMI is at least 40 kg/m2
We investigated the relationship between obesityrelated diseases (ORDs) and mortality by using the Mixed Proportional Hazard (MPH) model controlling for both observed and unobserved individual heterogeneity
Summary
The increasing prevalence of overweight and obesity has caused an increased risk of obesity-related comorbidities. These obesityrelated diseases (ORDs) include serious chronic diseases, such as coronary heart disease, hypertension, type 2 diabetes, stroke, dyslipidemia, and some cancers, such as endometrial, breast, colon cancers [1,2], and multiple myeloma [3]. Most of the studies did not take ORDs into consideration, even though obesity-attributable comorbidities have been known to add variation to the simple relationship between mortality risk and body mass index (BMI – the ratio of weight in kilograms to the height in meters squared) [25,26,28,29,30,31,32]. None has focused on the incidence of ORDs or the association of ORDs with mortality and life expectancy
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