Annual deaths attributable to obesity in the United States.
BACKGROUND
Obesity is a major health problem in the United States, but the number of obesity-attributable deaths has not been rigorously estimated.


OBJECTIVE
To estimate the number of deaths, annually, attributable to obesity among US adults.


METHODS
Data from 5 prospective cohort studies (the Alameda Community Health Study, the Framingham Heart Study, the Tecumseh Community Health Study, the American Cancer Society Cancer Prevention Study I, and the National Health and Nutrition Examination Survey I Epidemiologic Follow-up Study) and 1 published study (the Nurses' Health Study) in conjunction with 1991 national statistics on body mass index distributions, population size, and overall deaths.


METHODS
Adults, 18 years or older in 1991, classified by body mass index (kg/m2) as overweight (25-30), obese (30-35), and severely obese (>35).


METHODS
Relative hazard ratio (HR) of death for obese or overweight persons.


RESULTS
The estimated number of annual deaths attributable to obesity varied with the cohort used to calculate the HRs, but findings were consistent overall. More than 80% of the estimated obesity-attributable deaths occurred among individuals with a body mass index of more than 30 kg/m2. When HRs were estimated for all eligible subjects from all 6 studies, the mean estimate of deaths attributable to obesity in the United States was 280184 (range, 236111-341153). Hazard ratios also were calculated from data for nonsmokers or never-smokers only. When these HRs were applied to the entire population (assuming the HR applied to all individuals), the mean estimate for obesity-attributable death was 324 940 (range, 262541-383410).


CONCLUSIONS
The estimated number of annual deaths attributable to obesity among US adults is approximately 280000 based on HRs from all subjects and 325000 based on HRs from only nonsmokers and never-smokers.
Allison
D B
DB
Obesity Research Center, St Luke's/Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, NY 10025, USA. dba8@columbia.edu
Fontaine
K R
KR
Manson
J E
JE
Stevens
J
J
VanItallie
T B
TB
D000328:Adult; D000368:Aged; D015992:Body Mass Index; D002423:Cause of Death; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000401:mortality*; D016016:Proportional Hazards Models; D012306:Risk; D014481:United States / Q000453:epidemiology