title: Mortality attributable to obesity among middle-aged adults in the United States.
abstract: Obesity is considered a major cause of premature mortality and a potential threat to the longstanding secular decline in mortality in the United States. We measure relative and attributable risks associated with obesity among middle-aged adults using data from the Health and Retirement Study (1992-2004). Although class II/III obesity (BMI > or = or = 35.0 kg/m2) increases mortality by 40% in females and 62% in males compared with normal BMI (BMI = 18.5-24.9), class I obesity (BMI = 30.0-34.9) and being overweight (BMI = 25.0-29.9) are not associated with excess mortality. With respect to attributable mortality, class II/III obesity (BMI > or = 35.0) is responsible for approximately 4% of deaths among females and 3% of deaths among males. Obesity is often compared with cigarette smoking as a major source of avoidable mortality. Smoking-attributable mortality is much larger in this cohort: about 36% in females and 50% in males. Results are robust to confounding by preexisting diseases, multiple dimensions of socioeconomic status (SES), smoking, and other correlates. These findings challenge the viewpoint that obesity will stem the long-term secular decline in U.S. mortality.
authors.affiliation: University of Michigan, School of Public Health, 3628 SPH Tower, 1415 Washington Heights, Ann Arbor, MI 48109, USA. nkmehta@umich.edu
authors.forename: Neil K
authors.initials: NK
authors.lastname: Mehta
authors.forename: Virginia W
authors.initials: VW
authors.lastname: Chang
mesh_terms: D015992:Body Mass Index; D016001:Confidence Intervals; D015986:Confounding Factors, Epidemiologic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000150:complications / Q000453:epidemiology / Q000401:mortality*; D016016:Proportional Hazards Models; D012306:Risk; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology