That obesity can cut life short by causing
strokes and other illnesses comes as no surprise,
but a recent study reported quantifies the toll: The
most extreme cases cut a person's lifespan more
than cigarettes.

The analysis, published in the journal PLoS
Medicine, is the largest-ever study of the effect of
extreme obesity on mortality. It found that
people who are extremely obese – for someone
of average height, carrying an extra 100 lb (45
kg) or more – die 6.5 to 13.7 years earlier than their peers with a healthy weight.

The study, based on data from 20 large studies of
people in the United States, Sweden and Australia,
comes as rates of obesity have soared.
Worldwide, nearly 30 percent of people, or 2.1
billion, are either obese or overweight.


Overweight or obese?

"Overweight" is defined by body mass index
(BMI), a measure of weight relative to height. A
BMI, or weight in kilograms divided by the square
of height in meters, of 25.0 to 29.9 is considered
overweight. At the low end, that is 150 lb (68 kg)
for someone 5 feet 5 inches (1.65 meters) tall.

"Obesity" means a BMI of 30 or higher (180 lb at
5 feet 5 inches). "Extreme obesity" is a BMI of 40
or higher, or 241 lb at that height. (BMI Calculator
here: http://1.usa.gov/1aHAVvu )

Results of the study

The study included data on 9,564 adults with
extreme obesity and 304,011 of normal weight.
The overall risk of dying at any given time rose
continuously with increasing BMI within the
extremely obese group, mostly due to heart
disease, cancer and diabetes.
People with a BMI of 40 to 44.9 lost an average of
6.5 years of life. Those with a BMI of 45 to 49.9
lost 8.9 years, while BMIs of 50 to 54.9 cut 9.8
years and 55 to 59.9 cut 13.7 years. Among
people with a healthy weight, those who smoked
lost about 8.9 years.

The study, by scientists at the National Cancer
Institute, did not calculate whether less extreme
obesity shortens life, and the researchers could
not say whether the results would hold for
poorer, non-Western populations.
Because extreme obesity was so rare in the past,
it was not possible to calculate its effect on
mortality until now.

The new calculation is unlikely to cause people
with extreme obesity to shed pounds, for "that
presupposes that the main reason people don't
lose weight is lack of willpower, and I'd argue
that's not the case," said Dr Lee Kaplan, director of
the weight centre at Massachusetts General Hospital in Boston. "But it could have a beneficial
effect if it galvanizes society to change in ways
that stop promoting obesity and to develop
aggressive treatments for extreme obesity."

In the United States, 36 percent of adults are
obese, according to the National Centre for Health
Statistics. The incidence of BMIs of 40 or higher
has more than quadrupled since the mid-1980s,
and about one in six U.S. adults is extremely
obese.

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