Extreme obesity cuts average lifespan tremendously

By Melissa Healy

Los Angeles Times (MCT)

Those with a body mass index, or BMI, above 40 are robbed of at least six-and-a-half years, on average, of expected lifespan, a study has found. And the toll in years lost rises with the degree of obesity, reaching nearly 14 years for the most obese — those with a BMI above 55, researchers said.

The study found that the reduction in life expectancy associated with being extremely obese was similar to that seen in adults who smoke. And as a person’s obesity rises to higher levels, his or her expected lifespan falls below that of smokers.

The findings come from a project that aggregated the results of about 20 long-term studies on obesity conducted in the United States, Australia and Sweden. They were published Tuesday in the journal PLoS Medicine, in what is believed to be the largest study to date of the health consequences of severe obesity.

Compared with their normal-weight peers, the extremely obese are more likely to succumb early to heart disease, cancer and diabetes. For men with “class III obesity”, the rate of death attributable to heart disease and diabetes is especially elevated compared with normal-weight males. For women in the same obesity category, cancer deaths dramatically outstripped those among normal-weight women.

But premature deaths attributable to all causes, from injury to chronic lower respiratory infections, were consistently higher in those with severe obesity, the study found.

The extremely obese — those who generally would need to lose 100 pounds or more to attain a “normal healthy weight” — are a fast-growing segment of the US population, now representing about 6 per cent of American adults.

The ranks of those with a BMI over 40 have grown fourfold since the 1980s. The population with a BMI over 50 has grown by 10 per cent in the same period.

Look up your BMI, a rough indicator of a body’s degree of fatness, at http://www.nhlbi.nih.gov/guidelines/obesity/BMI/bmicalc.htm.

The medical costs for such patients are outsized as well, accounting for one in five healthcare dollars spent per capita in the year 2000.

The latest findings suggest that extreme obesity may be even more dangerous for men than it is for women and for younger adults compared with older ones. They come as evidence mounts that weight-loss medications, as well as diet and lifestyle counselling, work only modestly in helping the obese lose weight and keep it off.

Increasing research has shown bariatric surgery to be highly effective not only at inducing weight loss but at forestalling and reversing the health consequences of obesity. But the substantial costs of such surgery are expected to limit its widespread use.

As the extremely obese age and their ranks continue to grow, the authors of the current study said, their medical problems may reverse progress made in driving down cardiovascular disease through smoking-cessation programmes and more widespread treatment of risk factors, and in driving down cancer deaths with better prevention and treatment. Cancers more prevalent among the obese are those of the breast, colon, pancreas, ovaries, kidney, esophagus, thyroid and gall bladder.

“If current global trends in obesity continue, we must expect to see substantially increased rates of mortality due to these major causes of death, as well as increasing health care costs,” the authors concluded.