Table 1.
Effect of Obesity on Mortality: A Summary of Controlled Trials
| Reference | Study Population | Endpoints | Weight Categories | Outcomes |
|---|---|---|---|---|
| Flegal (2007)83 | NHANES I, II, III cohort 571 000 years of follow-up | CV mortality, cancer mortality | Underweight, overweight (BMI 25–30 kg/m2), obese (BMI ≥ 30 kg/m2) | Significant ↑ in CVD and obesity-related cancer mortality |
| Manson (1995)84 | Nurses’ Health Study 115 195 women, aged 30–55 years, free of CVD and cancer at baseline; 16-year follow-up | All-cause mortality, CV mortality, cancer mortality | Overweight (BMI 29–31.9 kg/m2) Obese (BMI ≥ 32 kg/m2) | P < 0.001, trend for ↑ all-cause mortality; for BMI ≥ 32 kg/m2 vs < 19 kg/m2. RR of CV mortality 4.1 and cancer 2.1 |
| McTigue (2006)85 | Women's Health Initiative Observational Study 90 185 women; mean follow-up of 7 years | All-cause mortality | Normal (BMI 18.5–24.9 kg/m2) Obese (BMI ≥ 30 kg/m2) | All = cause mortality ↑ 68.4/10 000 normal 84.5 for obese |
| Stevens (1998)87 | ACS Prevention Study I; 324 000 healthy, never smoking men and women; 12-year follow-up | All-cause mortality, CV mortality | Overweight (BMI 29—31.9 kg/m2) Obese (BMI ≥ 32 kg/m2) | 50% ↑ in all-cause mortality associated with BMI > 27 kg/m2 in men aged 30–84 years and ≥ 29 in women aged 30–74 years |
| Adams (2006)82 | NIH-AARP cohort 527 265 men and women, aged 50–71 years; 10-year follow-up | All-cause mortality | Obese (BMI 30–34.9 kg/m2) | 1.1-fold ↑ in mortality compared with normal BMI; obesity = 18% of excess mortality |
| Calle (1999)6 | > 1 million in ACS Study II 14-year follow-up | All-cause mortality | Obese (BMI 30–32 kg/m2) | Among healthy nonsmokers risk of death ↑ 17%–32% |
| Fontaine (2003)90 | NHANES cohort adults aged 18–85 years | Years of life lost | Low BMI (< 17–19 kg/m2), high BMI (≥ 35 kg/m2) | Years of life lost were 1–9 for low BMI vs 9–13 for BMI ≥ 35 kg/m2 |
| Yan (2006)89 | 17 643 men and women aged 31–64 years; no risk factors at baseline | Mortality from CHD, CVD, or diabetes | Obese (BMI ≥ 30 kg/m2) | ↑ risk of hospitalization and mortality from CHD, CV disease, and diabetes vs normal weight |
| Thomas (2006)88 | 243 000 men and women aged 18–95 years, followed for up to 25 years | Total mortality, CVD mortality | Obese (BMI ≥ 30 kg/m2) | Total and CVD mortality was > 2-fold higher among obese vs nonobese |
Abbreviations: ACS, acute coronory syndrome; CHD, coronary heart disease; CV, cardiovascular; CVD, cardiovascular disease; NHANES, National Health and Nutrition Examination Survey; RR, relative risk.