Is the Health Burden Associated With Obesity Changing?
Is the Health Burden Associated With Obesity Changing?
Prioritization of obesity prevention and management policy is based on one's understanding of the health risks associated with increasing body weight. However, there is evidence that the magnitude of these health risks may be changing over time. Here, the authors analyze the theoretical drivers of these changes and then examine whether there is empirical evidence to support the theory. They conclude that, although the mortality risks associated with increasing body weight may be decreasing over time, the overall health burden appears likely to increase.
The health risks associated with increasing body weight are generally well understood. There are multiple cohort studies demonstrating that overweight and obesity are associated with an increased risk of a range of conditions, including diabetes, cardiovascular disease (CVD), some cancers, musculoskeletal disease, infertility, sleep apnea, disability, dementia, and mortality. An accurate understanding of the magnitude of these health risks is the basis of society's prioritization of obesity prevention and management strategies. There has been recent suggestion that the risk of mortality associated with increasing body weight has decreased over time, as well as questioning of the extent to which current body weight trends pose a real threat to population health.
There are a number of pathways through which changes in the relative risk relation between excess body weight and health risk factors, disease, and mortality may occur. There may be intrinsic differences in the extent to which excess body weight is associated with risk factor or disease incidence and mortality rates. This may in turn reflect different "types" of obesity or changes in factors such as ethnicity, activity, and dietary patterns associated with excess body weight. On the other hand, improvements in the treatment of risk factors and diseases will lead to increases in risk factor or disease prevalence but decreases in mortality rates.
Here, we analyze the evidence that the magnitude of the health risk associated with increasing body weight is changing over time. We analyze the theoretical drivers of these changes and then examine whether there is empirical evidence to support the theory. We searched in PubMed (National Library of Medicine, Bethesda, Maryland) for articles using the keywords ("obesity" [MeSH Terms] or "obesity" [All Fields]) and ("trends" [Subheading] or "trends" [All Fields]) and ("risk" [MeSH Terms] or "risk" [All Fields] or "mortality" [Subheading] or "mortality" [All Fields] or "mortality" [MeSH Terms]). References identifiable within the abstract as having examined changes in the relation between excess body weight and a risk factor or health outcome were retrieved. Articles published post-2004 were retrieved to represent recent trends. Additional references were retrieved from article reference lists and citation sources.
Abstract and Introduction
Abstract
Prioritization of obesity prevention and management policy is based on one's understanding of the health risks associated with increasing body weight. However, there is evidence that the magnitude of these health risks may be changing over time. Here, the authors analyze the theoretical drivers of these changes and then examine whether there is empirical evidence to support the theory. They conclude that, although the mortality risks associated with increasing body weight may be decreasing over time, the overall health burden appears likely to increase.
Introduction
The health risks associated with increasing body weight are generally well understood. There are multiple cohort studies demonstrating that overweight and obesity are associated with an increased risk of a range of conditions, including diabetes, cardiovascular disease (CVD), some cancers, musculoskeletal disease, infertility, sleep apnea, disability, dementia, and mortality. An accurate understanding of the magnitude of these health risks is the basis of society's prioritization of obesity prevention and management strategies. There has been recent suggestion that the risk of mortality associated with increasing body weight has decreased over time, as well as questioning of the extent to which current body weight trends pose a real threat to population health.
There are a number of pathways through which changes in the relative risk relation between excess body weight and health risk factors, disease, and mortality may occur. There may be intrinsic differences in the extent to which excess body weight is associated with risk factor or disease incidence and mortality rates. This may in turn reflect different "types" of obesity or changes in factors such as ethnicity, activity, and dietary patterns associated with excess body weight. On the other hand, improvements in the treatment of risk factors and diseases will lead to increases in risk factor or disease prevalence but decreases in mortality rates.
Here, we analyze the evidence that the magnitude of the health risk associated with increasing body weight is changing over time. We analyze the theoretical drivers of these changes and then examine whether there is empirical evidence to support the theory. We searched in PubMed (National Library of Medicine, Bethesda, Maryland) for articles using the keywords ("obesity" [MeSH Terms] or "obesity" [All Fields]) and ("trends" [Subheading] or "trends" [All Fields]) and ("risk" [MeSH Terms] or "risk" [All Fields] or "mortality" [Subheading] or "mortality" [All Fields] or "mortality" [MeSH Terms]). References identifiable within the abstract as having examined changes in the relation between excess body weight and a risk factor or health outcome were retrieved. Articles published post-2004 were retrieved to represent recent trends. Additional references were retrieved from article reference lists and citation sources.
