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Alison E. Field, ScD; Eugenie H. Coakley; Aviva Must, PhD; Jennifer L. Spadano, MA; Nan Laird, PhD; William H. Dietz, MD, PhD; Eric Rimm, ScD; Graham A. Colditz, MD, DrPH

Arch Intern Med. 2001;161:1581-1586.

Background  Overweight adults are at an increased risk of developing numerous chronic diseases.

Methods  Ten-year follow-up (1986-1996) of middle-aged women in the Nurses' Health Study and men in the Health Professionals Follow-up Study to assess the health risks associated with overweight.

Results  The risk of developing diabetes, gallstones, hypertension, heart disease, and stroke increased with severity of overweight among both women and men. Compared with their same-sex peers with a body mass index (BMI) (calculated as weight in kilograms divided by the square of height in meters) between 18.5 and 24.9, those with BMI of 35.0 or more were approximately 20 times more likely to develop diabetes (relative risk [RR], 17.0; 95% confidence interval [CI], 14.2-20.5 for women; RR, 23.4; 95% CI, 19.4-33.2 for men). Women who were overweight but not obese (ie, BMI between 25.0 and 29.9) were also significantly more likely than their leaner peers to develop gallstones (RR, 1.9), hypertension (RR, 1.7), high cholesterol level (RR, 1.1), and heart disease (RR, 1.4). The results were similar in men.

Conclusions  During 10 years of follow-up, the incidence of diabetes, gallstones, hypertension, heart disease, colon cancer, and stroke (men only) increased with degree of overweight in both men and women. Adults who were overweight but not obese (ie, 25.0BMI29.9) were at significantly increased risk of developing numerous health conditions. Moreover, the dose-response relationship between BMI and the risk of developing chronic diseases was evident even among adults in the upper half of the healthy weight range (ie, BMI of 22.0-24.9), suggesting that adults should try to maintain a BMI between 18.5 and 21.9 to minimize their risk of disease.

From the Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (Drs Field, Rimm, and Colditz); JSI Research and Training, Boston (Ms Coakley); Department of Family Medicine and Community Health, Tufts University School of Medicine, Boston (Dr Must); US Department of Agriculture, Human Nutrition Research Center on Aging at Tufts University (Dr Must and Ms Spadano); Departments of Biostatistics (Dr Laird), Nutrition (Dr Rimm), and Epidemiology (Drs Rimm and Colditz), Harvard School of Public Health, Boston; and Division of Nutrition and Physical Activity, Centers for Disease Control and Prevention, Atlanta, Ga (Dr Dietz).

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