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Obesity and Unhealthy Life-Years in Adult Finns
An Empirical Approach
Tommy L. S. Visscher, PhD;
Aila Rissanen, MD, PhD;
Jacob C. Seidell, PhD;
Markku Heliövaara, MD, PhD;
Paul Knekt, PhD;
Antti Reunanen, MD, PhD;
Arpo Aromaa, MD, PhD
Arch Intern Med. 2004;164:1413-1420.
Background Obesity is more strongly related to morbidity and disability than to mortality. Obese individuals are thus expected to have more unhealthy life-years than normal-weight persons. The objective of the present study was to quantify the number of excess unhealthy life-years in obese individuals.
Methods A representative cohort of 19 518 Finnish men and women aged 20 to 92 years was followed for 15 years. Participation rate was 83%. Obesity was defined as a body mass index of 30.0 or higher. The number of unhealthy life-years due to premature work disability, hospitalization for coronary heart disease, and need for long-term medication was calculated per category of body mass index.
Results During the follow-up of 15 years, obese men who never smoked aged 20 to 64 years had, on average, 0.63 more years of work disability, 0.36 more years of coronary heart disease, and 1.68 more years of longterm medication use, than normal-weight counterparts. Obese women had, respectively, 0.52, 0.46, and 1.49 more years from these conditions than normal weight women. The excess risks of morbidity and disability due to obesity were highest in the youngest age groups and exceeded those of mortality in all age groups. Obese men and women 65 years and older who never smoked had, respectively, 1.71 and 1.41 excess unhealthy life-years (not statistically significant) due to premature need for long-term medication compared with normal-weight subjects, but no excess unhealthy life-years due to coronary heart disease.
Conclusions Obesity has a lifetime impact on disability and morbidity. A further increase in obesity will lead to an increase in unhealthy life-years and in direct and indirect health care costs.
From the Department of Health and Disability, National Public Health Institute, Helsinki, Finland (Drs Visscher, Heliövaara, Knekt, Reunanen, and Aromaa); Department for Nutrition and Health, Faculty of Earth and Life Sciences, Free University Amsterdam, Amsterdam, the Netherlands (Drs Visscher and Seidell); Centre for Prevention and Health Services Research, National Institute for Public Health and the Environment, Bilthoven, the Netherlands (Dr Visscher); Knowledge Center Overweight, Free University Medical Center, Amsterdam, the Netherlands (Drs Visscher and Seidell); Obesity Research Unit, Helsinki University Central Hospital, Helsinki, Finland (Dr Rissanen); and Department of Internal Medicine, Free University Medical Center, Amsterdam, the Netherlands (Dr Seidell).The authors have no relevant financial interest in this article.
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