Annual deaths attributable to obesity in the United States

Context Obesity is a major health problem in the United States, but the num ber of obesity-attributable deaths has not been rigorously estimated. Objective To estimate the number of deaths, annually, attributable to obesi ty among US adults. Design Data from 5 prospective cohort studies (the Alameda Community Health Study, the Framingham Heart Study, the Tecumseh Community Hearth Study, th e American Cancer Society Cancer Prevention Study I, and the National Healt h and Nutrition Examination Survey I Epidemiologic Follow-up Study) and 1 p ublished study (the Nurses' Health Study) in conjunction with 1991 national statistic; on body mass index distributions, population size, and overall deaths. Subjects Adults, 18 years or older in 1991, classified by body mass index ( kg/m(2)) as overweight (25-30), obese (30-35), and severely obese (>35), Main Outcome Measure Relative hazard ratio (HR) of death for obese or overw eight persons. Results The estimated number of annual deaths attributable to obesity varie d with the cohort used to calculate the HRs, but findings were consistent o verall. More than 80% of the estimated obesity-attributable deaths occurred among individuals with a body mass index of more than 30 kg/m(2). When HRs were estimated for all eligible subjects from ail 6 studies, the mean esti mate of deaths attributable to obesity in the United States was 280 184 (ra nge, 236 111-341 153),Hazard ratios also were calculated from data for nons mokers or never-smokers only. When these HRs were applied to the entire pop ulation (assuming the HR applied to all individuals), the mean estimate for obesity-attributable death was 324 940 (range, 262 541-383 410). Conclusions The estimated number of annual deaths attributable to obesity a mong US adults is approximately 280 000 based on HRs from all subjects and 325 000 based on HRs from only nonsmokers and never-smokers.