Obesity and health: why slim?

The health risks of obesity are summarized in terms of disease in Fig. 1. Obesity is associated with a higher mortality incidence from cerebrovascular disease, coronary heart disease, diabetes mellitus and cancer of the breast, colon, endometrium and prostate (Lew & Garfinkel, 1979). Potent cardiovascular disease risk factors such as hypertension and hypercholesterolaemia have also been associated with overweight and obesity (Van Itallie, 1985). Digestive disorders implicated include hiatus hernia and gall-bladder disease (Friedman et al. 1966). Although information on the association of osteoarthritis and obesity is contradictory, the studies that do show an increased prevalence of osteoarthritis in obese persons indicate the knee as the most frequently involved joint (Bray, 1985). That gout is commoner in obese persons is supported by information from the Framingham Study (Kannel & Gordon, 1979). While the strength of these obesity and disease associations is variable, the strongest evidence exists for the cardiovascular disease association. In the American Cancer Society Study of 750 000 men and women coronary heart disease was the major disease responsible for the higher mortality among persons who were overweight compared with those in the average weight range. For example, mortality among men and women 3040% heavier than average was nearly 50% higher than those of average weight; among those more than 40% heavier than average, it was nearly 90% higher than those of average weight (Lew & Garfinkel, 1979). m-Stroke Hiatus hernia Gall bladder disease Diabetes mellitus icer Fig. 1. Health risks associated with obesity.