Is obesity more harmful to health than smoking or heavy drinking?
Despite the increasing prevalence of obesity, its impact on morbidity compared with other health risks is unclear. This paper compares the effects of overweight, smoking, heavy drinking and poverty on the occurrence of chronic medical conditions and physical quality of life.
Message
Obesity is more detrimental to health than smoking, heavy drinking or poverty.
Reference
R Sturm and KB Wells. Does obesity contribute as much to morbidity as poverty or smoking? Public Health 2001 115: 229-235.
Study
This study used data from a nationally representative household telephone survey of 9585 US adults conducted in 1998. Self-reported measures were used to collect information on height and weight, smoking status, problem drinking, poverty, 17 chronic medical conditions and physical quality of life.
Body mass index (kg/sq m) was categorised as normal (18.5 to 24.9), overweight (25 to 29.9), obese 1 (30 to 34.9) and obese 2 (35 or higher). Poverty was defined as family income under the federal poverty limit.
The 17 chronic conditions included the following: asthma, diabetes, hypertension, arthritis, physical disability such as loss of arm, leg, eyesight or hearing, trouble breathing, cancer, neurological condition, stroke or paralysis, angina/heart failure, coronary artery disease, chronic back problems, stomach ulcer, chronic liver disease, migraine or chronic severe headaches, chronic bladder problems and chronic gynaecological problems.
Results
A body mass index of 35 or more had a stronger adverse health effect than smoking, heavy drinking or poverty.
A body mass index of 30 to 35 had the same effect as poverty, but was more detrimental to health than smoking or heavy drinking.
Table 1 shows the effect of obesity, smoking, heavy drinking and poverty on the number of chronic medical conditions. Men and women with a body mass index of 30 to 35 had on average one half of an additional chronic condition compared with those of normal weight. Men and women with a body mass index of 35 or more had on average around one additional chronic condition compared with those of normal weight. These results were adjusted for age, ethnicity and marital status.
Table 1. The effect of obesity, smoking, heavy drinking and poverty on the number of chronic medical conditions. (Overweight/obesity relative to normal weight; smoking relative to non-smoking; heavy drinking relative to non- or light-drinking; poor relative to non-poor).
| Risk factor |
Additional chronic conditions associated with risk factors |
|