Obesity overtakes smoking as America’s biggest health problem

By Caroline Scott-Thomas

- Last updated on GMT

Related tags Obesity

The health burden of obesity in the United States has overtaken that of smoking, according to a new study examining the relative effects of the two problems on quality of life, mortality and morbidity.

More than a third of the US population is now obese, and nearly the same proportion again is overweight. Examining the cost of obesity-related diseases often focuses on tax: according to the Institute of Medicine, these illnesses, such as type-2 diabetes and cardiovascular disease, cost the tax payer $147bn in 2008. But this latest study, to be published in the American Journal of Preventative Medicine,​ examines​obesity’s effect on quality of life as well as years of life lost due to the condition.

The analysis of 1993-2008 data from the National Health Interview Survey and the Behavioral Risk Factor Surveillance System showed that smoking still had a higher mortality risk than obesity, but that by 2008 the obese were losing more quality-adjusted life years (QALYs) through disability and activity limitations, according to authors Dr Haomiao Jia of Columbia University, New York, and Dr Erica Lubetkin from the City College of New York.

“In 1993 the QALYs lost were much smaller for obesity compared to smoking…However, as a result of the increasing prevalence of obesity, the contribution of obesity-related QALYs lost increased consistently and had increased by 127 percent in 2008…slightly more than smoking did,”​ they wrote.

During the 15-year period, they found that incidence of smoking decreased by 18.5 percent, mostly in the last six years, while the proportion of the population that was obese increased by 85 percent.

Despite fewer people smoking, the health burden contributed by smoking has remained stable, they wrote, possibly “due to the differences in peak prevalence of smoking and differences in susceptibility to smoking-associated conditions among subgroups of the population.”

They noted that smoking and obesity are the two problems that have the greatest impact on mortality and morbidity in the United States.

The food industry has been under increasing pressure to play a part in mitigating the obesity problem and it has responded with a range of innovations for replacing fat and calorific sweeteners with lower-calorie alternatives. But it has also been argued that the food industry has exacerbated the incidence of obesity by creating a wide variety of tasty but high-calorie foods, for which it is thought people have a natural inclination due to evolutionary factors.

The full research paper is available online here.

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