The Disease Burden Associated With Overweight and Obesity

Must, Aviva; Spadano, Jennifer L.; Coakley, Eugenie; Field, Alison E.; Colditz, Graham A.; Dietz, William H.

doi:10.1001/jama.282.16.1523

Cited by 4,025 publications

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References 27 publications

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“…Obesity is a risk factor for several chronic diseases including NIDDM, CHD and some types of cancer (Must et al, 1999). The prevalence of overweight (body mass index (BMI) > 25 kg=m 2 ) and obesity (BMI > 30 kg=m 2 ) are estimated to be 63 and 55% among American middle-aged men and women, respectively (Must et al, 1999), and the increase in prevalence of obesity in the last two decades is 8% (Kuczmarski et al, 1994).…”

Section: The Glycemic Index In Obesitymentioning

confidence: 99%

Glycemic index in chronic disease: a review

et al. 2002

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Aim: The intent of this review is to critically analyze the scientific evidence on the role of the glycemic index in chronic Western disease and to discuss the utility of the glycemic index in the prevention and management of these disease states. Background: The glycemic index ranks foods based on their postprandial blood glucose response. Hyperinsulinemia and insulin resistance, as well as their determinants (eg high energy intake, obesity, lack of physical activity) have been implicated in the etiology of diabetes, coronary heart disease and cancer. Recently, among dietary factors, carbohydrates have attracted much attention as a significant culprit, however, different types of carbohydrate produce varying glycemic and insulinemic responses. Low glycemic index foods, characterized by slowly absorbed carbohydrates, have been shown in some studies to produce beneficial effects on glucose control, hyperinsulinemia, insulin resistance, blood lipids and satiety. Method: Studies on the short and long-term metabolic effects of diets with different glycemic indices will be presented and discussed. The review will focus primarily on clinical and epidemiological data, and will briefly discuss in vitro and animal studies related to possible mechanisms by which the glycemic index may influence chronic disease.

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Section: The Glycemic Index In Obesitymentioning

confidence: 99%

Glycemic index in chronic disease: a review

et al. 2002

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“…1,2 Between 1990 and 2000, the prevalence of morbid obesity increased from 0.78 to 2.2%, representing a total of over 4.8 million morbidly obese US adults in the year 2000. 3 Morbid obesity is associated with a substantially increased risk of morbidity and mortality from chronic health conditions, such as diabetes, hypertension, cardiovascular disease, and cancer, [4][5][6][7][8][9] and it has been linked to multidimensional impairments in health-related quality of life and psychosocial well-being. 10,11 Several articles have examined the impact of obesity, broadly defined as BMI Z30 kg/m 2 , on medical expenditures in the United States.…”

Section: Introductionmentioning

confidence: 99%

Impact of morbid obesity on medical expenditures in adults

2005

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CONTEXT: Morbid obesity (body mass index (BMI) Z40 kg/m 2 ) is associated with substantially increased morbidity and mortality from chronic health conditions and with poorer health-related quality of life; however, less is known about the impact of morbid obesity on healthcare expenditures. OBJECTIVE: To examine the impact of morbid obesity on healthcare expenditures using a nationally representative sample of US adults. DESIGN, SETTING, AND PARTICIPANTS: We performed a cross-sectional analysis of 16 262 adults from the 2000 Medical Expenditure Panel Survey, a nationally representative survey of the noninstitutionalized civilian population of the United States. Per capita healthcare expenditures were calculated for National Institutes of Health BMI categories, based on self-reported height and weight, using a two-part, multivariable model adjusted for age, gender, race, income, education level, type of health insurance, marital status, and smoking status. MAIN OUTCOME MEASURES: Odds of incurring any healthcare expenditure and per capita healthcare expenditures associated with morbid obesity in 2000. RESULTS: When compared with normal-weight adults, the odds of incurring any healthcare expenditure in 2000 were two-fold greater among adults with morbid obesity. Per capita healthcare expenditures for morbidly obese adults were 81% (95% confidence interval (CI): 48-121%) greater than normal-weight adults, 65% (95% CI: 37-110%) greater than overweight adults, and 47% (95% CI: 11-96%) greater than adults with class I obesity. Excess costs among morbidly obese adults resulted from greater expenditures for office-based visits, outpatient hospital care, in-patient care, and prescription drugs. Aggregate US healthcare expenditures associated with excess body weight among morbidly obese US adults exceeded $11 billion in 2000. CONCLUSIONS: The economic burden of morbid obesity among US adults is substantial. Further research is needed to identify interventions to reduce the incidence and prevalence of morbid obesity and improve the health and economic outcomes of morbidly obese adults.

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“…5 Obesity is a strong risk factor for diabetes, hypertension, hypercholesterolaemia, coronary heart disease, gall bladder disease and certain types of cancer. 6 Given the growing literature on the cardiovascular risk factors 7,8 associated with erectile dysfunction (ED), and the link between obesity and cardiovascular risk factors, there is strong evidence to suspect an association between obesity and ED.…”

Section: Introductionmentioning

confidence: 99%

Body mass index, physical activity and erectile dysfunction: An U-shaped relationship from population-based study

Cheng

2007

Int J Obes

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Objective: To investigate the relationships between body mass index (BMI), physical activity and erectile dysfunction (ED). Design and subjects: A population representative cross-sectional analytic study of ED in Hong Kong, with two-stage stratified random sampling, and face-to-face interviews conducted by trained interviewers with structured questionnaires. Study subjects were 1506 men aged 26-70. Results: Age (odds ratio (OR) ¼ 1.30; 95% confidence interval (CI) 1.20-1.40), physical activity (OR ¼ 0.91 per 500 kcal/week; 95% CI 0.84-0.98), and general psychological distress (OR ¼ 1.03 per GHQ score; 95% CI 1.00-1.06) were independently associated with ED after multivariate adjustments. An U-shaped relationship between BMI and ED was observed only among men with no exercise (oonce/week): BMI o18.5 (OR ¼ 2.99; 95% CI 1.01-8.86), 18.5-19.9 (OR ¼ 2.66; 95% CI 1.04-6.79), 20.0-20.9 (OR ¼ 1.37; 95% CI 0.49-3.79), 22.0-22.9 (OR ¼ 1.36; 95% CI 0.58-3.17), 23.0-24.9 (OR ¼ 1.66; 95% CI 0.70-3.93), X25.0 (OR ¼ 2.47; 95% CI 1.08-5.67) using BMI 21.0-21.9 as reference, adjusted for age, GHQ and smoking status. Being physically active (X1000 kcal/week) only reduced the risk of ED (OR ¼ 0.40, 95% CI 0.16-0.95) in men who were obese, adjusted for age, GHQ, smoking status and BMI. Conclusions: BMI and physical activity independently and differentially affected ED risk. BMI had greatest influence with low physical activity, and physical activity exerted greatest influence when BMI was high. This is the first study to demonstrate an U-shaped relationship between BMI and ED risk, but only in men with no exercise, and to identify underweight as a risk factor for ED. This relationship has clinical implications for obese as well as underweight individuals.

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The Disease Burden Associated With Overweight and Obesity

Abstract: Based on these results, more than half of all US adults are considered overweight or obese. The prevalence of obesity-related comorbidities emphasizes the need for concerted efforts to prevent and treat obesity rather than just its associated comorbidities.

Cited by 4,025 publications

References 27 publications

Glycemic index in chronic disease: a review

Glycemic index in chronic disease: a review

Impact of morbid obesity on medical expenditures in adults

Body mass index, physical activity and erectile dysfunction: An U-shaped relationship from population-based study

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