Charles A. Bertrand, M.D., FACP, DIM-CD (Ret.)
Associate Clinical Professor of Medicine at New York Medical College
and at the Medical University of South Carolina


OBESITY AND MORTALITY

Do fat people die earlier than slim people?

Surprising as it may seem, there is still some room for disagreement on this subject. One man says, "My Great-Uncle Arley was so fat they had to build a special seat for him on the trolley. And he lived to be 97." Another says, "Aunt Josephine weighed 330 pounds, poor soul. That's why she died at 38."

Of course, multiple factors contribute to death, whether early or late: heredity, high blood pressure, smoking, alcohol, stress, and many more. And over twenty percent of Americans are obese.

According to a recent study conducted by the American Cancer Society, obesity can definitely be a contributing factor. These findings - published in the New England Journal of Medicine (volume 341, October 7, 1999, pp. 1097-1104) - are about as conclusive as medical research can get. The sample size was enormous (in numbers rather than weight) - 487,000 men and 588,000 women. The subjects were monitored over a 14-year period, a sufficient period to establish trends. During this span almost 202,000 subjects, or about twenty percent, died.

The researchers, as part of this particular study, focused on a group of about 300,000 who had never smoked and were not ill on entering the program. They found that those with a "high body mass index," i.e. those who were overweight, died at a significantly greater rate than those who were slimmer. The report includes the reasons for death among this group, with heart disease and cancer the most common.

In the same issue of the New England Journal of Medicine, Dr. David F. Williamson published a companion editorial in which he says that any adult patient who gains ten pounds or grows two inches around the abdomen should be counseled by a physician, and the physician should prescribe both dietary changes and increased activity. Everyone associated with this problem should participate in efforts to reduce obesity, Williamson argues, including dietitians, food marketers, makers of dietary products, and other health-care providers.

However, the people most likely to effect healthful change are those who are overweight. They and they alone can ultimately determine the nature and amount of food they consume. Perhaps this study will make them aware of the necessity to eliminate their obesity - unless, of course, they have a Great-Uncle Arley.

Dietary discipline and exercise are the two major keys - and the best exercise is to push away from the table earlier, even if one still has a mild sensation of hunger.



The advice provided on this website is intended to be general in nature and should not be relied upon for specific treatment. If you need personal medical attention please contact your physician.


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