You are seeing this message because your Web browser does not support basic Web standards. Find out more about why this message is appearing and what you can do to make your experience on this site better.


ABOUT JAMA
Advanced Search

Welcome   | My Account | E-mail Alerts | Access Rights | Sign In


  Vol. 282 No. 16, October 27, 1999 TABLE OF CONTENTS
  JAMA
  •  Online Features
  Original Contribution
 This Article
 •Full text
 •PDF
 •Send to a friend
 • Save in My Folder
 •Save to citation manager
 •Permissions
 Citing Articles
 •Citation map
 •Citing articles on HighWire
 •Citing articles on ISI (667)
 •Contact me when this article is cited
 Related Content
 •Related article
 •Similar articles in JAMA
 Topic Collections
 •Obesity
 •Alert me on articles by topic

Annual Deaths Attributable to Obesity in the United States

David B. Allison, PhD; Kevin R. Fontaine, PhD; JoAnn E. Manson, MD, DrPH; June Stevens, PhD; Theodore B. VanItallie, MD

JAMA. 1999;282:1530-1538.

Context  Obesity is a major health problem in the United States, but the number of obesity-attributable deaths has not been rigorously estimated.

Objective  To estimate the number of deaths, annually, attributable to obesity among US adults.

Design  Data from 5 prospective cohort studies (the Alameda Community Health Study, the Framingham Heart Study, the Tecumseh Community Health Study, the American Cancer Society Cancer Prevention Study I, and the National Health and Nutrition Examination Survey I Epidemiologic Follow-up Study) and 1 published study (the Nurses' Health Study) in conjunction with 1991 national statistics on body mass index distributions, population size, and overall deaths.

Subjects  Adults, 18 years or older in 1991, classified by body mass index (kg/m2) as overweight (25-30), obese (30-35), and severely obese (>35).

Main Outcome Measure  Relative hazard ratio (HR) of death for obese or overweight persons.

Results  The estimated number of annual deaths attributable to obesity varied with the cohort used to calculate the HRs, but findings were consistent overall. More than 80% of the estimated obesity-attributable deaths occurred among individuals with a body mass index of more than 30 kg/m2. When HRs were estimated for all eligible subjects from all 6 studies, the mean estimate of deaths attributable to obesity in the United States was 280,184 (range, 236,111-341,153). Hazard ratios also were calculated from data for nonsmokers or never-smokers only. When these HRs were applied to the entire population (assuming the HR applied to all individuals), the mean estimate for obesity-attributable death was 324,940 (range, 262,541-383,410).

Conclusions  The estimated number of annual deaths attributable to obesity among US adults is approximately 280,000 based on HRs from all subjects and 325,000 based on HRs from only nonsmokers and never-smokers.


Author Affiliations: Obesity Research Center, St Luke's/Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, NY (Drs Allison and VanItallie); Department of Medicine, Johns Hopkins University School of Medicine and The Johns Hopkins Bayview Medical Center, Baltimore, Md (Dr Fontaine); Brigham and Women's Hospital, Harvard Medical School, and Harvard School of Public Health, Boston, Mass (Dr Manson); and Departments of Nutrition and Epidemiology, University of North Carolina, Chapel Hill (Dr Stevens).


RELATED ARTICLE

October 27, 1999
JAMA. 1999;282(16):1593-1594.
EXTRACT | FULL TEXT  


THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Design considerations and rationale of a multi-center trial to sustain weight loss: the weight loss maintenance trial
Brantley et al.
Clin Trials 2008;5:546-556.
ABSTRACT  

The WORD (Wholeness, Oneness, Righteousness, Deliverance): A Faith-Based Weight-Loss Program Utilizing a Community-Based Participatory Research Approach
Kim et al.
Health Educ Behav 2008;35:634-650.
ABSTRACT  

Fighting Obesity-Related Disease With Permanent Behavior Modification
Wexler
AMERICAN JOURNAL OF LIFESTYLE MEDICINE 2008;2:459-461.
 

Obesity and Pelvic Floor Disorders: A Systematic Review
Greer et al.
Obstet Gynecol 2008;112:341-349.
ABSTRACT | FULL TEXT  

Population-Based Prevention of Obesity: The Need for Comprehensive Promotion of Healthful Eating, Physical Activity, and Energy Balance: A Scientific Statement From American Heart Association Council on Epidemiology and Prevention, Interdisciplinary Committee for Prevention (Formerly the Expert Panel on Population and Prevention Science)
Kumanyika et al.
Circulation 2008;118:428-464.
ABSTRACT | FULL TEXT  

Body Mass Index, Abdominal Adiposity, Obesity, and Cardiovascular Reactions to Psychological Stress in a Large Community Sample
Carroll et al.
Psychosom. Med. 2008;70:653-660.
ABSTRACT | FULL TEXT  

Decreased number of circulating progenitor cells in obesity: beneficial effects of weight reduction
Muller-Ehmsen et al.
Eur Heart J 2008;29:1560-1568.
ABSTRACT | FULL TEXT  

Sociodemographic and Smoking Associated with Obesity in Adult Women in Iran: Results from the National Health Survey
Bakhshi et al.
J Public Health (Oxf) 2008;0:fdn024v1-7.
ABSTRACT | FULL TEXT  

Effect of Rimonabant on Progression of Atherosclerosis in Patients With Abdominal Obesity and Coronary Artery Disease: The STRADIVARIUS Randomized Controlled Trial
Nissen et al.
JAMA 2008;299:1547-1560.
ABSTRACT | FULL TEXT  

Gender differences in cardiovascular disease prevention
Jackson
Menopause Int 2008;14:13-17.
ABSTRACT | FULL TEXT  

Obesity affects spontaneous pregnancy chances in subfertile, ovulatory women
van der Steeg et al.
Hum Reprod 2008;23:324-328.
ABSTRACT | FULL TEXT  

Immigration and Generational Trends in Body Mass Index and Obesity in the United States: Results of the National Latino and Asian American Survey, 2002-2003
Bates et al.
Am. J. Public Health 2008;98:70-77.
ABSTRACT | FULL TEXT  

Cause-Specific Excess Deaths Associated With Underweight, Overweight, and Obesity
Flegal et al.
JAMA 2007;298:2028-2037.
ABSTRACT | FULL TEXT  

Comparison of Different Regression Analyses for Identifying Risk Factors in Obese and Nonobese Patients With Coronary Artery Disease
Yologlu et al.
ANGIOLOGY 2007;58:543-549.
ABSTRACT  

Changes in Urinary and Fecal Incontinence Symptoms With Weight Loss Surgery in Morbidly Obese Women
Burgio et al.
Obstet Gynecol 2007;110:1034-1040.
ABSTRACT | FULL TEXT  

Impact of insurance and supply of health professionals on coverage of treatment for hypertension in Mexico: population based study
Bleich et al.
BMJ 2007;335:875-875.
ABSTRACT | FULL TEXT  

Extreme Obesity and Risk of Stillbirth Among Black and White Gravidas
Salihu et al.
Obstet Gynecol 2007;110:552-557.
ABSTRACT | FULL TEXT  

Thematic review series: Adipocyte Biology. Sympathetic and sensory innervation of white adipose tissue
Bartness and Song
J. Lipid Res. 2007;48:1655-1672.
ABSTRACT | FULL TEXT  

Contribution of the Conserved Amino Acids of the Melanocortin-4 Receptor in D-[Nle4,Phe7]-{alpha}-Melanocyte-stimulating Hormone Binding and Signaling
Chen et al.
J. Biol. Chem. 2007;282:21712-21719.
ABSTRACT | FULL TEXT  

Relationship of Body Mass Index With Outcomes After Coronary Artery Bypass Graft Surgery
Wagner et al.
Ann. Thorac. Surg. 2007;84:10-16.
ABSTRACT | FULL TEXT  

Bariatric Surgery for Patients With Diabetes
Eckhauser et al.
Clin. Diabetes 2007;25:83-89.
ABSTRACT | FULL TEXT  

Prevalence, Challenges, and Solutions for 18F-FDG PET Studies of Obese Patients: A Technologist's Perspective
Botkin and Osman
J. Nucl. Med. Technol. 2007;35:80-83.
ABSTRACT | FULL TEXT  

Overweight and Obesity in Sexual-Minority Women: Evidence From Population-Based Data
Boehmer et al.
Am. J. Public Health 2007;97:1134-1140.
ABSTRACT | FULL TEXT  

Avoidance of Complications in Older Patients and Medicare Recipients Undergoing Gastric Bypass
Hallowell et al.
Arch Surg 2007;142:506-512.
ABSTRACT | FULL TEXT  

The Built Environment and Obesity
Papas et al.
Epidemiol Rev 2007;0:mxm009v1.
ABSTRACT | FULL TEXT  

Malabsorption of Oral Antibiotics in Pregnancy after Gastric Bypass Surgery
Magee et al.
J Am Board Fam Med 2007;20:310-313.
ABSTRACT | FULL TEXT  

Associations Between Body Composition, Anthropometry, and Mortality in Women Aged 65 Years and Older
Dolan et al.
Am. J. Public Health 2007;97:913-918.
ABSTRACT | FULL TEXT  

Obesity and Workers' Compensation: Results From the Duke Health and Safety Surveillance System
Ostbye et al.
Arch Intern Med 2007;167:766-773.
ABSTRACT | FULL TEXT  

Heterogeneity in the Prevalence of Risk Factors for Cardiovascular Disease and Type 2 Diabetes Mellitus in Obese Individuals: Effect of Differences in Insulin Sensitivity
McLaughlin et al.
Arch Intern Med 2007;167:642-648.
ABSTRACT | FULL TEXT  

Diseases Associated with Childhood Obesity
Choudhary et al.
Am. J. Roentgenol. 2007;188:1118-1130.
ABSTRACT | FULL TEXT  

Attenuation of Adipocyte Triacylglycerol Hydrolase Activity Decreases Basal Fatty Acid Efflux
Wei et al.
J. Biol. Chem. 2007;282:8027-8035.
ABSTRACT | FULL TEXT  

Effect of Body Mass Index on Diagnostic and Prognostic Usefulness of Amino-Terminal Pro-Brain Natriuretic Peptide in Patients With Acute Dyspnea
Bayes-Genis et al.
Arch Intern Med 2007;167:400-407.
ABSTRACT | FULL TEXT  

The impact of anthropomorphic indices on clinical outcomes in patients with acute ST-elevation myocardial infarction
Mehta et al.
Eur Heart J 2007;28:415-424.
ABSTRACT | FULL TEXT  

The Association Between Body Mass Index and Clinical Outcomes in Acute Lung Injury
Morris et al.
Chest 2007;131:342-348.
ABSTRACT | FULL TEXT  

Association between plasma adiponectin levels and unstable coronary syndromes
Wolk et al.
Eur Heart J 2007;28:292-298.
ABSTRACT | FULL TEXT  

Overweight Among Young Children in the Philadelphia Health Care Centers: Incidence and Prevalence
Robbins et al.
Arch Pediatr Adolesc Med 2007;161:17-20.
ABSTRACT | FULL TEXT  

Mechanism of oleoylethanolamide on fatty acid uptake in small intestine after food intake and body weight reduction
Yang et al.
Am. J. Physiol. Regul. Integr. Comp. Physiol. 2007;292:R235-R241.
ABSTRACT | FULL TEXT  

Estimating the Energy Gap Among US Children: A Counterfactual Approach
Wang et al.
Pediatrics 2006;118:e1721-e1733.
ABSTRACT | FULL TEXT  

Obesity and sepsis.
Vachharajani and Vital
J Intensive Care Med 2006;21:287-295.
ABSTRACT  

Gender and the Burden of Disease Attributable to Obesity
Muennig et al.
Am. J. Public Health 2006;96:1662-1668.
ABSTRACT | FULL TEXT  

Radiology of the Laparoscopic Roux-en-Y Gastric Bypass Procedure: Conceptualization and Precise Interpretation of Results
Scheirey et al.
RadioGraphics 2006;26:1355-1371.
ABSTRACT | FULL TEXT  

Cannabinoid-1 Receptor Antagonist, Rimonabant, for Management of Obesity and Related Risks
Gadde and Allison
Circulation 2006;114:974-984.
FULL TEXT  

Intake of sugar-sweetened beverages and weight gain: a systematic review.
Malik et al.
Am. J. Clin. Nutr. 2006;84:274-288.
ABSTRACT | FULL TEXT  

The significance of overweight and obesity for individual health behaviour: An economic analysis based on the Swedish surveys of living conditions 1980--81, 1988--89, and 1996--97
Bolin et al.
Scand J Public Health 2006;34:422-431.
ABSTRACT  

Mortality and cardiac and vascular outcomes in extremely obese women.
McTigue et al.
JAMA 2006;296:79-86.
ABSTRACT | FULL TEXT  

Obesity, adipokines, and prostate cancer in a prospective population-based study.
Baillargeon et al.
Cancer Epidemiol. Biomarkers Prev. 2006;15:1331-1335.
ABSTRACT | FULL TEXT  

Comparison of the Dexamethasone-Suppressed Corticotropin-Releasing Hormone Test and Low-Dose Dexamethasone Suppression Test in the Diagnosis of Cushing's Syndrome
Martin et al.
J. Clin. Endocrinol. Metab. 2006;91:2582-2586.
ABSTRACT | FULL TEXT  

Commentary: Grading the credibility of molecular evidence for complex diseases
Ioannidis
Int J Epidemiol 2006;35:572-578.
FULL TEXT  

Risk factors for cardiovascular disease and hormone therapy in women
Collins
Heart 2006;92:iii24-iii28.
FULL TEXT  

Body Weight and Mortality Among Men and Women in China
Gu et al.
JAMA 2006;295:776-783.
ABSTRACT | FULL TEXT  

Obesity Research--Limitations of Methods, Measurements, and Medications
Simons-Morton et al.
JAMA 2006;295:826-828.
FULL TEXT  

Central orexin sensitivity, physical activity, and obesity in diet-induced obese and diet-resistant rats
Novak et al.
Am. J. Physiol. Endocrinol. Metab. 2006;290:E396-E403.
ABSTRACT | FULL TEXT  

A Semiparametric Analysis of the Relationship of Body Mass Index to Mortality
Gronniger
Am. J. Public Health 2006;96:173-178.
ABSTRACT | FULL TEXT  

Roux-en-Y Gastric Bypass Surgery for Morbid Obesity: Evaluation of Postoperative Extraluminal Leaks with Upper Gastrointestinal Series
Carucci et al.
Radiology 2006;238:119-127.
ABSTRACT | FULL TEXT  

License to Run: Exercise Impacts Functional Plasticity in the Intact and Injured Central Nervous System by Using Neurotrophins
Vaynman and Gomez-Pinilla
Neurorehabil Neural Repair 2005;19:283-295.
ABSTRACT  

Reference Body Composition in Adult Rhesus Monkeys: Glucoregulatory and Anthropometric Indices
Raman et al.
J. Gerontol. A Biol. Sci. Med. Sci. 2005;60:1518-1524.
ABSTRACT | FULL TEXT  

Urinary and Anal Incontinence in Morbidly Obese Women Considering Weight Loss Surgery
Richter et al.
Obstet Gynecol 2005;106:1272-1277.
ABSTRACT | FULL TEXT  

Body Mass Index and Angiotensin-Dependent Control of the Renal Circulation in Healthy Humans
Ahmed et al.
Hypertension 2005;46:1316-1320.
ABSTRACT | FULL TEXT  

Obesity, courts, and the new politics of public health.
Kersh and Morone
Journal of Health Politics, Policy and Law 2005;30:839-868.
ABSTRACT  

Public opinion and the politics of obesity in America.
Oliver and Lee
Journal of Health Politics, Policy and Law 2005;30:923-954.
ABSTRACT  

BIOTERRORISM PREPAREDNESS EXPENDITURES MAY COMPROMISE PUBLIC HEALTH
Dowling and Lipton
Am. J. Public Health 2005;95:1672-1672.
FULL TEXT  

Helicobacter pylori and Overweight Status in the United States: Data from the Third National Health and Nutrition Examination Survey
Cho et al.
Am J Epidemiol 2005;162:579-584.
ABSTRACT | FULL TEXT  

Obesity and Mortality in Elderly Nursing Home Residents
Grabowski et al.
J. Gerontol. A Biol. Sci. Med. Sci. 2005;60:1184-1189.
ABSTRACT | FULL TEXT  

Associations Between Obesity and Receipt of Screening Mammography, Papanicolaou Tests, and Influenza Vaccination: Results from the Health and Retirement Study (HRS) and the Asset and Health Dynamics Among the Oldest Old (AHEAD) Study
Ostbye et al.
Am. J. Public Health 2005;95:1623-1630.
ABSTRACT | FULL TEXT  

Different Cycle Ergometer Outcomes in Severely Obese Men and Women Without Documented Cardiopulmonary Morbidities Before Bariatric Surgery
Dolfing et al.
Chest 2005;128:256-262.
ABSTRACT | FULL TEXT  

Body Mass Index and Mortality From Cardiovascular Disease Among Japanese Men and Women: The JACC Study
Cui et al.
Stroke 2005;36:1377-1382.
ABSTRACT | FULL TEXT  

Comparative Impact of Morbid Obesity vs Heart Failure on Cardiorespiratory Fitness
Gallagher et al.
Chest 2005;127:2197-2203.
ABSTRACT | FULL TEXT  

Diets and Cardiovascular Disease: An Evidence-Based Assessment
Parikh et al.
J Am Coll Cardiol 2005;45:1379-1387.
ABSTRACT | FULL TEXT  

Rise in Insulin Resistance Is Associated With Escalated Telomere Attrition
Gardner et al.
Circulation 2005;111:2171-2177.
ABSTRACT | FULL TEXT  

Outcome of Morbid Obesity in the Intensive Care Unit
Yaegashi et al.
J Intensive Care Med 2005;20:147-154.
ABSTRACT  

Antimitogenic effect of green tea (-)-epigallocatechin gallate on 3T3-L1 preadipocytes depends on the ERK and Cdk2 pathways
Hung et al.
Am. J. Physiol. Cell Physiol. 2005;288:C1094-C1108.
ABSTRACT | FULL TEXT  

Excess Deaths Associated With Underweight, Overweight, and Obesity
Flegal et al.
JAMA 2005;293:1861-1867.
ABSTRACT | FULL TEXT  

Deaths Attributable to Obesity
Mark
JAMA 2005;293:1918-1919.
FULL TEXT  

Prospective Study of Body Mass Index and Risk of Stroke in Apparently Healthy Women
Kurth et al.
Circulation 2005;111:1992-1998.
ABSTRACT | FULL TEXT  

Pharmacologic and Surgical Management of Obesity in Primary Care: A Clinical Practice Guideline from the American College of Physicians
Snow et al.
ANN INTERN MED 2005;142:525-531.
ABSTRACT | FULL TEXT  

Lifestyle Determinants and Mortality in German Vegetarians and Health-Conscious Persons: Results of a 21-Year Follow-up
Chang-Claude et al.
Cancer Epidemiol. Biomarkers Prev. 2005;14:963-968.
ABSTRACT | FULL TEXT  

A Potential Decline in Life Expectancy in the United States in the 21st Century
Olshansky et al.
NEJM 2005;352:1138-1145.
ABSTRACT | FULL TEXT  

Impact of Obesity and the Metabolic Syndrome on Risk Factors in African American Stroke Survivors: A Report From the AAASPS
Ruland et al.
Arch Neurol 2005;62:386-390.
ABSTRACT | FULL TEXT  

Origins and evolution of the Western diet: health implications for the 21st century
Cordain et al.
Am. J. Clin. Nutr. 2005;81:341-354.
ABSTRACT | FULL TEXT  

Impact of adiponectin gene polymorphisms on plasma lipoprotein and adiponectin concentrations of viscerally obese men
Berthier et al.
J. Lipid Res. 2005;46:237-244.
ABSTRACT | FULL TEXT  

Surgical Management of Morbid Obesity
Schneider and Mun
Diabetes Care 2005;28:475-480.
FULL TEXT  

Correction: Actual Causes of Death in the United States, 2000
Mokdad et al.
JAMA 2005;293:293-294.
FULL TEXT  

Health Care Expenditures Associated With Overweight and Obesity Among US Adults: Importance of Age and Race
Wee et al.
Am. J. Public Health 2005;95:159-165.
ABSTRACT | FULL TEXT  

Relation of Body Mass Index in Young Adulthood and Middle Age to Medicare Expenditures in Older Age
Daviglus et al.
JAMA 2004;292:2743-2749.
ABSTRACT | FULL TEXT  

The obesity epidemic: prospects for prevention
Skidmore and Yarnell
QJM 2004;97:817-825.
ABSTRACT | FULL TEXT  

Exercise Capacity in Adult African-Americans Referred for Exercise Stress Testing: Is Fitness Affected by Race?
Lavie et al.
Chest 2004;126:1962-1968.
ABSTRACT | FULL TEXT  

Prevention Conference VII: Obesity, a Worldwide Epidemic Related to Heart Disease and Stroke: Group III: Worldwide Comorbidities of Obesity
Caterson et al.
Circulation 2004;110:e476-e483.
FULL TEXT  

Clinical Implications of Obesity With Specific Focus on Cardiovascular Disease: A Statement for Professionals From the American Heart Association Council on Nutrition, Physical Activity, and Metabolism: Endorsed by the American College of Cardiology Foundation
Klein et al.
Circulation 2004;110:2952-2967.
ABSTRACT | FULL TEXT  

Impact of Obesity on Medical Problems and Quality of Life in Taiwan
Tsai et al.
Am J Epidemiol 2004;160:557-565.
ABSTRACT | FULL TEXT  

Estimating Deaths Attributable to Obesity in the United States
Flegal et al.
Am. J. Public Health 2004;94:1486-1489.
ABSTRACT | FULL TEXT  

Body Mass Index, Physical Activity, and the Risk of Decline in Overall Health and Physical Functioning in Late Middle Age
He and Baker
Am. J. Public Health 2004;94:1567-1573.
ABSTRACT | FULL TEXT  

Methods of Calculating Deaths Attributable to Obesity
Flegal et al.
Am J Epidemiol 2004;160:331-338.
ABSTRACT | FULL TEXT  

The Neurological Complications of Bariatric Surgery
Berger
Arch Neurol 2004;61:1185-1189.
FULL TEXT  

Body mass index and short-term weight change in relation to mortality in Dutch women after age 50 y
Maru et al.
Am. J. Clin. Nutr. 2004;80:231-236.
ABSTRACT | FULL TEXT  





HOME | CURRENT ISSUE | PAST ISSUES | TOPIC COLLECTIONS | CME | SUBMIT | SUBSCRIBE | HELP
CONDITIONS OF USE | PRIVACY POLICY | CONTACT US | SITE MAP
 
© 1999 American Medical Association. All Rights Reserved.