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To the Editor: The need for concern regarding epidemic US obesity trends was highlighted by the study by Dr Flegal and colleagues¹ that confirmed the association between obesity and mortality from cardiovascular disease and certain cancers. Furthermore, individuals with severe obesity have particularly high mortality from cardiovascular and noncancer noncardiovascular causes. However, the results should not be interpreted to suggest that overweight does not confer health risk. Considerable data link overweight with coronary heart disease,^2-3 as well as incident hypertension^3-5 and diabetes,^3-5 2 cardiovascular risk factors with established morbidity and mortality consequences. They are likely to mediate much of the effects of overweight body mass index on long-term mortality.

The study by Flegal et al did not consider treatment of cardiovascular risk factors. The management of cardiovascular risk factors can alleviate much of their associated health risk, potentially masking the full impact of overweight on health. However, effective treatment does . . . [Full Text of this Article]

Kathleen McTigue, MD, MS, MPH
mctiguekm@upmc.edu
Department of Medicine

Lewis Kuller, MD, DrPH
Department of Epidemiology
University of Pittsburgh
Pittsburgh, Pennsylvania

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