Original Article

International Journal of Obesity (2008) 32, 832–836; doi:10.1038/sj.ijo.0803784; published online 18 December 2007

Shift in the composition of obesity in young adult men in Sweden over a third of a century

M Neovius1,2, A Teixeira-Pinto3 and F Rasmussen1

  1. 1Department of Public Health Sciences, Karolinska Institutet, Karolinska University Hospital (Norrbacka), Stockholm, Sweden
  2. 2Department of Medicine, Obesity Unit, Karolinska Institutet, Karolinska University Hospital (Huddinge), Stockholm, Sweden
  3. 3Department of Biostatistics and Medical Informatics, CINTESIS Research Unit, Faculty of Medicine, University of Porto, Porto, Portugal

Correspondence: Dr M Neovius, Department of Public Health Sciences, Karolinska Institute, Karolinska University Hospital (Norrbacka), Stockholm SE-17176, Sweden. E-mail: martin.neovius@ki.se

Received 12 September 2007; Revised 28 October 2007; Accepted 13 November 2007; Published online 18 December 2007.

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Abstract

Objective:

 

To assess whether the composition of the obese category (body mass index (BMI)greater than or equal to30) has changed during the last one-third of a century in young adult men.

Design:

 

Retrospective study of 1 580 913 men (18.3plusminus0.4 years) representing 82% of the Swedish male population at military conscription age between 1969 and 2005. Measured height and weight were used to define moderate and morbid obesity as BMI 30–34.9 and greater than or equal to35, respectively. Data on socio-economic position (SEP), place of residence (urban, semi-urban and rural), age and test center were also collected.

Results:

 

From the period 1969–1974 to 2000–2005, the prevalence of moderate obesity almost quintupled (0.8–3.8% ; P<0.0001), while morbid obesity increased 10-fold (0.1–1.3% ; P<0.0001). The composition of the obese category changed from 12.9 to 25.1% morbidly obese during the same time, corresponding to an annual growth in the odds of 2.8% (CI95% 2.5–3.1% ) per year within the obese category. Compared to 1969–1974, the odds ratios of obesity and morbid obesity, respectively, were 1.6 (1.6–1.7) and 1.9 (1.7–2.2) in 1980–1984, 2.8 (2.7–2.9) and 4.0 (3.5–4.5) in 1990–1994, and 6.0 (5.7–6.3) and 11.4 (10.1–12.9) in 2000–2005, after adjustment for SEP, urban/rural place of residence, age and test center. Extrapolation of the growth rate during the observation period resulted in an estimated 4% morbidly obese in 2020.

Conclusion:

 

Morbid obesity increased faster than moderate obesity during the last 35 years. As the health risks and costs of obesity-related morbidity increase disproportionately in the morbidly obese, it is important to assess morbid obesity in prevalence studies, and distinguish the morbidly from the moderately obese in cost analyses.

Keywords:

BMI, morbid obesity, prevalence, trends

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