Epidemiology and Population Health

Impact of overweight, obesity and severe obesity on life expectancy of Australian adults

Subjects

Abstract

Background/objectives:

Adult obesity has been shown to substantially heighten the risk of adverse health outcomes but its impact on life expectancy (LE) has not been quantified in Australia. Our aim is to estimate reductions in LE and years of life lost (YLL) associated with overweight and obesity, relative to those at a healthy weight for Australian adults aged 20–69 years.

Subjects/methods:

We used a microsimulation model of obesity progression in Australia that integrates annual change in BMI based on age and sex, with Australian life-table data and published relative risk of all-cause mortality for different BMI categories. Remaining LE and YLL compared to healthy weight were estimated using 10-year cohorts, by sex. A nationally representative sample of 12,091 adults aged 20–69 from the 2014/15 Australian National Health Survey were used to represent the input population of 14.9 million.

Results:

Estimated remaining years of LE for healthy weight men and women aged 20–29 years was approximately 57.0 (95% CI 56.7–57.4) and 59.7 (95% CI 59.4–60.0) years, respectively. YLL associated with being overweight at baseline was approximately 3.3 years. For those obese and severely obese the loss in LE was predicted to be 5.6–7.6 years and 8.1–10.3 years for men and women aged 20–29 years, respectively. Across men and women, excess BMI in the adult population is responsible for approximately 36.3 million YLLs. Men stand to lose 27.7% more life years compared to women.

Conclusions:

Overweight and obesity is associated with premature mortality at all ages, for both men and women. Adults aged 20–39 years with severe obesity will experience the largest YLL, relative to healthy weight. More needs to be done in Australia to establish a coherent, sustained, cost-effective strategy to prevent overweight and obesity, particularly for men in early adulthood.

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References

  1. 1.

    Chang S-H, Pollack LM, Colditz GA. Life years lost associated with obesity-related diseases for US non-smoking adults. PLoS ONE. 2013;8:e66550.

    CAS  Article  Google Scholar 

  2. 2.

    Collaboration PS. Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies. Lancet. 2009;373:1083–96.

    Article  Google Scholar 

  3. 3.

    Finkelstein EA, Brown DS, Wrage LA, Allaire BT, Hoerger TJ. Individual and aggregate years‐of‐life‐lost associated with overweight and obesity. Obesity. 2010;18:333–9.

    Article  Google Scholar 

  4. 4.

    Flegal KM, Graubard BI, Williamson DF, Gail MH. Excess deaths associated with underweight, overweight, and obesity. JAMA. 2005;293:1861–7.

    CAS  Article  Google Scholar 

  5. 5.

    Fontaine KR, Redden DT, Wang C, Westfall AO, Allison DB. Years of life lost due to obesity. JAMA. 2003;289:187–93.

    Article  Google Scholar 

  6. 6.

    Jia H, Zack MM, Thompson WW. Population-based estimates of decreases in quality-adjusted life expectancy associated with unhealthy body mass index. Public Health Rep. 2016;131:177–84.

    Article  Google Scholar 

  7. 7.

    Kitahara CM, Flint AJ, de Gonzalez AB, Bernstein L, Brotzman M, MacInnis RJ, et al. Association between class III obesity (BMI of 40–59 kg/m2) and mortality: a pooled analysis of 20 prospective studies. PLoS Med. 2014;11:e1001673.

    Article  Google Scholar 

  8. 8.

    Nagai M, Kuriyama S, Kakizaki M, Ohmori-Matsuda K, Sone T, Hozawa A, et al. Impact of obesity, overweight and underweight on life expectancy and lifetime medical expenditures: the Ohsaki Cohort Study. BMJ Open. 2012;2:e000940.

    Article  Google Scholar 

  9. 9.

    Peeters A, Barendregt JJ, Willekens F, Mackenbach JP, Al Mamun A, Bonneux L. Obesity in adulthood and its consequences for life expectancy: a life-table analysis. Ann Intern Med. 2003;138:24–32.

    Article  Google Scholar 

  10. 10.

    Preston SH, Stokes A. Contribution of obesity to international differences in life expectancy. Am J Public Health. 2011;101:2137–43.

    Article  Google Scholar 

  11. 11.

    Reuser M, Bonneux L, Willekens F. The burden of mortality of obesity at middle and old age is small. A life table analysis of the US Health and Retirement Survey. Eur J Epidemiol. 2008;23:601.

    Article  Google Scholar 

  12. 12.

    Steensma C, Loukine L, Orpana H, Lo E, Choi B, Waters C, et al. Comparing life expectancy and health-adjusted life expectancy by body mass index category in adult Canadians: a descriptive study. Popul Health Metr. 2013;11:21.

    Article  Google Scholar 

  13. 13.

    Hayes A, Lung T, Bauman A, Howard K. Modelling obesity trends in Australia: unravelling the past and predicting the future. Int J Obes. 2016;41:178–85.

    Article  Google Scholar 

  14. 14.

    Australian Bureau of Statistics. National Health Survey: first results 2014-15 [Internet]. Canberra: ABS; 2015 [cited 9th August 2017]. Available from: http://www.abs.gov.au/ausstats/abs@.nsf/mf/4364.0.55.001.

  15. 15.

    Australian Bureau of Statistics. 4363.0 - National Health Survey: Users' Guide, 2014-15: Imputation [Internet]. Canberra: ABS; 2017 [cited 9th August 2017]. Available from: http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/4363.0~2014-15~Main%20Features~Imputation~18.

  16. 16.

    Australian Bureau of Statistics. 3302.0.55.001 - Life Tables, States, Territories and Australia, 2013-2015: Data Cubes [Internet]. Canberra: ABS; 2016 [cited 9th August 2017]. Available from: http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/3302.0.55.0012013-2015?OpenDocument#Data.

  17. 17.

    Australian Institute of Health and Welfare. Overweight and obesity in Australia: a birth cohort analysis. Canberra: AIHW; 2017. 46p. Cat. no: 215.

  18. 18.

    Shields M, Gorber SC, Tremblay MS. Effects of measurement on obesity and morbidity. Health Rep. 2008;19:77.

    Google Scholar 

  19. 19.

    National Vascular Disease Prevention Alliance. Absolutecardiovascular disease management. Quick reference guide for health professionals [Internet]. NVPA; 2012 [cited 9th August 2017]. Available from: http://cvdcheck.org.au/pdf/Absolute_CVD_Risk-Quick_Reference_Guide.pdf.

  20. 20.

    Sharpe N, Coppell K, Bennett W. New Zealand Cardiovascular Guidelines Handbook: a summary resource for primary care practitioners. Wellington: New Zealand: Guidelines Group; 2009.

    Google Scholar 

  21. 21.

    Keating C, Backholer K, Gearon E, Stevenson C, Swinburn B, Moodie M, et al. Prevalence of class-I, class-II and class-III obesity in Australian adults between 1995 and 2011–12. Obes Res Clin Pract. 2015;9:553–62.

    Article  Google Scholar 

  22. 22.

    Peeters A, Magliano DJ, Backholer K, Zimmet P, Shaw JE. Changes in the rates of weight and waist circumference gain in Australian adults over time: a longitudinal cohort study. BMJ Open. 2014;4:e003667.

    Article  Google Scholar 

  23. 23.

    Hayes A, Gearon E, Backholer K, Bauman A, Peeters A. Age-specific changes in BMI and BMI distribution among Australian adults using cross-sectional surveys from 1980 to 2008. Int J Obes. 2015;39:1209–16.

    CAS  Article  Google Scholar 

  24. 24.

    Jia H, Lubetkin EI. The impact of obesity on health-related quality-of-life in the general adult US population. J Public Health (Bangk). 2005;27:156–64.

    Article  Google Scholar 

  25. 25.

    Sach T, Barton G, Doherty M, Muir K, Jenkinson C, Avery A. The relationship between body mass index and health-related quality of life: comparing the EQ-5D, EuroQol VAS and SF-6D. Int J Obes. 2007;31:189–96.

    CAS  Article  Google Scholar 

  26. 26.

    Sendi P, Brunotte R, Potoczna N, Branson R, Horber FF. Health-related quality of life in patients with class II and class III obesity. Obes Surg. 2005;15:1070–6.

    Article  Google Scholar 

  27. 27.

    Walter S, Kunst A, Mackenbach J, Hofman A, Tiemeier H. Mortality and disability: the effect of overweight and obesity. Int J Obes. 2009;33:1410–8.

    CAS  Article  Google Scholar 

  28. 28.

    Obesity Policy Coalition and The Global Obesity Centre. Tipping the Scales: Australian Obesity Prevention Consensus [Internet]. OPC; 2017 [cited 11th December 2017]. Available from: http://www.opc.org.au/downloads/tipping-the-scales/tipping-the-scales.pdf.

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Acknowledgements

We thank the Australian Bureau of Statistics for access to confidential unit record files pertaining to Australian Health Survey data. Dr. Lung is supported by a National Health and Medical Research Council Early Career Fellowship and the National Heart Foundation Postdoctoral Fellowship (NHMRC APP1141392). SJ is supported by an NHMRC Principal Research Fellowship (NHMRC APP1119443). Ms Killedar is supported by the Kassulke scholarship for PhD research. Dr. Tan receives funding support from the National Health and Medical Research Council Centre of Research Excellence in Early Prevention of Obesity in Childhood.

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Correspondence to Thomas Lung.

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Lung, T., Jan, S., Tan, E.J. et al. Impact of overweight, obesity and severe obesity on life expectancy of Australian adults. Int J Obes 43, 782–789 (2019). https://doi.org/10.1038/s41366-018-0210-2

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