Obesity’s Final Toll: Influence on Mortality Rate, Attributable Deaths, Years of Life Lost and Population Life Expectancy

  • K. R. Fontaine
  • S. W. Keith
  • J. A. Greenberg
  • S. J. Olshansky
  • D. B. Allison
Reference work entry


 Obesity is recognized as a contributor to health maladies and premature death for millennia and, given the worldwide increase in the prevalence of obesity, is currently one of the greatest public health challenges of the twenty-first century. Apart from obesity’s association with diseases in virtually every major organ system, it also adversely affects quality of life, and appears to have a marked effect on duration of life. That is obesity, herein defined as “excess” of body fat, probabilistically threatens future health and longevity. In this chapter we review the association of obesity to indices of mortality, including: (1) mortality rate (MR), (2) attributable deaths, (3)  years of life lost (YLL) and (4) population life expectancy. Overall, there appears to be a J- or U-shaped association between body weight and mortality rate. The extent to which the elevated mortality rate with low BMIs represents causation or merely association remains the subject of debate and inquiry. The (presumed causal) association of obesity with elevated mortality rate translates into a substantial number of  obesity-attributable deaths and reduced life expectancy. There are several methodological and statistical issues involved in estimating the effect of obesity on indices of longevity. Among these issues are  reverse causation,  confounding, confounding by indication,  regression dilution, secular changes in the true effects of obesity on mortality, accounting for uncertainty, and choosing reference categories and cut-points. We review these issues and offer suggestions for future research.


Body Mass Index Reverse Causation Body Mass Index Category Body Mass Index Group Body Mass Index Level 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

List of Abbreviations:


bioelectric impedance analysis


 body mass index


cardiovascular disease


fat-free mass


fat mass


 hazard ratios


Institute of Medicine


mortality rate


First National Health and Nutrition Examination Survey


Second National Health and Nutrition Examination Survey


Third National Health and Nutrition Examination Survey


NHANES II mortality study


NHANES I epidemiological follow-up study


United States


waist circumference


waist-to-hip ratio


years of life lost


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Copyright information

© Springer Science+Business Media LLC 2010

Authors and Affiliations

  • K. R. Fontaine
  • S. W. Keith
  • J. A. Greenberg
  • S. J. Olshansky
  • D. B. Allison

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