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Studies Associate Adolescent Obesity with Premature Death

By Hugh C. McBride

Rising obesity rates among young people have been linked to increases in a wide range of negative health consequences, including diabetes, hypertension, sleep disorders, and depression. But a series of studies in recent years may have made the most direct and ominous association of all: Adolescent obesity can kill.

The Swedish Study: Overweight Teens

According to Feb. 29 article by MedPage Today staff writer Kristina Fiore, health experts with Sweden’s Karolinska Institute have determined that overweight young people face a risk of premature death that is similar to the threat posed by adolescent smoking:

Hypothesizing that both weight and smoking in late adolescence increase the risk of mortality, the researchers conducted a retrospective study of 45,920 Swedish men who had been followed for 38 years, beginning in 1969.
During the follow-up, 2,897 patients died.
The researchers found that obesity and overweight in late adolescence increased mortality risk, regardless of smoking status.
Compared with normal-weight men, the risk of mortality increased with both overweight and obesity.

“Excess risk in the overweight and obese are to a large extent driven by increased mortality due to cardiovascular causes and cancers," Dr. Martin Neoviu, one of the leaders of the Karolinska study, said in Fiore’s article.

The Harvard Study: Young Women & Obesity

The Swedish study was not the first scientific inquiry into the relationship between adolescent obesity and premature death. In 2006, researchers with the Harvard School of Public Health reported that young women who are overweight at age 18 have an increased risk of dying at a younger than average age.

A July 19, 2006 article on the Medical News Today website noted that the Harvard study was significant because it involved subjects who were born after 1945, which made the team’s findings more relevant to modern Americans.

The study, which was led by research scientist Rob van Dam, analyzed data from 102,400 women between the ages of 24 and 44. The information had been collected during the Nurses Health Study II, which began in 1989.

Highlights of the Harvard effort, as reported by Medical News Today, included the following:

The study participants reported their current height and weight, as well as their weight at age 18. They also answered questions in a number of other areas, including disease history, alcohol consumption, smoking, and exercise habits.
Follow-up questionnaires were sent to participants until July 1, 2001, or to the date of their death, whichever came first.
The results showed that women with a higher BMI at 18 consumed more alcohol, smoked more, and were less likely to engage in vigorous physical activity during adolescence.
During the 12-year follow-up period (1989-2001), in which 710 participants died, the Harvard researchers found that women with a higher BMI at age 18 had a higher risk of dying prematurely.
Women with a higher BMI during adolescence who never smoked had a significantly increased risk of premature death compared to those with a low BMI.

“This paper underscores the importance of efforts to prevent excessive weight gain in children, not only to prevent obesity but also to prevent moderate overweight,” Frank Hu, a co-author of the study, said in the Medical News article. The Harvard study was published in the July 18, 2006 issue of the Annals of Internal Medicine.

The NCI Study: Weight Gains Later in Life

Those who maintain a healthy weight throughout their teen years may have avoided the risks describe earlier in this article, but that doesn’t mean that reaching the legal drinking age – or nearing retirement age, for that matter – is any reason to stop paying attention to one’s weight.

In 2006, a study that was sponsored by the National Cancer Institute revealed that gaining too many extra pounds could raise one’s risk of dying earlier than would otherwise be expected. On Aug. 23, 2006, Washington Post writer Rob Stein reported on the NCI team’s findings:

In the hope of helping settle the question, the National Cancer Institute launched the new study, involving 527,265 men and women ages 50 to 71. The researchers asked the subjects detailed questions about their health and lifestyles, including their diet and physical activity, as well as their height and weight, including how much they weighed when they were 50.

After a decade, the researchers found that those who were moderately overweight when they were 50 were at significantly elevated risk of dying prematurely, and those who were obese were two to three times as likely. Just being overweight was not nearly as dangerous, but it still boosted the risk by 20 to 40 percent, the study found.

The response of other experts to the NCI report varied widely, with some questioning the researchers’ methodology and data analysis while others praised the effort and warned of a continued public health crisis if the warnings such as this one continued to go unheeded.

“It's a very important paper,” said JoAnn Manson of the Harvard School of Public Health, who fell into the supportive category. "The study included many members of the baby-boomer generation. So the results, unfortunately, portend a large burden of chronic disease and excess mortality in upcoming decades in that generation.”

Reducing the Risk

Regardless of the degree to which experts agree on the negative effects of overweight and obesity, the majority of healthcare professionals believe that excess weight can cause myriad problems for individuals of almost any age.

Many people have been able to achieve and maintain a healthy weight by adopting a healthy diet and exercise plan on their own, while others may benefit from enrolling in a therapeutic boarding school for overweight young people or a residential weight loss program for adults in order to pursue the healthiest possible life.

If you or someone you love is struggling with a weight-related problem, consult your primary healthcare provider or educate yourself online about the many weight loss resources that are available to you.

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