Health Effects of Overweight and Obesity in 195 Countries

Ashkan Afshin; Marissa Bettay Reitsma; Christopher J L Murray

doi:10.1056/nejmc1710026

Cited by 219Obesity, Physical Activity, DietDiabetes, Cardiovascular Risks, and LipoproteinsBody Composition Measurement Techniques

Health Effects of Overweight and Obesity in 195 Countries

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Ashkan Afshin, Marissa Bettay Reitsma, Christopher J L Murray·2017·New England Journal of Medicine

DOI 10.1056/nejmc1710026

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Abstract

Health Effects of Overweight and Obesity in 195 CountriesTo the Editor: The Global Burden of Disease (GBD) collaborators (July 6 issue) 1 report that more than two thirds of deaths related to high body-mass index (BMI) were due to cardiovascular disease, which suggests that BMI-defined obesity has a major effect on cardiovascular disease.Some readers may wonder whether the perceived burden of obesity could have been even larger if an accurate measure of body fat, instead of BMI, had been used.Data from the Aerobics Center Longitudinal Study, involving 30,000 persons assessed with a state-of-the-art method to determine adiposity, suggest that this may not be the case. 2 We observed that BMI had a significantly higher discriminating capacity than bodyfat percentage or fat-mass index for predicting mortality from cardiovascular disease, and our study provided a physiological explanation for this finding.Our data also strongly support the use of BMI for defining obesity at an epidemiologic level, particularly in relation to mortality from cardiovascular disease.Furthermore, these findings suggest that obesity may be defined as an excess of body weight according to height (high BMI), rather than as an excess of body fat (high body-fat percentage or fat-mass index), as is generally stated.3

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Although obesity is theoretically reversible and addressing it could provide the biggest opportunity to limit the advance of diabetes, current trends suggest that obesity rates are likely to continue to climb.
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From Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of Disease Study 2021 (2023) · cites this paper as [51]

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Authors: Afshin, A., Reitsma, M. B., & Murray, C. J. L.
Affiliations: Institute for Health Metrics and Evaluation (US)
ORCID: Marissa Bettay Reitsma
Venue: New England Journal of Medicine
Publisher: Massachusetts Medical Society
Published: 2017-10-12
Volume: 377
Issue: 15
Pages: 1495-1497
ISSN: 0028-4793 (ISSN-L)
1533-4406
DOI: 10.1056/nejmc1710026
OpenAlex: W2766120686
Cited by: 219
References: 12
Citations by year: 2026: 9 · 2025: 19 · 2024: 29 · 2023: 38 · 2022: 31 · 2021: 21 · 2020: 35 · 2019: 26 · 2018: 7 · 2017: 2
Type: journal article
Language: en
Open access: green
serval.unil.ch
Licence: other-oa
Locations: New England Journal of Medicine (publishedVersion)
PubMed (publishedVersion)
SERVAL (Université de Lausanne) (publishedVersion, other-oa)
IRIS (submittedVersion)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
Keywords: obesity, overweight, body mass index, cardiovascular mortality, body fat percentage, fat mass index, adiposity measurement, obesity definition, global burden of disease
MeSH terms: Cross-Sectional Studies, Developing Countries, Humans, Obesity, Body Mass Index, Prevalence, Overweight

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Health Effects of Overweight and Obesity in 195 Countries

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