Obesity and Unhealthy Life-Years in Adult Finns

Background: Obesity is more strongly related to morbidity and disability than to mortality. Obese individuals are thus expected to have more unhealthy life-years than normal-weight persons. The objective of the present study was to quantify the number of excess unhealthy life-years in obese individuals. Methods:Arepresentativecohortof19518Finnishmen andwomenaged20to92yearswasfollowedfor15years. Participationratewas83%.Obesitywasdefinedasabody mass index of 30.0 or higher. The number of unhealthy life-years due to premature work disability, hospitalization for coronary heart disease, and need for long-term medication was calculated per category of body mass index. Results: During the follow-up of 15 years, obese men who never smoked aged 20 to 64 years had, on average, 0.63 more years of work disability, 0.36 more years of coronary heart disease, and 1.68 more years of longterm medication use, than normal-weight counterparts. Obesewomenhad,respectively,0.52,0.46,and1.49more years from these conditions than normal weight women. The excess risks of morbidity and disability due to obesity were highest in the youngest age groups and exceeded those of mortality in all age groups. Obese men and women 65 years and older who never smoked had, respectively, 1.71 and 1.41 excess unhealthy life-years (not statistically significant) due to premature need for long-termmedicationcomparedwithnormal-weightsubjects, but no excess unhealthy life-years due to coronary heart disease. Conclusions: Obesity has a lifetime impact on disability and morbidity. A further increase in obesity will lead to an increase in unhealthy life-years and in direct and indirect health care costs.