Obesity second only to smoking: Lancet study

Public Health

14 Jul 2016

A large study published in The Lancet this week involving almost 4 million adults reports has that being overweight or obese is associated with an increased risk of premature death, second only to smoking. Here’s what the experts had to say.

Dr Lennert Veerman, is from the School of Public Health at The University of Queensland. He recently published on how a sugar tax would impact on Australian health outcomes.

“In this landmark study, the authors have shown that overweight is associated with increased mortality. By restricting the analysis to disease-free never-smokers who were followed up for at least five years, they removed much – but not all – of the bias that plagued earlier studies. The study proves that overweight is not good for health, even at an advanced age.

This confirms that the majority of Australians risk an early grave due to their weight. Diets alone are not going to fix this, and blaming individuals is stigmatizing and achieves nothing. We need to reduce waist lines across the board, and governments have to take the lead.

Healthy food needs to be available and affordable, and a junk food levy would discourage unhealthy consumption, and bring in funds to subsidize healthy food. Australia needs fruits, veggies and wholemeal bread, not sugared drinks.

Active transport – walking, cycling, public transport – has to be made easier so car use can be reduced. Australia needs footpaths and bikeways, not extra car lanes.”

Professor Sanchia Aranda is CEO, Cancer Council Australia

“This study is consistent with what we also know about the relationship between obesity and cancer. Given the unprecedented population weight gain in Australia the last 30 years, we can expect to see the number of cancers and cancer deaths related to obesity and overweight increase in the future unless we take action.

“Cancer Council estimates show around 4000 cancers diagnosed in Australia each year are related to obesity or overweight alone. Even more cancer cases are linked to poor nutrition and inadequate physical activity.

“Women are more likely to be diagnosed with a weight-related cancer. Around 2300 of the 4000 obesity-related cancer cases diagnosed annually are in females. This is partly because of the high level of association between body mass and cancers of the female breast and the endometrium. Obesity is also a major risk factor for cancers of the oesophagus, colon and kidney, in both men and women.

“Unless we improve our diets and our level of physical activity, we will see incidence of obesity and overweight-related cancers continue to increase. Cancer is already Australia’s biggest cause of premature death. Obesity is a major challenge for governments, federal, state and local, which must take some responsibility for how food is formulated, marketed and labelled and how communities can be supported in being more active. It is also important for individuals to be more aware that their weight can have a significant impact on their cancer risk.”

Associate Professor Marina Reeves is a National Breast Cancer Foundation Research Fellow at The University of Queensland 

“There had been a  need for this type of analysis due to the confusion around the ‘obesity paradox’. Some previous research had suggested that being overweight was actually better, or protective, particularly for older adults. This study removes of a lot of the ‘noise’ in previous research by excluding smokers and those with pre-existing disease.

These results show the importance of advocating for funding for preventative health services and how to manage the large proportion of Australians who are already overweight or obese and in need of assistance to manage their weight.”

Dr Lauren Ball is a NHMRC Early Career Research Fellow at the Menzies Health Institute Queensland, Griffith University

“The Lancet article clearly highlights that overweight and obesity is a major risk factor for morbidity and mortality. Given the substantial and increasing prevalence of obesity across the world, additional strategies are required to support patients to have healthy lifestyle behaviours, including eating well and exercising regularly.

This article also comes at a time where we cannot ignore the role of lifestyle behaviours on our health. Governments need to place much higher priority on supporting healthy lifestyles, including changes to health care system structures, regulating food supply and incentivising physical activity opportunities.

We need to take innovative action if we are to have an innovative outcome, and this cannot be ignored any more.”

Professor Anna Peeters is Professor of Epidemiology and Equity in Public Health at the World Health Organization Collaborating Centre for Obesity Prevention at Deakin University

“This is an important study using the largest sample so far of healthy, never smokers from around the world to demonstrate the high risks of mortality for those with obesity.

It demonstrates that for Australia and New Zealand there is an increase in the risk of dying of around one third for every increase in BMI unit after the overweight range.

With two-thirds of Australian adults overweight or obese this underscores the seriousness of current obesity rates for future life expectancy in Australia.

Obesity may lead to the first decrease in life expectancy seen in decades. Equally important is the demonstration of the impact of overweight and obesity on premature mortality.

The study estimates that if we are able to prevent overweight and obesity in Australia we would prevent 1 in 6 premature deaths.

If we needed yet another reason to step up our efforts to prevent obesity, this is it. We must see comprehensive obesity prevention policies from our government, including restrictions on unhealthy food and drink marketing, a sugary drinks tax and a national physical activity and nutrition strategy.”


Professor Tim Olds is from the Alliance for Research in Exercise Nutrition and Activity (ARENA) at the Sansom Institute, University of South Australia

“Interesting study. One weakness is the exclusion of about 60% of participants for various reasons, including the rather odd exclusion of people who have ever smoked.

In other studies, this has been shown to shift the BMI associated with the lowest mortality (longest life expectancy) towards the lower end of the spectrum.

In other words, if the study included people who had ever smoked, the “ideal” BMI would likely be higher. Exclusion of those who have ever smoked might bias the sample towards higher socio-economic status participants, and people with generally healthier habits.

The study does cast some light on, and brings into question, the so-called “obesity paradox” — the finding that overweight people live longer. You see this even in these data in the Australasian and South Asian subsets.”

These expert quotes were put together by the Australian Science Media Centre, an independent, not-for-profit service for journalists, working to improve links between the news media and the scientific community.

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