ORIGINAL CONTRIBUTION Years of Life Lost Due to Obesity

MANY PUBLIC HEALTH OFFIcials and organizations have tried to warn the public about the dangers of obesity. One of the strongest warnings came from the US surgeon General who stated that a failure to address overweight and obesity “could wipe out some of the gains we’ve made in areas such as heart disease, several forms of cancer, and other chronic health problems.” For a health message to be effective, it should be both understood by the recipient and the information should be perceived as relevant. In trying to convey the magnitude of the deleterious effects of obesity, investigators have presented information on the health care costs due to obesity, the relative mortality rates among obese vs nonobese persons, and the number of annual deaths that might be attributable to obesity. These messages may not be effective for individuals in the United States, who may be less interested in population-level effects. One way to quantify the individual effect is in terms of the expected number of years of life lost (YLL). The YLL is defined as the difference between the number of years a person would be expected to live if he/ she was not obese and the number of years expected to live if the person were obese. To our knowledge, only 1 study has attempted to calculate YLL estimates due to obesity. Stevens et al found that YLL estimates were greater for older than younger obese individuals. This seems counterintuitive and may be the result of the investigators restricting their analysis to a 12-year period rather than estimating YLL across the remaining life span. This may have led to marked underestimation of YLL and may have created a spurious positive correlation between baseline age and YLL. Therefore, we conducted a study estimating YLL across the entire life span to provide meaningful values. METHODS Method of Calculation The YLL due to obesity can be estimated by combining 3 types of information: an estimate of the distribution of body mass index (BMI) for each year