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This week's Economist reports on the relationship between obesity and long life.

Health and longevity

Long live the fat American

Obesity may threaten life expectancy. Or maybe not

Jun 30th 2011 | NEW YORK | from the print edition

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AMERICA’S obesity epidemic is so called for a reason. Roughly one in three adults is obese. In 2008 close to 25m Americans were diabetic, according to a study published on June 25th. Nevertheless, Americans are living longer than ever. In 2007 the average life expectancy at birth was 78 years. This follows decades of progress. The question is whether obesity might change that.
National progress in life expectancy masks wide local disparities, according to a study published on June 15th and written by researchers at the University of Washington and Imperial College London. Men in Holmes County, Mississippi, for example, have a life expectancy of 65.9 years, the same as men in Pakistan and 15.2 years behind men in Fairfax, Virginia. Gaps between America’s counties have widened since the early 1980s. Most alarming, 702 counties, or 30% of those studied, saw a statistically significant decline in life expectancy for women from 2000 to 2007; 251 counties saw a statistically significant decline for men.

America’s advances on the national level, meanwhile, have lagged behind those of other developed countries. A panel at the National Research Council recently took on the task of studying longevity. For American women, a rise in life expectancy of 3.3 years from 1980 to 2007 amounted to just 60% of the gains in other rich countries.

Related topics

• United States
• Body weight
• Geriatric medicine
• Health and fitness
• Longevity and Healthy Aging

Much can be blamed on mid-century smoking habits. Obesity’s effect, however, is debated. While both Americans and Australians have ballooning bellies, Australia’s life expectancy has continued to move up nicely. Researchers at the National Research Council estimated that America’s high rates of obesity accounted for between one-fifth and one-third of its lagging life expectancy relative to other rich countries.
It is unclear whether obesity might have a greater impact in future. As medicine continues to advance, the paunchy may lead longer lives. Already, America’s most rotund citizens benefit from bypass surgery and cholesterol-lowering statins. The prevalence of high cholesterol and blood pressure among the obese in 1999-2000 was about half what it was in the early 1960s.
But medical progress may do only so much. “Obesity is being acquired at such young ages that you wonder what the limits of these technologies will be,” argues Eric Reither of Utah State University. In a paper to be published in the August issue of Health Affairs, Mr Reither, Jay Olshansky of the University of Illinois at Chicago and Yang Yang of the University of North Carolina contend that obesity threatens progress in life expectancy. Predictions based on past patterns of mortality, they say, fail to take account of trends among the young. The early onset of obesity may bring severe health problems, such as kidney failure, by the time today’s children reach adulthood.
James Vaupel, director of Duke University’s Population Research Institute, is sceptical of the argument that obesity may reverse future progress in life expectancy. More worrying, he says, is that rising obesity will lead to higher levels of disability. Mr Olshansky remains wary. “We have this hurricane that’s about to sweep across the country,” he insists, “and we can’t see it yet.”