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Fat chance for morality

The seemingly inexorable increase in life expectancy observed over the last century may be about to stop. Some commentators are going even further. Earlier this year, Professor Claude Bouchard, president of the International Society for the Study of Obesity, stated: “I suspect that within a short period of time we will begin to see a reduction in life expectancy.”

Over the last 30 years there has been a sustained decline in the number of deaths from heart disease in the US. This decline now appears to be grinding to a halt, which is being attributed to the increased prevalence of obesity and associated heart problems this can lead to.

This is far from a minor issue. The US Centers for Disease Control and Prevention have estimated that 400,000 deaths occur in the US each year as a result of poor dietary habits and physical inactivity. To put that into perspective, the CDC estimates that there are 435,000 deaths a year related to smoking. In the US, obesity is poised to overtake smoking as the leading preventable cause of death.

In the UK, around two-thirds of the population are now overweight or obese. The position in the US is similar. Obesity has rapidly emerged as a significant issue. While the proportion of the adult population that is overweight but not obese has remained relatively stable, the proportion that is obese has more than doubled to over 30 per cent since the 1960s.

Obesity is not confined to the adult population. Although a lower proportion of the teenage population are obese in absolute terms, the development of obesity has been much more rapid, trebling over the same time period to around 15 per cent.

In the US, obesity is now more prevalent in children and adolescents than smoking was 30 to 40 years ago. Over the last 20 years, the increase in obesity has more than offset the reduction in smoking.

The development of obesity has been so rapid that we are likely to be seeing only the early impact of it in terms of actual deaths. Deaths from lung cancer peaked almost 30 years after smoking began to reduce in popularity. If there is a similar lag between poor dietary habits and future heart disease mortality, then even if the spread of obesity can be halted now, the full impact is unlikely to be felt for another 30 years.

The implications for an obese individual are grave. A non-smoking, obese 40-year-old can expect to die around seven years earlier than their normal-weight counterpart. Obesity does not simply reduce life expectancy, it increases the likelihood of dying at all ages. An obese 40-year-old is twice as likely to die before age 70 as a normal -weight person.

Although weight loss in later life can help offset some of the effects, it does not appear that it will completely reverse it. At least some of the damage has already been done. A temporary period of obesity will permanently reduce a person&#39s life expectancy.

As with life-shortening medical conditions and smoker/non-smoker status, weight – or rather an individual&#39s body mass index – is increasingly being used as an input to financial services companies&#39 pricing models. The results can be dramatic. A clinically obese diabetic could increase their annuity income by around one-quarter merely by disclosing their height, weight and diabetes details. Not all companies will take into account these factors, emphasising the importance of obtaining independent advice and utilising the open-market option.

There are many parallels between obesity and smoking, separated by around 30 to 40 years. Both involve a degree of personal choice. Neither was viewed as socially unacceptable. Medical evidence emerged linking both to premature death. Both became factors impacting on the price of financial services products. Both the tobacco and food industries have been subjected to increased labelling requirements. The industries have developed low-tar and low-fat variants of their products.

Potentially, we are now at the point where the paths may diverge. Thirty years ago saw the start of a sharp decline in cigarette consumption. This was a decade after the health risks of smoking had been made public and coincided with non-smokers&#39 rights movements coming to prominence.

Obesity does not have the equivalent third-party impact of passive smoking. Obesity may not galvanise the equivalent social pressure that non-smoker groups generated. This, coupled with concerns over protecting the rights of the individual to choose (to eat and not exercise), means there is a real risk that society will be ineffective in curbing obesity.

Scott Dolfi is chief executive at GE Life


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