Does Obesity in Women during Adolescence Increase the Risk for Premature Death?

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The summary below is from the full report titled "The Relationship between Overweight in Adolescence and Premature Death in Women." It is in the 18 July 2006 issue of Annals of Internal Medicine (volume 145, pages 91-97). The authors are R.M. van Dam, W.C. Willett, J.E. Manson, and F.B. Hu.

What is the problem and what is known about it so far?

Researchers think that obesity during childhood and adolescence may have many bad consequences. Previous studies have suggested that obese adolescents may be at increased risk for premature death when compared with those who maintained a normal weight during that period of their lives. The problem is that previous studies regarding obesity during childhood and adolescence were done a long time ago when medical care was less sophisticated. In addition, many of the persons who took part in these studies eventually became cigarette smokers, which may have affected their life span. In view of the fact that public health and medical care have improved since the earlier studies, and because the results may have been affected by factors other than obesity, current researchers are concerned that the old data may be invalid.

Why did the researchers do this particular study?

To find out whether obesity at age 18 years was associated with a higher risk for death during early adulthood and middle age.

Who was studied?

102,400 U.S. female nurses who participated in the Nurses' Health Study II and who were 24 to 44 years old at the start of the study in 1989.

How was the study done?

When the participants first entered the Nurses' Health Study II in 1989, each reported her current weight and height as well as her weight at age 18 years. The researchers then calculated the participant's body mass index (BMI). Body mass index is a calculation that relates a person's weight to height and judges it to be low, normal, overweight, or obese according to standards of normality agreed to by most doctors. The researchers then found out how many of the participants had died during the 12-year period of observation after they had entered the Nurses' Health Study and determined the cause of death.

What did the researchers find?

During the 12-year follow-up, there were 710 deaths. Women with a low BMI at age 18 years had no extra risk for death when compared with those who were of normal weight, but a higher-than-normal BMI at age 18 years was associated with a higher risk for death. Although smokers in all BMI categories were at greater risk for death than nonsmokers, adjusting for smoking status did not eliminate the risk for death associated with obesity at age 18 years. Causes of death during follow-up in those with elevated BMI at age 18 years included cancer, cardiovascular disease, and suicide.

What were the limitations of the study?

The researchers could not be certain that they had accounted for all of the other possible causes for their findings other than obesity. In addition, they had to rely on the participants' recall of their weight at age 18 years.

What are the implications of the study?

Obesity during adolescence can have an adverse effect on health many years later.

Read all Rapid Responses

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Annals Online, 31 Jul 2006 [Full text]