Obsesity Threatens to Reverse Growth in U.S. Life Spans

BOSTON, March 16 - For the first time in two centuries, a generation of children in America may have shorter life expectancies than their parents, according to a report that contends that the rapid rise in childhood obesity, if left unchecked, may shorten life spans by as much as five years.

The report, to be published on Thursday in the New England Journal of Medicine, says that the prevalence and severity of obesity is so great, especially in children, that associated diseases and complications - like type 2 diabetes, heart disease, kidney failure and cancer - are likely to strike people at younger and younger ages.

The report says that the average life expectancy of today's adults, now roughly 77 years, is at least four to nine months shorter than it would be if there were no obesity. That means that obesity is already shortening average life spans by a greater rate than accidents, homicides and suicides combined, the authors say.

And they say that because of obesity, the children of today may wind up living two to five years less than they otherwise would, a negative effect on life span that could be greater than that caused by cancer or coronary heart disease.

"Obesity is such that this generation of children could be the first basically in the history of the United States to live less healthful and shorter lives than their parents," said Dr. David S. Ludwig, director of the obesity program at Children's Hospital Boston and one of the authors of the report.

Longevity projections are notoriously slippery and politically charged, with consequences for issues like Social Security, corporate pension plans, health insurance and health care costs. The New England Journal report, which wades into several controversial aspects of public health, is likely to stir debate on both scientific and political grounds.

For one, some demographers and obesity experts question whether the authors' estimate is overly alarmist.

"Yes, it is almost certain that the risks of these various disease will rise as obesity rises in the population, but you also have to assume that the medical sciences will get better at treating some of these complications," said Dr. Rudolph L. Leibel, an obesity researcher at Columbia University. "Certainly doing that is going to end up costing more, but it may not end up stripping months or years off life."

An editorial in the same issue of the New England Journal, written by Dr. Samuel H. Preston, a demographer at the University of Pennsylvania, raises similar questions. It suggests that the predictions of decreased life expectancy might be "excessively gloomy," given potential advances in medicine and genetic engineering, and the reduction of harmful behaviors like smoking.

Dr. Preston concludes, however, that "the rising prevalence and severity of obesity are capable of offsetting the array of positive influences on longevity" and "are already reducing life expectancy among the U.S. population." "A failure to address the problem could impede the improvements in longevity that are otherwise in store," he wrote.

The report's lead author, Dr. S. Jay Olshanky, a professor of public health at the University of Illinois at Chicago, said he considered the report's projections of reduced life expectancy to be "very conservative, and I think the negative effect is probably greater than we have shown."

He said he believed that it was a mistake to count on medical advancements or to "make forecasts based on technologies that do not exist."

"Hopefully we can fix obesity so that our projections are wrong," Dr. Olshansky said. "But we're seeing such large increases in obesity in the last couple of decades that it's hard to imagine that we're going to be able to work fast enough to attenuate this problem."

"We're in the quiet before the storm," he said. "It's like what happens if suddenly a massive number of young children started chain smoking. At first you wouldn't see much public health impact - you'd see some kids with smoker's cough and increased asthma. But years later it would translate into emphysema, heart disease and cancer, and if you waited until mortality rates increased, it would be too late to stop the impact."

He added: "That's very much like obesity. There is an unprecedented increase in prevalence of obesity at younger and younger ages without much obvious public health impact. But when they start developing heart attack, stroke, kidney failures, amputations, blindness and ultimately death at younger ages, then that could be a huge effect on life expectancy."

Estimating the number of obesity-related deaths has already proved controversial. Last November, the federal Centers for Disease Control and Prevention said its earlier estimate that 400,000 people dieannually from obesity was inflated. A revised, lower estimate is expected soon.

The New England Journal report uses an estimate of 300,000 deaths, which some experts believe is still too high. The report projected life expectancy by calculating how much longer people would live if "everyone who is currently obese were to lose enough weight to obtain an optimal" body-mass index, a measure of the relationship between a person's height and weight. The authors believe it is more accurate than other projections, which are based on extrapolating from past years' health information.

The report comes at a time when the country is embroiled in a debate over Social Security. And while the report's authors say they started their research long before the current debate, they write that "the U.S. population may be inadvertently saving Social Security by becoming more obese" and dying sooner, but that "this 'benefit' will occur at the expense of the economy in the form of lost productivity before citizens reach retirement and large increases in Medicare costs associated with obesity and its complications."

The authors also have a clear view that the way to combat obesity is to get people to change their behavior, a prescription that not everyone believes is feasible. Dr. Ludwig espouses an ambitious program that would include getting food companies not to advertise soft drinks and other unhealthy foods to children, giving schools more money so they could serve healthy lunches and enhance physical education, and getting insurance companies to cover treatment for obesity.

"It's premature to jump to the conclusion that that's the strategy we need," said Dr. Donna Stroup, director of the coordinating center for health promotion at the Centers for Disease Control. Still, Dr. Stroup said, the New England Journal paper is "very important to us in the sense of building scientific background about what we already know about obesity."

"What it does is to put what we know in a language that is very compelling," she said.

You're right. We all have our little indulgences. Mine is my pipe and occassional cigars. There's a risk, yes. I accept the risk, and derive pleasure from these things. Cigarettes are a much higher risk, but if someone enjoys that, who am I to preach at them, considering I too use tobacco? For others, it's candy, and for still others, it's the (hopefully only) occasional adult beverage.

Still, the bigger we are, the more volume we occupy. The more pressure on our arteries. The more cells to potentially mutate into devastating neoplasms. We all have to weigh (no pun intended) the risk against the vice.

And I'd wager they were better tasting, too. Smaller quantities, higher quality.

Seemed so at the time. But even today, the first three spoons of chocolate ice cream are the best. The rest of the pint is unnecessary. :-)
Better when shared with the rest of the family.

Must be all those 'obese' running backs. How CAN a guy weigh that much and only be 5-10? CDC is working 24/7 on the problem.

Your government at work.

Blame xBox and scooters. I can't understand why kids would want to sit in front of a TV for 6 hours a day. I did my share of TV watching, and I ate biscuits and gravy and bacon, but I was outside until it was dark playing army or indians or something. I didn't have a nintendo until 8th grade when I bought it with Christmas money, and even then it was just for boring nights and rainy days. There is no secret to preventing obesity. The issue's complexity is blown way out of proportion. It's ALL about exercise.

A hamburger was more likely to be 3 oz. than the 8-12 oz. ones we see today.

Less.

McDonalds used (and still uses) 10 burgers per pound of meat. Ray Kroc said that he wanted to simplify inventory; 100 buns = 10 lb = $15 in sales.
After Dave Thomas (Wendy's) introduced the 1/4 lb patty as the "standard", McD had to counter with it's Quarter-pounder®

McDonalds used (and still uses) 10 burgers per pound of meat.

I believe that. And it seems like a reasonable portion to me. I haven't had many McD's, but their regular burger always seemed like enough. Esp. if one adds a side (not Super-Sized!)

you should watch that movie... supersize me. obesity should not be treated as a joke. i see parents let there children eat unhealthy processed foods, sit on there arse, watch mind numbing TV, then wonder why they have ADHD, and increased health risk problems. please. parents know the problem stems from their behaviour, and as a nation of lazy fat couch potatoes, too afraid to get off there arse and do the hard work... you deserve your arteries to be clogged and for your child to cry on your shoulder because noone likes him because he smells from being so fat. can't walk let alone run... this is not a joke. healthy = happy.

I agree that obesity is not a joke. But I don't think it's a reason to turn child-rearing over to the gov't.
I didn't see that movie, because my understanding of the movie is that it tries to make McD's look responsible for this guy's weight gain, and that's just not true.

If we can't each be responsible for our own life and health, then our country is doomed. I'm not ready to go there.

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