Assessment of Excess Mortality in Obesity

Quantification of the excess mortality from all causes associated with obesity remains controversial. In this paper, 6,193 obese patients, those with a body mass index (weight (kg)/height (m)2 (BMI)) range of 25-74 kg/m2, recruited from 1961 to 1994 in DQsseldorf, Germany, were followed for a mean time of 14 (standard deviation, 8.2) years, yielding 87,179 observed patient-years. During the study period, 1,028 patients (16.6%) died. The entire cohort was grouped into approximate quartiles according to BMI: group 1, BMI from 25 to <32; group 2, BMI from 32 to <36; group 3, BMI from 36 to <40; group 4, BMI s = 40 kg/m2: The following risk ratios were estimated by means of Cox proportional hazards models using the lowest BMI group as reference category: group 2 for men, 1.02 (95 % confidence interval 0.76-1.37); for women, 1.23 (95 % confidence interval 0.96-1.58); group 3 for men, 1.50 (95 % confidence interval 1.09-2.06); for women, 1.33 (95% confidence interval 1.03-1.73); and group 4 for men, 2.10 (95 % confidence interval 1.53-2.88); for women, 2.25 (95 % confidence interval 1.78-2.84). The following standardized mortality ratios were calculated by using the respective geographic area (the Federal State of North Rhine Westphalia) as reference population: group 1 for men, 1.26 (95 % confidence interval 0.98-1.61); for women, 1.00 (95 % confidence interval 0.81-1.23); group 2 for men, 1.31 (95 % confidence interval 1.09-1.57); for women, 1.20 (95 % confidence interval 1.02-1.40); group 3 for men, 1.92 (95 % confidence interval 1.53-2.38); for women, 1.27 (95 % confidenc