Impact of obesity on life expectancy among different European countries: secondary analysis of population-level data over the 1975-2012 period

OBJECTIVE: This study assesses the impact of obesity on life expectancy for 26 European national populations and the USA over the 1975-2012 period.

DESIGN: Secondary analysis of population-level obesity and mortality data.

SETTING: European countries, namely Austria, Belarus, Belgium, the Czech Republic, Denmark, Estonia, Finland, France, Hungary, Iceland, Ireland, Italy, Latvia, Lithuania, Luxembourg, the Netherlands, Norway, Poland, Portugal, the Russian Federation, Slovakia, Spain, Sweden, Switzerland, Ukraine and the UK; and the USA.

PARTICIPANTS: National populations aged 18-100 years, by sex.

MEASUREMENTS: Using data by age and sex, we calculated obesity-attributable mortality by multiplying all-cause mortality (Human Mortality Database) with obesity-attributable mortality fractions (OAMFs). OAMFs were obtained by applying the weighted sum method to obesity prevalence data (non-communicable diseases (NCD) Risk Factor Collaboration) and European relative risks (Dynamic Modeling for Health Impact Assessment (DYNAMO- HIA)). We estimated potential gains in life expectancy (PGLE) at birth by eliminating obesity-attributable mortality from all-cause mortality using associated single-decrement life tables.

RESULTS: In the 26 European countries in 2012, PGLE due to obesity ranged from 0.86 to 1.67 years among men, and from 0.66 to 1.54 years among women. In all countries, PGLE increased over time, with an average annual increase of 2.68% among men and 1.33% among women. Among women in Denmark, Switzerland, and Central and Eastern European countries, the increase in PGLE levelled off after 1995. Without obesity, the average increase in life expectancy between 1975 and 2012 would have been 0.78 years higher among men and 0.30 years higher among women.

CONCLUSIONS: Obesity was proven to have an impact on both life expectancy levels and trends in Europe. The differences found in this impact between countries and the sexes can be linked to contextual factors, as well as to differences in people's ability and capacity to adopt healthier lifestyles.