Obesity 153more at risk if obese, women are more concerned about weight than men,
and most treatment studies examine women. It has been suggested that most
problems seem to be associated with severe obesity and weights in the top
10 percent (Wooley and Wooley, 1984); however a study of 14,077 women
indicated a direct linear relationship between BMI and risk factors for heart
disease including blood pressure, cholesterol, and blood glucose (Ashton,
Nanchahal, and Wood, 2001). Similar studies have also reported a relationship
between BMI increases in the lower range of the spectrum and hyperten-
sion (National Institutes of Health, 1998), diabetes (Ford, Williamson, and
Liu, 1997; Aucott, 2008), heart attack (Willett et al., 1995), musculoskeletal
disease (Anandacoomarasamy et al., 2008), and 10 out of 17 types of
cancer (Reeves et al., 2007), and asthma in adolescents (Mamun et al., 2007;
and see Romero-Corral et al., 2006, for a systematic review of the literature).
The World Health Organization has identified obesity as one of the major
chronic diseases which increases the risk of a number of noncommunicable
diseases (such as Type 2 diabetes and high blood pressure) (Must et al., 1999).
A recent study by Masso-Gonzalez et al. (2009) estimatedthe incidence and
prevalence of diabetes in the UK general population (aged between 10 and 79)
between 1996 and 2005. While the incidence of Type 1 diabetesremained
relatively constant throughout the study period, the proportion of indi-
viduals newly diagnosed with Type 2 diabetesincreased from 46 percent
to 56 percent. This marked increase over a decade is probably largely explained
by the rise in obesity in the UK.
There is also evidence for an association between obesity and mortality
(Romero-Corral, 2006), which is shown in figure 8.2. This indicates that
increased BMI is associated with decreased life expectancy. There is, however,
some debate as to whether the link between obesity and mortality is linear
or whether in fact mildly overweight or obese people live longer than their
thinner counterparts. From this perspective, it is healthier to be overweight
than to be either thin or obese. Although some evidence points to such
a nonlinear relationship, researchers have argued that this is due to the pro-
blems with using BMI; the timing of when BMI is measured, as obesity-
induced illnesses can reduce weight loss; and the presence of confounding
variables such as smoking, alcohol intake, and other demographics which
might influence the obesity–mortality relationship (Flanders and Augestad,
2008; Romero-Corral et al., 2008; Rothman, 2008; Cooper, 2008). As a means
to address some of these methodological problems, Moore et al. (2008)
explored the impact of BMI measured 10 years prior to death in a large
cohort of 50,186 women. The results showed a direct relationship between