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Overweight, Obesity & Mortality

Review of: Adams KF, Schatzkin A, Harris TB, et al: "Overweight, obesity, and mortality in a large prospective cohort of persons 50 to 71 years old." New England Journal of Medicine. 355(8):763-778, 2006.

The Science

This report was generated by tracking the death rates of members of the American Association of Retired Persons (AARP) who provided their height and weight to the National Institute of Medicine. Their Body Mass Index, BMI, (weight in kilograms divided by the square of their height in meters) was calculated, and they were followed over a 10-year period. During this time, their death rates were tabulated. The authors of this study restricted their analysis to healthy persons who had never smoked.

Obesity was defined as a BMI of greater than 30, and overweight was a BMI of 25 to 29.9. Researchers found that death rates were significantly higher for persons at both extremes of the scale, extremely underweight and obese. Interestingly, they found that in middle age (50-60 years old), death rates were 20-40% greater for those who were merely overweight.

The Street

You are probably wondering what is the EMS perspective of this study. Well? Look at yourself in the mirror. Jump on the scale, measure your height and calculate your BMI. Surprised? What about the average BMI of your squad? For me, this was a wake-up call.

I knew that I was not obese and didn't even consider myself overweight, just a little heavy. But here are my numbers. I'm 5'8" (1.73 meters) tall and 185 lbs (83.92). My BMI is therefore 28.1. Not only am I overweight; I'm almost obese!

How can we as a healthcare profession fault our patients for not taking care of themselves, when we can't even follow simple healthy living habits like keeping our weight under control and not smoking? Who will take care of the caregivers? Are we a generation of "do as I say and not as I do"?

I'll make a deal with you. Help me to stay fit, give up my daily cigar, control my cholesterol and generally live healthy, and I'll not harp on you for missing that IV on the patient with a BMI of 40. Better yet, why don't you join me on this journey of self-improvement?

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