Obesity-related quality-adjusted life years lost in the U.S. from 1993 to 2008

Background: Although trends in the prevalence of obesity and obesity-attributable deaths have been examined, little is known about the resultant burden of disease associated with obesity.

Purpose: This study examined trends in the burden of obesity by estimating the obesity-related quality-adjusted life years (QALYs) lost-defined as the sum of QALYs lost due to morbidity and future QALYs lost in expected life years due to premature deaths-among U.S. adults along with differences by gender, race/ethnicity, and state.

Methods: Health-related quality-of-life data were taken from the 1993-2008 Behavioral Risk Factor Surveillance System to calculate QALYs lost due to morbidity. Age-specific mortality data were used to calculate QALYs lost due to mortality.

Results: QALYs lost due to obesity in U.S. adults have more than doubled from 1993 to 2008. Black women had the most QALYs lost due to obesity, at 0.0676 per person in 2008. This number was 31% higher than the QALYs lost in black men and about 50% higher than the QALYs lost in white women and white men. A strong and positive relationship between obesity-related QALYs lost and the percentage of the population reporting no leisure-time physical activity at the state level (r=0.71) also was found.

Conclusions: This analysis enables the overall impact of obesity on both morbidity and mortality to be examined using a single value. The overall health burden of obesity has increased since 1993 and such increases were observed in all gender-by-race subgroups and in all 50 states and the District of Columbia.