Implications of obesity in exceptional longevity

Except for the world’s poorest regions, it is estimated that global obesity [body mass index (BMI) >30 kg/m2] prevalence will reach 18% (men) and >21% (women) by 2025 (1). Recent nationally representative surveys in the US for the 2013–2014 period indicate age-adjusted obesity prevalence of 35.0% and 40.4% among adult men and women, respectively (2) and of 17.0% for children and adolescents aged 2–19 years (3). On the other hand, because healthy life expectancy also shows global improvement, the world is becoming apparently heavier and healthier (4). This finding is paradoxical given the association of obesity, and especially severe/morbid obesity, and/or its metabolic consequences with all-cause mortality as well as with a broad range of diseases and health complaints (5). In fact, recent data suggest that life expectancy will start to decline in the US over this century. Accordingly, we could be approaching a tipping point where technological and medical care advances might no longer compensate for our poor lifestyle habits (6)