Obesity, fat, and public health

Abstract

This issue is devoted largely to obesity. We are indebted to associate editors Debbie Lawlor and Nish Chaturvedi who have been responsible for its conception, commissioning material, reviewing the very large number of submitted manuscripts, and finally putting the issue together. The relationship between obesity and health has been subject of scientific debate for decades. Lester Breslow's paper, written in 1952 and reprinted here, demonstrates a strong relationship between obesity and all-cause mortality, with particularly strong associations with diabetes and vascular causes of death.¹ Insurance companies provided the data for investigations in this era, and it is interesting that such sources have been forgotten, but were the forerunners of the modern cohort studies. The strongest evidence that reducing weight brings health benefit is provided by insured people who were charged excess premiums because of being overweight but obtained lower ratings following weight loss—their mortality risk fell dramatically. Breslow also comments, presciently, on the increased vascular and diabetes death rates of those of ‘normal’ weight—a topic examined in Chen's paper from China where the distribution of body weight is markedly lower than in Western countries.²