The Silent Killer: How Obesity Can Be as Bad as Smoking (or worse!)

The Silent Killer: How Obesity Can Be as Bad as Smoking (or worse!)

February 14, 2024

In the ongoing debate between smoking and obesity, the scale of health risks has long been contested. Both habits are known to be detrimental to health, but which poses a greater threat? Recent research sheds light on this question, suggesting that obesity might be as bad as, if not worse than, smoking in terms of health consequences.

Smoking, long recognized as a leading cause of preventable death worldwide, is linked to a myriad of health problems, including lung cancer, heart disease, body-wide premature aging, and respiratory issues. The harmful effects of smoking have been extensively studied and publicized, leading to widespread awareness campaigns, US Surgeon General warnings, and smoking cessation programs like the Great American Smokeout held every November. Health insurance companies even use smoking status along with age and gender to set monthly premium rates for individual policies. 

However, obesity, once considered solely a matter of aesthetics, is increasingly recognized as a significant health concern. The link between obesity and various chronic diseases, such as diabetes, hypertension, arthritis, cardiovascular disease and sleep apnea, is now well-established. Moreover, like smoking, obesity is clearly associated with an increased risk of premature death and a decreased quality of life.

A research brief by the RAND Corporation highlights the staggering health and economic costs associated with obesity. According to the brief, obesity-related medical spending in the United States reached an estimated $173 billion in 2019; medical costs for adults who had obesity were $1,861 higher than medical costs for people with healthy weight. Additionally, obesity is associated with lower productivity and higher absenteeism in the workforce, further straining families and economies.

Comparing the health risks of smoking and obesity, a study published by Verywell Health explores the potential impacts on life expectancy. While smoking has long been recognized as a leading cause of premature death, the study suggests that severe obesity (defined as a body mass index of 35 or higher) may have a similar or even greater impact on life expectancy. The study found that severely obese individuals may lose 8-10 years of life expectancy, comparable to the impact of smoking.

Moreover, the study highlights the synergistic effects of smoking and obesity on health outcomes. Individuals who smoke and are obese face significantly higher risks of developing chronic diseases and experiencing premature death than those who only smoke or are only obese.

These findings underscore the urgent need for comprehensive strategies to address both smoking and obesity as public health priorities. Efforts to reduce smoking rates, such as tobacco control policies, smoking cessation programs, and public awareness campaigns, have made significant strides in improving public health; in the past 20 years smoking prevalence has decreased from 21% of adults to 12%. In comparison, initiatives to combat obesity are failing disastrously. 

Although efforts at promoting healthy lifestyles, improving access to nutritious foods, and encouraging regular physical activity have helped some individuals, obesity prevalence rates are zooming upwards. Over the last 20 years, US obesity rates have climbed from 30% to 42%. The average US woman now weighs over 170 lbs, which is 50 lbs above the recommended amount for the average height woman; the average US man now weighs 200 lbs with a 41 inch waist – we know cardiovascular disease skyrockets above a 37 inch waistline (belly button circumference). 

In conclusion, while smoking and obesity are both significant health concerns, current evidence suggests that obesity might be as bad as, if not worse than, smoking in terms of health consequences, especially in light of the opposing prevalence trendlines. The detrimental effects of obesity on life expectancy, chronic disease burden, and healthcare costs underscore the importance of addressing obesity as a pressing public health issue. By implementing comprehensive strategies to prevent and manage obesity at a system level, and offering individual therapy options beyond self-care such as dietician referrals, medications, or surgery, we can work towards a healthier future for both individuals and communities.