Nobody ever said it would be easy to lose those extra pounds. But at the start of each year, millions of Americans make resolutions to stick to the latest sure-thing diet, exercise regime, and overall health maintenance re-boot. Some folks go to extremes, with juice cleanses, detoxes, supplements, or fasting, none of which have been shown to have any long term benefits, and many even carry some serious risks. Whether it’s a diet change or a crash and burn extreme regimen, sadly, most individuals may lose the weight temporarily, only to lose the stamina of maintaining those new year healthy habits before the first of February hits.
But new evidence shows yet another reason to make more of an effort to keep the weight off. A recent study published in JAMA Oncology looked at the already well-known issue of excess body weight (EBW) as an increased risk factor for particular cancers in each of the individual U.S. states, between 2011 and 2015. Over one in three Americans are overweight or obese, which is defined as having a BMI (body mass index, which is calculated as weight in kilograms divided by height in meters squared) of over 25. A BMI of 25-29.9 indicates that an individual is overweight; a BMI of greater than 30 indicates obesity.
The study obtained its data from self-reported BMI values from the National Health and Nutrition Examination Survey and the US Cancer Statistics database. It then calculated relative risks of several specific cancers, state by state, based on high BMI individuals. Cancers known to be associated with higher likelihood patients with higher BMI include: colorectum, esophagus, stomach, liver, gallbladder, pancreas, breast (female), uterus, ovary, kidney, thyroid, and multiple myeloma.
It is estimated that over to 110,000 cancer cases per year in this country in adults over age 30 are attributable to EBW. The majority of these (close to 75,000) are seen in women, which translates to close to 10% of non-melanoma cancers in women being related to elevated BMI. The differences in cancer cases between genders is likely explained by particular cancers (breast, uterus, ovary) unique to women having an association and relative increased risk with EBW. (While men can develop breast cancer, breast cancer in men is not associated with EBW).
On a state-by-state basis, for men, Montana had the lowest EBW-related cancer incidence (3.9%), and Texas had the highest (6.0%). The overall EBW-related cancer incidence was nearly double in women, ranging from 7.1% in Hawaii to 11.4% in the District of Columbia. States with the highest EBW-related cancer incidence for both men and women were several in the South and Midwest, as well as Alaska and the District of Columbia. Those with the lowest incidence of EBW-related cancer cases were in the Mountain states (Nevada, Wyoming, Montana, and Colorado), New England, and Hawaii. Specific cancers demonstrating the highest EBW-related incidence in both men and women included esophageal, liver, gallbladder, and kidney.
The obesity epidemic continues to pose a grave concern, with no improvement in sight. It now affects millions of children, but fewer than half of them receive appropriate counseling, and even fewer have adequate access to care. This will only add to the ever-expanding waist band of this country, leading to higher incidence of diabetes, cardiovascular disease, and various cancers in the coming decades. Based on the recent study, up to 1 in 12 cancer cases in this country are attributable to EBW. Future strategies focusing on supporting efforts to reduce the frequency of high BMI’s and their multiple associated health burdens, as well as reducing disparities in access to care, will be steps in the right direction to reduce the major disease burden seen as a result of obesity.