Obesity, diabetes, and the moving targets of healthy-years estimation
Many studies have attempted to quantify the effect of obesity on death, fueling a sustained controversy about which levels of bodyweight can harm health.1 However, many investigators have argued that life expectancy does not capture the essence of the damage that obesity causes across a lifetime and that better long-term metrics are needed to convey risk, judge interventions, and motivate behaviour.2 In The Lancet Diabetes & Endocrinology, Steven Grover and colleagues3 model the effect of diabetes and cardiovascular disease in people who are overweight or obese and show what is intuitively known, but not often quantified, about obesity—that its effect on the number of number of healthy-years lost is far greater than its effect on total years of life.