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Some evidence indicates that obese people are getting healthier. They have fewer cardiovascular risk factors than they used to, and mortality seems to be falling. Trends in disability are going in the opposite direction, however. Analysis of two routine national surveys from the US shows that disability in the over 60s is getting worse not better for people with a body mass index of at least 30. Between 1988 and 1994, 36.8% of this group reported difficulty with tasks such as walking a quarter of mile, lifting or carrying 10 lbs, standing from an armless chair, or walking up 10 steps. That figure had increased to 42.2% by the second survey carried out between 1999 and 2004 (P=0.03). The gap between obese people and others widened between the surveys, even for more serious disabilities affecting activities of daily living.
Diabetes and arthritis may be partly to blame, says a linked editorial (p 2066). While public health efforts have helped reduce cardiovascular risk factors such as smoking, high blood pressure, and abnormal serum lipids, strategies to prevent obesity related diabetes and arthritis have fallen behind. The prevalence of diabetes continues to rise, and the link between arthritis and obesity is stronger than ever.