Obesity in young adulthood and later disability pension: A population-based cohort study of 366,929 Swedish men

Abstract

Obese men in Sweden are at higher risk of receiving disability pension. The relationship between BMI and disability pension is J-shaped. An important future task is to estimate the societal costs due to disability pension of obese people.

Association between obesity status in young adulthood and disability pension

“…13 The present analysis extended the previous Analyses adjusted for muscular strength (handgrip, arm flexion, leg extension), SEP, municipality, age at testing, testing center and year of testing.…”

“…Other studies on BMI and disability pension have sometimes used the WHO recommended BMI categories, 13,15 but several have mixed the normal weight with the underweight, 2,11,21 or the normal weight and the overweight, 12 complicating comparisons and potentially obscuring the nonlinear relationships. Others have just compared obese vs nonobese subjects, 22 lumping the underweight, normal weight and overweight together.…”

“…9 The influence of obesity status on productivity costs has received considerable attention. 1,10 However, many studies have been afflicted by limitations such as mixing of underweight and normal weight subjects, 2,11,12 lack of analysis of underlying causes, [13][14][15] problems with reverse causality and/ or left censoring. 11,12,15 Partly or totally mixing the underweight and normal weight categories may obscure the actual BMI (body mass index)-disability relationship, as the risk in underweight subjects appears to be distinct from the risk associated with normal weight.…”

“…11,12,15 Partly or totally mixing the underweight and normal weight categories may obscure the actual BMI (body mass index)-disability relationship, as the risk in underweight subjects appears to be distinct from the risk associated with normal weight. 13 Other studies have mixed the normal weight with the overweight category, 12 which also may lead to distortions. Furthermore, the shape of the relationship between BMI and specific causes of disability pension may differ markedly from the overall association.…”

“…Furthermore, the shape of the relationship between BMI and specific causes of disability pension may differ markedly from the overall association. 2,11 Previous studies have either not investigated this at all, 13,15 or used nonstandard obesity classification in combination with a small number of cases. 2,11 When analyzing the associations in middle-aged populations, the risk of reverse causality also increases, that is, a low/high BMI is caused by an underlying disease rather than the opposite.…”