Letters Smoking v obesity

Sedentary health strategy logic

BMJ 2010; 341 doi: https://doi.org/10.1136/bmj.c5292 (Published 29 September 2010) Cite this as: BMJ 2010;341:c5292
  1. Richard Weiler, specialist registrar in sport and exercise medicine and general practitioner1
  1. 1Homerton University Hospital NHS Trust, London E9 6SR, UK
  1. rweiler{at}doctors.org.uk

    It is illogical to place so much emphasis on obesity as a leading public health concern.1 Population attributable risks suggest that physical inactivity causes about 35% of coronary heart disease, 32% of colon cancer, and 35% of type 2 diabetes.2 In another study, population attributable risks for coronary heart disease were smoking 43%, saturated fatty acid intake 13%, obesity (body mass index >30) 14%, and sedentary lifestyle 40%.3

    Increased physical activity reduces mortality by as much as smoking cessation, even in later life,4 and the comparative risk of obesity is not so clearly defined.

    A recent BMJ poll suggested that when presented with the evidence most readers (83%) understand that health strategy should focus on increasing physical activity, rather than treating obesity. Many undesirable health risks are greatly reduced by physical activity and improved fitness, even in the absence of weight loss.5

    To suggest smoking and obesity, rather than physical activity, have a comparable impact is dangerously misleading. All independent risk factors are important, but lack of physical activity and smoking are far greater public health threats than obesity.


    Cite this as: BMJ 2010;341:c5292


    • Competing interests: None declared.


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