Fat distribution of overweight persons in relation to morbidity and subjective health

The association between fat distribution, morbidity and subjective health was studied in 95 overweight adult men and 210 overweight adult women. Retrospective morbidity data were taken from a continuous morbidity registration made by general practitioners over a period of maximally 17 years. In addition information about subjective health and weight history was obtained from a self-administered questionnaire. Anthropometric measurements were taken and, on the basis of waist-hip and waist-thigh circumference ratios, subjects were classified into upper body segment obesity, intermediate obesity, and lower body segment obesity. It was found that, adjusted for age and body mass index, a high waist-thigh circumference ratio was a risk factor for hypertension and for gout or diabetes in women and arthrosis in men. A low waist-thigh ratio was associated with a high prevalence of varicose veins in women. The associations of waist-hips circumference ratio with morbidity were less pronounced, with the exception of hypertension in men. Information from the questionnaire revealed that persons with upper body segment obesity (especially men) felt less healthy and had more health complaints. These findings were more pronounced for subjects less than 50 years of age than for those of 50 years and older. The weight histories suggest that women with lower body segment obesity had a longer history of obesity than women with upper body segment obesity. This was not found in men. It is concluded that classification of obesity on the basis of circumference ratios is useful for the evaluation of health hazards of overweight subjects.