Obesity in Europe: prevalence and consequences for use of medical care.

Obesity {defined herein as a body mass index (BMI) greater than 30 kg/m2} is common in middle-aged Europeans, particularly in women from Mediterranean and Eastern European countries. Epidemiological comparison shows no relationship between obesity and coronary heart disease mortality in men, but a weak association in women, which became stronger after adjustment for smoking. Within individual countries, however, increased BMI is associated with increased cardiovascular risk factors in populations across Europe. In The Netherlands, the direct annual healthcare costs associated with overweight and obesity (BMI greater than 25 kg/m2) have been calculated to be approximately 1 billion Dutch guilders, which corresponds to about 4% of total healthcare costs.