Trends in obesity-related cardiovascular and cancer mortality in Switzerland 1995-2019: an analysis of multiple causes of death

Obesity increases cardiovascular disease (CVD) and cancer mortality risk, with prevalence rising globally over recent decades. In the United States, steep obesity increases contributed to adverse trends in obesity-related mortality and to slowing decline in overall CVD mortality, particularly among younger generations. Switzerland experienced slower obesity increases, but the contribution of obesity to mortality trends remains uncharacterized. We analyzed all adult deaths recorded in Swiss mortality statistics between 1995 and 2019. Obesity-related CVD and cancer deaths were identified using multiple cause of death approaches. Annual changes in age-standardized mortality rates were estimated via segmented regression. Age-period-cohort models assessed cohort variations. Overall, CVD mortality declined steadily while cancer mortality decline attenuated after 2005, primarily reflecting slower declines in obesity-unrelated cancer mortality. Obesity-related mortality increased from 1995 to 2005 and then decreased, while obesity-unrelated rates decreased throughout 1995-2019. These diverging trends did not slow overall CVD mortality decline. Age-period-cohort modeling revealed lower obesity-related mortality rates in younger versus older generations. In Switzerland, unlike in the United States, trends in obesity-related mortality did not slow the decline of overall CVD mortality. Obesity-related mortality rates did not increase in younger generations, highlighting the role of reduced childhood obesity prevalence and improved management of obesity-related conditions in Switzerland.