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Medical Updates: Weight and America

Nearly two-thirds of adults in the
United States are overweight, and 30.5 percent are obese, according to data from the 1999-2000 National
Health and Nutrition Examination Survey (NHANES). This
fact sheet presents statistics on the prevalence of
overweight and obesity in the U.S., as well as their
disease, mortality, and economic costs. To understand
these statistics, it is necessary to know how overweight
and obesity are defined and measured. This fact sheet
also explains why statistics from different sources may
not match.
Overweight and obesity are known risk factors for:
-
diabetes
-
heart disease
-
stroke
-
hypertension
-
gallbladder disease
-
osteoarthritis (degeneration of
cartilage and bone of joints)
-
sleep apnea and other breathing
problems
-
some forms of cancer (uterine,
breast, colorectal, kidney, and gallbladder)
Obesity
is also associated with:
-
high blood cholesterol
-
complications of pregnancy
-
menstrual irregularities
-
hirsutism (presence of excess body
and facial hair)
-
stress incontinence (urine leakage
caused by weak pelvic-floor muscles)
-
psychological disorders such as
depression
-
increased surgical risk
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What are overweight and obesity? |
Overweight refers to an excess of body weight
compared to set standards. The excess weight may
come from muscle, bone, fat, and/or body water.
Obesity refers specifically to having an
abnormally high proportion of body fat.[1]
A person can be overweight without being obese,
as in the example of a bodybuilder or other
athlete who has a lot of muscle. However, many
people who are overweight are also obese.
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How are
overweight and obesity measured? |
A number of methods are used to determine if
someone is overweight or obese. Some are
based on the relation between height and
weight; others are based on measurements of
body fat. The most commonly used method
today is body mass index (BMI).
BMI can be used to screen
for both overweight and obesity in adults.
It is the measurement of choice for many
obesity researchers and other health
professionals, as well as the definition
used in most published information on
overweight and obesity. BMI is a calculation
based on height and weight, and it is not
gender-specific. BMI does not directly
measure percent of body fat, but it is a
more accurate indicator of overweight and
obesity than relying on weight alone.
BMI is found by dividing a
person’s weight in kilograms by height in
meters squared. The mathematical formula is:
weight (kg) /
height squared (m²).
To determine BMI using
pounds and inches, multiply your weight in
pounds by 704.5,* then divide the result by
your height in inches, and divide that
result by your height in inches a second
time.
* The multiplier 704.5
is used by the National Institutes of
Health. Other organizations may use a
slightly different multiplier; for example,
the American Dietetic Association suggests
multiplying by 700. The variation in outcome
(a few tenths) is insignificant.
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Body Mass Index Table
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To use the table, find the appropriate height in
the left-hand column labeled Height. Move across
to a given weight. The number at the top of the
column is the BMI at that height and weight.
Pounds have been rounded off. |
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|
BMI |
19 |
20 |
21 |
22 |
23 |
24 |
25 |
26 |
27 |
28 |
29 |
30 |
31 |
32 |
33 |
34 |
35 |
36 |
37 |
38 |
39 |
40 |
Weight
(Pounds) |
|
Height (Inches) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
58 |
91 |
96 |
100 |
105 |
110 |
115 |
119 |
124 |
129 |
134 |
138 |
143 |
148 |
153 |
158 |
162 |
167 |
172 |
177 |
181 |
186 |
191 |
|
59 |
94 |
99 |
104 |
109 |
114 |
119 |
124 |
128 |
133 |
138 |
143 |
148 |
153 |
158 |
163 |
168 |
173 |
178 |
183 |
188 |
193 |
198 |
|
60 |
97 |
102 |
107 |
112 |
118 |
123 |
128 |
133 |
138 |
143 |
148 |
153 |
158 |
163 |
168 |
174 |
179 |
184 |
189 |
194 |
199 |
204 |
|
61 |
100 |
106 |
111 |
116 |
122 |
127 |
132 |
137 |
143 |
148 |
153 |
158 |
164 |
169 |
174 |
180 |
185 |
190 |
195 |
201 |
206 |
211 |
|
62 |
104 |
109 |
115 |
120 |
126 |
131 |
136 |
142 |
147 |
153 |
158 |
164 |
169 |
175 |
180 |
186 |
191 |
196 |
202 |
207 |
213 |
218 |
|
63 |
107 |
113 |
118 |
124 |
130 |
135 |
141 |
146 |
152 |
158 |
163 |
169 |
175 |
180 |
186 |
191 |
197 |
203 |
208 |
214 |
220 |
225 |
|
64 |
110 |
116 |
122 |
128 |
134 |
140 |
145 |
151 |
157 |
163 |
169 |
174 |
180 |
186 |
192 |
197 |
204 |
209 |
215 |
221 |
227 |
232 |
|
65 |
114 |
120 |
126 |
132 |
138 |
144 |
150 |
156 |
162 |
168 |
174 |
180 |
186 |
192 |
198 |
204 |
210 |
216 |
222 |
228 |
234 |
240 |
|
66 |
118 |
124 |
130 |
136 |
142 |
148 |
155 |
161 |
167 |
173 |
179 |
186 |
192 |
198 |
204 |
210 |
216 |
223 |
229 |
235 |
241 |
247 |
|
67 |
121 |
127 |
134 |
140 |
146 |
153 |
159 |
166 |
172 |
178 |
185 |
191 |
198 |
204 |
211 |
217 |
223 |
230 |
236 |
242 |
249 |
255 |
|
68 |
125 |
131 |
138 |
144 |
151 |
158 |
164 |
171 |
177 |
184 |
190 |
197 |
204 |
210 |
216 |
223 |
230 |
236 |
243 |
249 |
256 |
262 |
|
69 |
128 |
135 |
142 |
149 |
155 |
162 |
169 |
176 |
182 |
189 |
196 |
203 |
210 |
216 |
223 |
230 |
236 |
243 |
250 |
257 |
263 |
270 |
|
70 |
132 |
139 |
146 |
153 |
160 |
167 |
174 |
181 |
188 |
195 |
202 |
209 |
216 |
222 |
229 |
236 |
243 |
250 |
257 |
264 |
271 |
278 |
|
71 |
136 |
143 |
150 |
157 |
165 |
172 |
179 |
186 |
193 |
200 |
208 |
215 |
222 |
229 |
236 |
243 |
250 |
257 |
265 |
272 |
279 |
286 |
|
72 |
140 |
147 |
154 |
162 |
169 |
177 |
184 |
191 |
199 |
206 |
213 |
221 |
228 |
235 |
242 |
250 |
258 |
265 |
272 |
279 |
287 |
294 |
|
73 |
144 |
151 |
159 |
166 |
174 |
182 |
189 |
197 |
204 |
212 |
219 |
227 |
235 |
242 |
250 |
257 |
265 |
272 |
280 |
288 |
295 |
302 |
|
74 |
148 |
155 |
163 |
171 |
179 |
186 |
194 |
202 |
210 |
218 |
225 |
233 |
241 |
249 |
256 |
264 |
272 |
280 |
287 |
295 |
303 |
311 |
|
75 |
152 |
160 |
168 |
176 |
184 |
192 |
200 |
208 |
216 |
224 |
232 |
240 |
248 |
256 |
264 |
272 |
279 |
287 |
295 |
303 |
311 |
319 |
|
76 |
156 |
164 |
172 |
180 |
189 |
197 |
205 |
213 |
221 |
230 |
238 |
246 |
254 |
263 |
271 |
279 |
287 |
295 |
304 |
312 |
320 |
328 |
An expert panel convened by the National Heart,
Lung, and Blood Institute (NHLBI) in cooperation
with the National Institute of Diabetes and
Digestive and Kidney Diseases (NIDDK), both part
of the National Institutes of Health (NIH)
identified overweight as a BMI of 25–29.9 kg/m²,
and obesity as a BMI of 30 kg/m² or greater.
However, overweight and obesity are not mutually
exclusive, since people who are obese are also
overweight.[1] Defining overweight as a BMI of
25 or greater is consistent with the
recommendations of the World Health Organization
<[2] and most other countries.
Calculating BMI is simple,
quick, and inexpensive—but it does have
limitations. One problem with using BMI as a
measurement tool is that very muscular people
may fall into the “overweight” category when
they are actually healthy and fit. Another
problem with using BMI is that people who have
lost muscle mass, such as the elderly, may be in
the “healthy weight” category—according to their
BMI—when they actually have reduced nutritional
reserves. BMI, therefore, is useful as a general
guideline to monitor trends in the population,
but by itself is not diagnostic of an individual
patient’s health status. Further evaluation of a
patient should be performed to determine his or
her weight status and associated health risks.
For more information on
measuring overweight and obesity, see Weight and
Waist Measurement: Tools for Adults.
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Why do statistics about overweight and obesity
differ? |
The definitions or measurement characteristics
for overweight and obesity have varied over
time, from study to study, and from one part of
the world to another. The varied definitions
affect prevalence statistics and make it
difficult to compare data from different
studies. Prevalence refers to the total number
of existing cases of a disease or condition in a
given population at a given time. Some
overweight- and obesity-related prevalence rates
are presented as crude or unadjusted estimates,
while others are age-adjusted estimates.
Unadjusted prevalence estimates are used to
present cross-sectional data for population
groups at a given point or time period. For
age-adjusted rates, statistical procedures are
used to remove the effect of age differences in
populations that are being compared over
different time periods. Unadjusted estimates and
age-adjusted estimates will yield slightly
different values.
Previous studies in the United
States have used the 1959 or the 1983
Metropolitan Life Insurance tables of desirable
weight-for-height as the reference for
overweight.[3] More recently, many Government
agencies and scientific health organizations
have estimated overweight using data from a
series of cross-sectional surveys called the
National Health Examination Surveys (NHES) and
the National Health and Nutrition Examination
Surveys (NHANES). The National Center for Health
Statistics (NCHS) of the Centers for Disease
Control and Prevention (CDC) conducted these
surveys. Each had three cycles: NHES I, II, and
III spanned the period from 1960 to 1970, and
NHANES I, II, and III were conducted in the
1970’s, 1980’s, and early 1990’s. Since 1999,
NHANES has become a continuous survey.
Many reports in the literature
use a statistically derived definition of
overweight from NHANES II (1976–1980). This
definition (based on the gender-specific 85th
percentile values of BMI for 20 to 29 year olds)
is a BMI greater than or equal to (>)
27.3 for women and 27.8 for men. NHANES II
further defines “severe overweight” (based on
95th percentile values) as BMI > 31.1 for
men and BMI > 32.2 for women.[4] Some
studies round these numbers to a whole number,
which affects the statistical prevalence. In
1995, the World Health Organization recommended
a classification for three “grades” of
overweight using BMI cutoff points of 25, 30,
and 40.[5] The International Obesity Task Force
suggested an additional cutoff point of 35 and
slightly different terminology.[6]
The expert panel convened by
NHLBI and NIDDK released a report in June 1998,
that provided definitions for overweight and
obesity similar to those used by the World
Health Organization. The panel identified
overweight as a BMI > 25 to less than
(<)30, and obesity as a BMI > 30. These
definitions, widely used by the Federal
government and increasingly by the broader
medical and scientific communities, are based on
evidence that health risks increase more steeply
in individuals with a BMI > 25.
BMI cutoff points are a
guide for definitions of overweight and
obesity and are useful for comparative purposes
across populations and over time; however, the
health risks associated with overweight and
obesity are on a continuum and do not
necessarily correspond to rigid cutoff points.
For example, an overweight individual with a BMI
of 29 does not acquire additional health
consequences associated with obesity simply by
crossing the BMI threshold > 30. However,
health risks generally increase with increasing
BMI.
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Prevalence statistics related to overweight and
obesity*
*
The statistics presented here are based on the
following definitions unless otherwise
specified: overweight = BMI> 25 to < 30;
obesity = BMI > 30. |
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Overweight and obesity are found worldwide, and
the prevalence of these conditions in the United
States ranks high along with other developed
nations. Approximately 300,000 adult deaths in
the United States each year are attributable to
unhealthy dietary habits and physical inactivity
or sedentary behavior.[7]
Below are some frequently
asked questions and answers about overweight and
obesity statistics. Data are based on NHANES
1999-2000. Unless otherwise specified, the
figures given represent age-adjusted estimates.
Population numbers are based on the U.S. Census
Bureau Census 2000.
Q: How many adults are
overweight?
A:
Nearly two-thirds of U.S. adults are overweight
(BMI > 25, which includes those who are
obese).[8]
All adults (20+ years
old): 129.6 million (64.5 percent)
Women (20+ years old): 64.5 million (61.9
percent)
Men (20+ years old): 65.1 million (67.2
percent)
Q: How many adults are obese?
A:
Nearly one-third of U.S. adults are obese (BMI
> 30).[8]
All adults (20+ years
old): 61.3 million (30.5 percent)
Women (20+ years old): 34.7 million (33.4
percent)
Men (20+ years old): 26.6 million (27.5
percent)
Q: How many adults are at a
healthy weight?
A:
Less than half of U.S. adults have a healthy
weight (BMI > 18.5 to < 25).[9]
All adults (20-74 years
old): 67.3 million (33.5 percent)
Women (20-74 years old): 36.7 million (35.3
percent)
Men (20-74 years old): 30.6 million (31.8
percent)
Q: How has the prevalence of
overweight and obesity in adults changed
over the years?
A:
The prevalence has steadily increased over the
years among both genders, all ages, all
racial/ethnic groups, all educational levels,
and all smoking levels.10 From 1960 to 2000, the
prevalence of overweight (BMI > 25 to <
30) increased from 31.5 to 33.6 percent in U.S.
adults aged 20 to 74.[9]The prevalence of
obesity (BMI > 30) during this same time
period more than doubled from 13.3 to 30.9
percent, with most of this rise occurring in the
past 20 years.8 From 1988 to 2000, the
prevalence of extreme obesity (BMI > 40)
increased from 2.9 to 4.7 percent, up from 0.8
percent in 1960.3,8 In 1991, four states had
obesity rates of 15 percent or higher, and none
had obesity rates above 16 percent. By 2000,
every state except Colorado had obesity rates of
15 percent or more, and 22 states had obesity
rates of 20 percent or more.11 The prevalence of
overweight and obesity generally increases with
advancing age, then starts to decline among
people over 60.[3]
Q: What is the prevalence of
overweight and obesity in minorities?
A:
The age-adjusted prevalence of combined
overweight and obesity (BMI > 25) in
racial/ethnic minorities—especially minority
women—is generally higher than in whites in the
United States.[8]
Non-Hispanic Black women:
77.3%
Mexican American women: 71.9%
Non-Hispanic White women: 57.3%
Non-Hispanic Black men: 60.7%
Mexican American men: 74.7%
Non-Hispanic White men:
67.4%
(Statistics are for
populations 20+ years old)
Studies using this definition
of overweight and obesity provide
ethnicity-specific data only for these three
racial-ethnic groups. Studies using definitions
of overweight and obesity from NHANES II have
reported a high prevalence of overweight and
obesity among Hispanics and American Indians.
The prevalence of overweight (BMI > 25)
and obesity (BMI > 30) in Asian Americans
is lower than in the population as a whole.[1]
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