Obesity epidemic in the united states

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Prevalence rates for overweight and obesity in the United States are generated from the National Health and Nutrition Examination Survey (NHANES) program. These cross-sectional surveys have been conducted since 1960 on a large representative sample of the US population and provide national estimates for overweight and obesity in children and adults from 2 to 74 yr of age. The National Health Examination Survey (NHES I,

Fig. 1. J-shaped curve of all-cause mortality compared with body mass index. From ref. 1. Table 1

Classification of Overweight and Obesity by BMI

Fig. 1. J-shaped curve of all-cause mortality compared with body mass index. From ref. 1. Table 1

Classification of Overweight and Obesity by BMI

Obesity class

BMI (kg/m2)

Underweight

< 18.5

Normal

18.5-24.9

Overweight

25.0-29.9

Obesity

I

30.0-34.9

II

35.0-39.9

III

> 40

1960-62) was followed by three NHANES surveys (NHANES I, 1971-74; NHANES II, 1976-80; NHANES II,I 1988-94). In 1999 NHANES became a continuous survey; the 1999-2000 data were first published in 2002.

Data for these surveys reveal dramatic increases in overweight or obesity between NHANES II and III, which were continued at an even greater rate in 1999-2000. The prevalence of overweight increased significantly, from 56% in NHANES III to 65.2% in 1999-2000. These changes are summarized in Table 2 (7).

When changes in weight are partitioned into overweight (BMI 25-29.9) and obese (BMI > 30), it can be see that the prevalence for overweight increased very little (<2%); however, the prevalence for obesity doubled, from 15.1 to 31.1%, between NHANES III and 1999-2002. Within the obesity category, the prevalence of self-reported BMI greater than 40 increased from 0.5 to 2% of the US population and those with a BMI greater than 50 quadrupled, from 0.5 to 2% between 1986 and 2000 (8). Individuals at the higher end of the BMI spectrum appear to be getting larger at a faster rate than the remaining population.

Fig. 2. Obesity patterns and trends across the world, adults aged 20 yr and older. (A) Prevalence rates; (B) obesity trends (the annual percentage point increase in prevalence). With permission from ref. 6.

Table 2

Prevalence and Trends of Overweight and Obesity Among Adults in the United States, 1960-2002

Table 2

Prevalence and Trends of Overweight and Obesity Among Adults in the United States, 1960-2002

Overweight

Overweight but not

Survey year

or obese % (SE)

obese % (SE)

Obese % (SE)

1960-1962

44.8 (1.0)

31.5 (0.5)

13.3 (0.6)

1971-1974

47.7 (0.7)

33.1 (0.6)

14.6 (0.5)

1976-1980

47.4 (0.8)

32.3 (0.6)

15.1 (0.5)

1988-1994

56.0 (0.9)

32.7 (0.6)

23.3 (0.7)

1999-2002

65.2 (0.8)

34.1 (0.8)

31.1 (1.0)

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