Endocrinology and Metabolism Clinics of North America
Review articleEpidemiologic trends in overweight and obesity
Section snippets
Definitions and measurement of overweight and obesity
Body fat may be defined as consisting of nonessential lipids in the form of triglycerides (triacylglycerols) stored in adipose tissue cells known as adipocytes. Adipose tissue itself is a complex structure that includes adipocytes and vascular, neural, and other tissues [7]. Obesity is generally defined conceptually as the condition of excess body fat. There is, however, no precise definition of excess. The degree of adiposity is a continuous trait not marked by any clear division into normal
Definitions for adults
The terms overweight and obesity have been used with a wide variety of meanings. In 1959 and in 1983, the life insurance industry produced height and weight tables based on the mortality experience of policy holders, which indicated the range of weights by height and frame size at which mortality was lowest for men and women aged 25–59 years [10], [11]. One convention often used in the past was to define overweight as a body weight of 20% or more above the midpoint of the weight range for a
Definitions for children and adolescents
For adults, the currently used definitions of overweight and obesity are related to functional outcomes of mortality and morbidity and are based on fixed values of BMI that do not vary by age or gender [3]. Among children and youth, however, the definitions are based on statistical values of BMI from a reference population and vary by gender and age. Various reference data sets for childhood BMI are available. One reference set of BMI values consists of gender-specific smoothed percentiles for
Overweight and obesity: prevalence and trends
Systematic data on obesity generally cannot be gathered from medical records or vital statistics; thus, prevalence estimates are usually derived from surveys or population studies. Because of the logistic difficulties involved in making measurements of body fat in population studies, virtually all data on prevalence and trends are based on measurements of weight and height using the classifications described previously rather than of body fat.
In the United States, the NHANES program provides
Host and environmental determinants
The answer to the question of whether the prevalence of overweight or obesity is higher for men or for women is unclear, given the differences in body composition between men and women and the issues in defining obesity. The answer also varies according to the definition used. Generally, in the United States and in Europe, the prevalence of overweight, defined as a BMI of 25 or more, is higher for men than for women, but the prevalence of obesity, defined as a BMI of 30 or more, is higher for
Risk factors
The human body can metabolize protein, carbohydrates, and fat to meet energy needs. The principal energy storage is in the form of fat, which, unlike protein or carbohydrates, can be stored in the body in relatively large amounts. This ability to store fat allows energy stores to be mobilized in times of famine or food deprivation. From an historical and evolutionary perspective, starvation is a greater danger than overabundance. Famine and starvation still occur in the world today in wartime
Preventive efforts
Public health and clinical guidelines on treatment for obesity generally include degree of overweight, health risk factors, and comorbid conditions as aspects to consider when making decisions on treatment and identifying the most appropriate treatment for an individual [3]. Evidence suggests that even without reaching “ideal” weight, a moderate amount of weight loss can be beneficial in reducing levels of some risk factors for mortality or morbidity, such as blood pressure. Long-term weight
Public health impact and epidemiologic issues
The net effect of overweight and obesity on morbidity and mortality is difficult to quantify. Higher body weight is associated with increased incidence and prevalence of numerous conditions, including hypertension, diabetes mellitus, hyperlipidemia, certain cancers, musculoskeletal disorders, CVD, and increased risk of disability [3]. Higher body weights are associated with increased risks of cardiovascular mortality and morbidity [65]. Higher body weight is also associated with some benefits,
References (78)
- et al.
Do obese children become obese adults? A review of the literature
Prev Med
(1993) - et al.
Indices of relative weight and obesity
J Chronic Dis
(1972) - et al.
Health implications of obesity: an NIH consensus development conference
J Am Diet Assoc
(1985) - et al.
Sex differences in the relation of visceral adipose tissue accumulation to total body fatness
Am J Clin Nutr
(1993) - et al.
Reference data for obesity: 85th and 95th percentiles of body mass index (wt/ht2) and triceps skinfold thickness
Am J Clin Nutr
(1991) - et al.
Prevalence of overweight in US children: comparison of US growth charts from the Centers for Disease Control and Prevention with other reference values for body mass index
Am J Clin Nutr
(2001) - et al.
Guidelines for overweight in adolescent preventive services: recommendations from an expert committee. The Expert Committee on Clinical Guidelines for Overweight in Adolescent Preventive Services
Am J Clin Nutr
(1994) - et al.
Genetic influences on the response of body fat and fat distribution to positive and negative energy balances in human identical twins
J Nutr
(1997) - et al.
Report of a National Institutes of Health–Centers for Disease Control and Prevention workshop on the feasibility of conducting a randomized clinical trial to estimate the long-term health effects of intentional weight loss in obese persons
Am J Clin Nutr
(1999) - et al.
Risk stratification of obesity as a coronary risk factor
Am J Cardiol
(2002)
Contribution of abdominal obesity and hypertriglyceridemia to impaired fasting glucose and coronary artery disease
Am J Cardiol
Prevalence and trends in obesity among US adults, 1999–2000
JAMA
Prevalence and trends in overweight among US children and adolescents, 1999–2000
JAMA
Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults—the evidence report
Obes Res
Implications of childhood obesity for adult health: findings from Thousand Families cohort study
BMJ
Health consequences of obesity in youth: childhood predictors of adult disease
Pediatrics
Integrative physiology of human adipose tissue
Int J Obes Relat Metab Disord
Use of the body mass index (BMI) as a measure of overweight in children and adolescents
J Pediatr
New weight standards for men and women
Stat Bull Metrop Insur Co
1983 Metropolitan height and weight tables
Stat Bull Metrop Insur Co
Treat obesity seriously: a clinical manual
Complications of obesity
Ann Intern Med
Physical status: the use and interpretation of anthropometry. Report of a WHO expert committee
Energy and protein requirements. Report of a joint FAO/WHO/UNU expert consultation
The global epidemic of obesity
Nutrition and your health: dietary guidelines for Americans
Human body composition and the epidemiology of chronic disease
Obes Res
2000 CDC growth charts for the United States: methods and development
Vital Health Stat
Centers for Disease Control and Prevention 2000 growth charts for the United States: improvements to the 1977 National Center for Health Statistics version
Pediatrics
Improving growth status of Asian refugee children in the United States
JAMA
Genetic and environmental determinants of growth in Mexican-Americans
Pediatrics
Height and weight standards for preschool children. How relevant are ethnic differences in growth potential?
Lancet
Establishing a standard definition for child overweight and obesity worldwide: international survey
BMJ
The effects of age categorization on estimates of overweight prevalence for children
Int J Obes Relat Metab Disord
Obesity evaluation and treatment: expert committee recommendations. The Maternal and Child Health Bureau, Health Resources and Services Administration, and the Department of Health and Human Services
Pediatrics
Pediatric nutrition surveillance system—United States, 1980–1991
Mor Mortal Wkly Rep CDC Surveill Summ
Summary of WIC nutrition risk criteria: a scientific assessment
J Am Diet Assoc
Changes in the distribution of body mass index of adults and children in the US population
Int J Obes Relat Metab Disord
Cited by (239)
Beyond recent BMI: BMI exposure metrics and their relationship to health
2020, SSM - Population HealthClinical and psychological responses to synbiotic supplementation in obese or overweight adults: A randomized clinical trial
2019, Complementary Therapies in MedicineThe risk of incident extrahepatic cancers is higher in non-alcoholic fatty liver disease than obesity – A longitudinal cohort study
2019, Journal of HepatologyCitation Excerpt :Some associations are flawed because of bias that exaggerates the effect of obesity on cancer incidence, but strong evidence supports this association with 11 cancers, predominantly among digestive organs and hormone-related malignancies in women.4 The prevalence of obesity has more than doubled in the last 4 decades6,7 and as a result, the incidence of non-alcoholic fatty liver disease (NAFLD) has increased substantially.8–10 Large population studies have clearly established that malignancy is among the top 2 causes of death in NAFLD, vastly surpassing liver-related mortality, which occurs in 1–2% of patients.11,12
Errors in body mass index from self-reported data by sex and across waves of Add Health
2019, Annals of EpidemiologyCitation Excerpt :Differences in misreporting patterns by sex have also been observed [12,13]. Such misreporting has implications for body mass index (BMI), an elevated level of which is a risk factor for many chronic diseases [14–18]. From a clinical perspective, it could be argued that misreporting might not be problematic as height and weight are easily assessed, but misreporting could become more critical in survey-based epidemiological studies.
Desaturation in procedural sedation for children with long bone fractures: Does weight status matter?
2017, American Journal of Emergency Medicine