Overweight and obesity in the United States: prevalence and trends, 1960-1994

• Published in: INT. J. OBESITY 1998-01, Vol.22 (1), p.39-47
• Main Authors: FLEGAL, K. M, CARROLL, M. D, KUCZMARSKI, R. J, JOHNSON, C. L
• Format: Article
• Language: English
• Subjects: Analysis. Health state; Biological and medical sciences; Epidemiology; General aspects; Medical sciences; Public health. Hygiene; Public health. Hygiene-occupational medicine
• ISSN: 0307-0565; 1476-5497
• DOI: 10.1038/sj.ijo.0800541

Objective: To describe the prevalence of, and trends in, overweight and obesity in the US population using standardized international definitions. Design: Successive cross-sectional nationally representative surveys, including the National Health Examination Survey (NHES I; 1960-62) and the National Health and Nutrition Examination Surveys (NHANES I: 1971-1974; NHANES II: 1976-1980; NHANES III: 1988-94). Body mass index (BMI: kg/m super(2)) was calculated from measured weight and height. Overweight and obesity were defined as follows: Overweight (BMI greater than or equal to 25.0); pre-obese (BMI 25.0-29.9), class I obesity (BMI 30.0-34.9), class II obesity (BMI 35.0-39.9), and class III obesity (BMI greater than or equal to 40.0). Results: For men and women aged 20-74 y, the age-adjusted prevalence of BMI 25.0-29.9 showed little or no increase over time (NHES I: 30.5%, NHANES I: 32.0%, NHANES II: 31.5% and NHANES III: 32.0%) but the prevalence of obesity (BMI greater than or equal to 30.0) showed a large increase between NHANES II and NHANES III (NHES I: 12.8%; NHANES I, 14.1%; NHANES II, 14.5% and NHANES III, 22.5%). Trends were generally similar for all age, gender and race-ethnic groups. The crude prevalence of overweight and obesity (BMI >> 25.0) for age greater than or equal to 20 y was 59.4% for men, 50.7% for women and 54.9% overall. The prevalence of class III obesity (BMI greater than or equal to 40.0) exceeded 10% for non-Hispanic black women aged 40-59 y. Conclusions: Between 1976-80 and 1988-94, the prevalence of obesity (BMI greater than or equal to 30.0) increased markedly in the US. These findings are in agreement with trends seen elsewhere in the world. Use of standardized definitions facilitates international comparisons.