> 35 in (> 88 cm)
Disease risk for type 2 diabetes, hypertension, and cardiovascular disease.
Increased waist circumference can also be a marker for increased risk even in persons of normal weight.
In addition to an increase in total body weight, a proportionally greater amount of fat in the abdomen or trunk compared with the hips and lower extremities has been associated with increased risk for metabolic syndrome, type 2 diabetes mellitus, hypertension, and heart disease in both men and women ( 23 , 24 ). Abdominal obesity is commonly reported as a waist-to-hip ratio, but it is most easily quantified by a single circumferential measurement obtained at the level of the superior iliac crest ( 20 ). For the practioner, waist circumference should be measured in a standardized way ( 20 ) at each patient’s visit along with body weight. The original US national guidelines on overweight and obesity categorized men at increased relative risk for co-morbidities such as diabetes and cardiovascular disease if they have a waist circumference greater than 102 cm (40 inches) and women if their waist circumference exceeds 88 cm (35 inches) ( Table 1 ) ( 20 ). These waist circumference thresholds are also used to define the “metabolic syndrome” by the most recent guidelines from the American Heart Association and the National Lipid Association (e.g., triglyceride levels > 150 mg/dL, hypertension, elevated fasting glucose (100 – 125 mg/dL)) or prediabetes (hemoglobin A1c between 5.7 and 6.4%) ( 25 , 26 ). Thus, an overweight person with predominantly abdominal fat accumulation would be considered “high” risk for these diseases even if that person does not meet BMI criteria for obesity. Such persons would have “central obesity.” It is commonly accepted that the predictive value for increased health risk by waist circumference is in patients at lower BMI’s (< 35 kg/m 2 ) since those with class 2 obesity or higher will nearly universally have waist circumferences that exceed disease risk cut-offs.
However, the relationships between central adiposity with co-morbidities are also a continuum and vary by race and ethnicity. For example, in those of Asian descent, abdominal (central) obesity has long been recognized to be a better disease risk predictor than BMI, especially for type 2 diabetes ( 27 ). As endorsed by the International Diabetes Federation ( 28 ) and summarized in a WHO report in 2008 ( 29 ), different countries and health organizations have adopted differing sex- and population-specific cut offs for waist circumference thresholds predictive of increased comorbidity risk. In addition to the US criteria, alternative thresholds for central obesity as measured by waist circumference include > 94 cm (37 inches) and > 80 cm (31.5 inches) for men and women of European anscestry and > 90 cm (35.5 inches) and > 80 cm (31.5 inches) for men and women of South Asian, Japanese, and Chinese origin ( 28 , 29 ), respectively.
In the United States (US), data from the National Health and Nutrition Examination Survey using measured heights and weights shows that the steady increase in obesity prevalence in both children and adults over the past several decades has not waned, although there are exceptions among subpopulations as described in greater detail below. In the most recently published US report (2017-2020), 42.4% of adults (BMI ≥ 30 kg/m 2 ) ( 30 ) and 20.9% of youth (BMI ≥ 95 th percentile of age- and sex-specific growth charts) ( 31 ) have obesity, and the age-adjusted prevalence of severe obesity (BMI ≥ 40 kg/m 2 ) was 9.2% ( 30 ) ( Figure 1 ).
Trends in age-adjusted obesity (BMI ≥ 30 kg/m 2 ) and severe obesity (BMI ≥ 40 kg/m 2 ) prevalence among adults aged 20 and over: United States, 1999–2000 through 2017–2018. Taken from reference ( 30 ).
Age-Adjusted Prevalence of Obesity and Severe Obesity in US Adults. National Health and Nutrition Examination Survey data, prevalence estimates are weighted and age-adjusted to the projected 2000 Census population using age groups 20-39, 40-59, and 60 or older. Significant linear trends (P < .001) for all groups except for obesity among non-Hispanic Black men, which increased from 1999-2000 to 2005-2006 and then leveled after 2005-2006. Data taken from reference ( 31 ).
On average, the obesity rate in US adults has nearly tripled since the 1960’s (Reference ( 32 ) and Figure 2 ). These large increases in the number of people with obesity and severe obesity, while at the same time the level of overweight has remained steady ( 32 , 33 ), suggests that the “obesogenic” environment is disproportionately affecting those portions of the population with the greatest genetic potential for weight gain ( 34 ). This currently leaves slightly less than 30% of the US adult population as having a healthy weight (BMI between 18.5 and 25 kg/m 2 ).
Men and women now have similar rates of obesity and the peak rates of obesity for both men and women in the US occur between the ages of 40 and 60 years ( Figures 2 and 3 ). In studies that have measured body composition, fat mass also peaks just past middle age in both men and women, but percent body fat continues to increase past this age, particularly in men because of a proportionally greater loss in lean mass ( 35 - 37 ). The menopausal period has also been associated with an increase in percent body fat and propensity for central (visceral) fat distribution, even though total body weight may change very little during this time ( 38 - 41 ).
The rise in obesity prevalence rates has disproportionately affected US minority populations ( Figure 2 ). The highest prevelance rates of obesity by race and ethnicity are currently reported in Black women, native americans, and Hispanics ( Figure 2 and reference ( 42 )). In general, women and men who did not go to college were more likely to have obesity than those who did, but for both groups these relationships varied depending on race and ethnicity (see below). Amongst women, obesity prevelance rates decreased with increasing income in women (from 45.2% to 29.7%), but there was no difference in obesity prevalence between the lowest (31.5%) and highest (32.6%) income groups among men ( 43 ).
Prevalence of obesity among adults aged 20 and over, by sex and age: United States, 2017–2018. Taken from reference ( 30 ).
The interactions of socieconomic status and obesity rates varied based on race and ethnicity ( 43 ). For example, the expected inverse relationship between obesity and income group did not hold for non-Hispanic Black men and women in whom obesity prevelance was actually higher in the highest compared to lowest income group (men) or showed no relationship to income by racial group at all (women) ( 43 ). Obesity prevalence was lower among college graduates than among persons with less education for non-Hispanic White women and men, Black women, and Hispanic women, but not for Black and Hispanic men. Asian men and women have the lowest obesity prevelance rates, which did not vary by eduction or income level ( 43 ).
As discussed above, central weight distribution occurs more commonly in men than women and increases in both men and women with age. In one of the few datasets that have published time-trends in waist circumference, it has been shown that over the past 20 years, age-adjusted waist circumferences have tracked upward in both US men and women ( Figure 4 ). Much of this likely reflects the population increases in obesity prevelance since increasing fat mass and visceral fat track together ( 52 ).
Age-adjusted mean waist circumference among adults in the National Health and Nutrition Examination Survey 1999-2012. Adapted from ( 51 ).
Childhood obesity is a risk factor for adulthood obesity ( 44 - 46 ). In this regard, the similar tripling of obesity rates in US youth (ages 2-19 years old) ( Figure 5 ) to 20.9% in 2018 ( 31 ) is worrisome and will contribute to the already dismal projections of the US adult population approaching 50% obesity prevelance by the year 2030 ( 47 ). Obesity prevalence was 26.2% among Hispanic children, 24.8% among non-Hispanic Black children, 16.6% among non-Hispanic White children, and 9.0% among non-Hispanic Asian children ( 48 ). Like adults, obesity rates in children are greater when they are live in households with lower incomes and less education of the head of the household ( 49 ). In this regard, these obesity gaps have been steadily widening in girls, whereas the differences between boys has been relatively stable ( 49 ).
Trends in obesity among children and adolescents aged 2–19 years, by age: United States, 1963–1965 through 2017–2018. Obesity is defined as body mass index (BMI) greater than or equal to the 95th percentile from the sex-specific BMI-for-age 2000 CDC Growth Charts. Taken from reference ( 50 ).
With regard to socieconomic status, the inverse trends for lower obesity rates and higher income and education (of households) held in all race and ethnic origin groups with the following exceptions: obesity prevalence was lower in the highest income group only in Hispanic and Asian boys and did not differ by income among non-Hispanic Black girls ( 49 ).
Historically, international obesity rates have been lower than in the US, and most developing countries considered undernutrition to be their topmost health priority ( 53 ). However, international rates of overweight and obesity have been rising steadily for the past several decades and, in many countries, are now meeting or exceeding those of the US ( Figure 6 ) ( 54 , 55 ). In 2016, 1.3 billion adults were overweight worldwide and, between 1975 to 2016, the number of adults with obesity increased over six-fold, from 100 million to 671 million (69 to 390 million women, 31 to 281 million men) ( 54 ). Especially worrisome have been similar trends in the youth around the world ( Figure 6 ), from 5 million girls and 6 million boys with obesity in 1975 to 50 million girls and 74 million boys in 2016 ( 54 ), as this means the rise in obesity rates will continue for decades as they mature into adults.
The growth in the wordwide prelance of overweight and obesity is thought to be primarily driven by economic and technological advancements in all developing societies ( 56 , 57 ). These forces have been ongoing in the US and other Western countries for many decards but are being experienced by many developing countries on a compressed timescale. Greater worker productivity in advancing economies means more time spent in sedentary work (less in manual labor) and less time spent in leisure activity. Greater wealth allows the purchase of televisions, cars, processed foods, and more meals eaten out of the house, all of which have been associated with greater rates of obesity in children and adults. More details and greater discussion of these issues can be found in Endotext Chapters on Non-excercise Activity Thermogenesis ( 58 ) and Obesity and the Environment ( 9 ).
Regardless of the causes, these trends in global weight gain and obesity are quickly creating a tremendous burden on health-care systems and cost to countries attempting to respond to the increased treatment demands ( 59 ). They are also feuling a rise in global morbity and mortality for chronic (non-communicable) diseases, especially for cardiovascular disease and type 2 diabetes mellitus, and especially in Asian and South Asian populations where rates of type 2 diabetes are currently exploding ( 15 , 60 - 63 ). Efforts need to be made to deliver adequate health care to those currently with obesity and, at the same time, find innovative and alternative solutions that allow economies to prosper and to incorporate technologies that will reverse current trends in obesity and obesity-related complications.
Trends in the number of adults, children, and adolescents with obesity and with moderate and severe underweight by region. Children and adolescents were aged 5–19 years. (Taken from ( 54 )).
Obesity is both a chronic disease in its own right and a primary contributor to other leading chronic diseases such as type 2 diabetes, dyslipidemia, hypertension, and cardiovascular diseases. In the clinic, obesity is still best defined using commonly available tools, including BMI and waist circumference; although it is hoped that newer imaging modalities allowing more precise quantification of amount and distribution of excess lipid depots will improve obesity risk assessment. The general rise in obesity taking place in the US over the past 50 years is now occurring globally. In the US, the prevalence rates of obesity in adult men and women are now similar at 40%, and minorities are disproportionately affected, including Blacks, Native Americans, and Hispanics, with obesity rates of 50% or higher. Particularly worrisome is the global increase in obesity prevalence in children and adolescents as these groups will continue to contribute to a rising adult obesity rates for several decades to come. As important as finding solutions that address the global logistical and financial challenges facing health-care systems attempting to meet current demands of obesity and weight-related co-morbidities will be finding innovative solutions that prevent and reverse current population weight gain trends.
This electronic version has been made freely available under a Creative Commons (CC-BY-NC-ND) license. A copy of the license can be viewed at http://creativecommons.org/licenses/by-nc-nd/2.0/ .
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O besity is a chronic and multifacto-rial disease and has become a worldwide epidemic with devas-tating health and economic consequences. In 2015, there were an estimated 603.7 million adults and 107.7 million children with obesity worldwide, and the rate of obesity had doubled in nearly half of coun-tries since 1980.1 Projections estimate that ...
In this research, the prevalence rate of obesity and overweight was 30.4%, 7.7% of them were obese, and 22.7% were overweight. The obesity rates between males and females were not different.
In the United States, overweight and obesity are chronic diseases that contribute to excess morbidity and mortality. Despite public health efforts, these disorders are on the rise, and their consequences are burgeoning. 1 The Centers for Disease Control and Prevention report that during 2017 to 2018, the prevalence of obesity in the United States was 42.4%, which was increased from the ...
The present study conducted a systematic literature review to examine obesity research and machine learning techniques for the prevention and treatment of obesity from 2010 to 2020. Accordingly, 93 papers are identified from the review articles as primary studies from an initial pool of over 700 papers addressing obesity.
Obesity has become a global epidemic and is one of today's most public health problems worldwide. Obesity poses a major risk for a variety of serious diseases including diabetes mellitus, non-alcoholic liver disease (NAFLD), cardiovascular disease, hypertension and stroke, and certain forms of cancer (Bluher, 2019).Obesity is mainly caused by imbalanced energy intake and expenditure due to a ...
1.2 Measuring obesity 4 1.3 Levels and trends of overweight and obesity in the WHO European Region 5 1.4 Health consequences of obesity 16 1.5 Determinants of obesity 19 1.6 Tackling obesity in individuals 20 1.7 Preventing obesity in populations 21 1.8 Conclusion 21 References 22 2. Obesity across the life course 26 2.1 Introduction 26
Figure 1. Trends in Overweight, Obesity, and Extreme Obesity Among Adults Aged 20 to 74 years: United States, 1960-1962 Through 2009-2010 ..... 4 Figure 2. The 1998 Clinical Guidelines: Classification of Overweight and Obesity by BMI,
PDF | Obesity is a prevalent, complex, progressive and relapsing chronic disease, characterized by abnormal or excessive body fat (adiposity), that... | Find, read and cite all the research you ...
Obesity is a complex chronic disease in which abnormal or excess body fat (adiposity) impairs health, increases the risk of long-term medical complications and reduces lifespan. 1 Epidemiologic studies define obesity using the body mass index (BMI; weight/height 2), which can stratify obesity-related health risks at the population level.Obesity is operationally defined as a BMI exceeding 30 kg ...
230. % Daily Value. 10% 5%. 0% 7%. 13%. ncludes 10g Added Sugars Protein 3g14%GLOBALLY IN 2017:Nutrition, overweight and obesityUnhealthy diets and excess b. dy weight are leading risk factors for death and disability in the WHO European Region (1). Addressing malnutrition in all its forms is e.
The Obesity Society (TOS) first published a position statement on obe-sity as a disease in 2008 (1). This statement reflected the thoughtful deliberations and consensus of Society members that was published in the same year (2). In 2016, an updated in-house position paper affirmed the 2008 declaration, stating, "TOS recommits to its position ...
1. Introduction. Obesity is a chronic disease that is increasing in prevalence and is now considered to be a global epidemic. Epidemiologic studies have revealed an association between high body mass index (BMI) and an extensive range of chronic diseases such as Non Alcoholic Fatty Liver (NAFL), cardiovascular disease , , diabetes mellitus , several malignancies , , musculoskeletal diseases ...
Obesity is excessive accumulation of body fat, that results from the impairment in energy balance mechanisms [3, 4]. Example of the condition edema can illustrate this point. Edema is not a result ...
PDF | Abstract Obesity is a chronic metabolic disease characterized by an increase of body fat stores. It is a gateway to ill health, and has become one... | Find, read and cite all the research ...
Introduction. Obesity in children and adolescents is a global health issue with increasing prevalence in low-income and middle-income countries (LMICs) as well as a high prevalence in many high-income countries.1 Obesity during childhood is likely to continue into adulthood and is associated with cardiometabolic and psychosocial comorbidity as ...
The obesity epidemic. The World Health Organization (WHO) defines overweight and obesity as abnormal or excessive fat accumulation that presents a risk to health (WHO, 2016a).A body mass index (BMI) ≥25 kg/m 2 is generally considered overweight, while obesity is considered to be a BMI ≥ 30 kg/m 2.It is well known that obesity and overweight are a growing problem globally with high rates in ...
See the 2020-2030 Strategic Plan for NIH Nutrition Research. The NHLBI is an active member of the National Collaborative on Childhood Obesity (NCCOR) external link. , which is a public-private partnership to accelerate progress in reducing childhood obesity. The NHLBI has been providing guidance to physicians on the diagnosis, prevention ...
The age-adjusted prevalence of obesity among U.S. adults was 42.4% in 2017-2018. The prevalence was 40.0% among younger adults aged 20-39, 44.8% among middle-aged adults aged 40-59, and 42.8% among older adults aged 60 and over. There were no significant differences in prevalence by age group (Figure 1). Figure 1.
PDF | Background and purpose: The aims of this article are to review the effects of obesity on health and well-being and the evidence indicating they... | Find, read and cite all the research you ...
Recent research has established the physiology of weight regulation, the pathophysiology that leads to unwanted weight gain with establishment of a higher body-weight set point, and the defense of the overweight and obese state even when reasonable attempts in lifestyle improvement are made. This knowledge has informed our approach to obesity as a chronic disease.
The Plan was originally published in 2011. In 2018-2019, the Obesity Research Task Force confirmed that the challenges and opportunities identified in the Plan reflect the current research landscape and should continue to guide obesity research. Full Report for the scientific community (PDF, 716.76 KB) Summary Report non-technical (PDF, 627.47 KB)
Obesity can impair the functioning of hepato-. biliary system, as well. Obese individuals have a. higher incidence of gall bladder stones, particularly cholesterol gallstones. Obese and ...
Obesity. Obesity is the term used to indicate the high range of weight for an individual of given height that is associated with adverse health effects.1 Definitions of overweight and obesity for adults are based on set cutoff points directly related to an individual's body mass index (BMI, weight in kilograms divided by the square of height ...