Title of article:

Criteria for definition of overweight in transition: background and recommendations for the United States.

Authors: Kuczmarski RJ, Flegal KM.
Journal: Am J Clin Nutr. 2000 Nov;72(5):1067-8.

Abstract

Overweight and obesity are leading nutrition-related disorders of clinical and public health concern. Assessment and classification of these conditions are dependent on specific body mass index (BMI; in kg/m(2)) cutoff points. US government agencies are making the transition to a revised BMI definition of overweight from that previously recommended for general use. The purpose of this article is to inform the broader medical and scientific communities of the transition that is underway in the United States to identify and classify overweight among adults by using BMI. Historical background on the use of BMI in a variety of applications, as reported in US federal government agency documents, provides an understanding of previous and current weight-for-height guidelines and the basis for arriving at them. On the basis of the current Dietary Guidelines for Americans, US government agencies are moving toward the use of criteria for overweight and obesity that are consistent with current international standards. Clinicians, researchers, and journal editors should be aware of the transition toward a common definition of healthy weight, overweight, and obesity. To facilitate comparisons and reporting of data, others are encouraged to consider making this transition as well.

Comments and Key points

This article has the most comprehensive summary of body mass index thresholds, to define obesity and overweight. It is an excellent source of references. It is available for viewing as free full text at http://www.ajcn.org/cgi/content/full/72/5/1074.

However, as you read this article, it will become apparent that only 2 or 3 overweight BMI criteria actually exist, and they simply repeat over and over in the scientific literature. The criteria are simply assumed, presumed, or adopted, with very little justification given. Instead, experts refer to earlier experts, again and again.

To summarize this article, the main overweight criteria are:

Number Original Criterion Source Reference
1. Overweight BMI is:
Men >=27.8, Women >= 27.3 kg/m2		 NIH Consensus
Development Panel,
based on NHANES II		 1985: 1,2
2. Overweight BMI is: Men & Women:
Age 19–24
> 24.0 kg/m2		 Age 25–34
> 25.0		 Age 35–44
> 26.0
Age 45–54
> 27.0 kg/m2		 Age 55–65
> 28.0		 Age over 65
> 29.0
Committee on Diet
and Health		 1989: 3
3. Overweight BMI is:
Men & Women >=25.0 kg/m2		 Dietary Guidelines
(2nd ed)		 1987: 4

And the other Institutions and Committees that have adoped these criteria are:

Number Who else Adopted the same Criteria Reference
1.

Health United States,
Najjar et al,

 1985: 5
1987: 6
3.

Healthy People 2000,
Dietary Guidelines (4th ed),
World Health Organization Consultation on Obesity,
NHLBI Expert Panel,
Health United States,
Dietary Guidelines (5th ed),

1990: 7
1995: 8
1997: 9,10
1998: 11
1999: 12
2000: 13

This is a review article, covering the scope of USA overweight criteria. It doesn't cover any international considerations.

References

  1. Van Itallie TB. Health implications of overweight and obesity in the United States. Ann Intern Med 1985;103:983–8.
  2. National Institutes of Health Consensus Development Panel on the Health Implications of Obesity. Health implications of obesity. Ann Intern Med 1985;103:1073–7.
  3. Committee on Diet and Health. Diet and health: implications for reducing chronic disease risk. Washington, DC: National Academy Press, 1989.
  4. US Department of Agriculture and US Department of Health and Human Services. Nutrition and your health: dietary guidelines for Americans. Washington, DC: US Government Printing Office, 1985. (Home and Garden Bulletin no. 232.)
  5. National Center for Health Statistics, Public Health Service. Health United States, 1985. Washington, DC: US Government Printing Office, 1985. [DHHS publication (PHS) 86-1232.]
  6. Najjar MF, Rowland M. Anthropometric reference data and prevalence of overweight, United States, 1976–80. Washington, DC: US Government Printing Office, 1987. [Series 11, 238; DHHS publication (PHS) 87-1688.]
  7. US Department of Health and Human Services. Public Health Service. Healthy people 2000: national health promotion and disease prevention objectives. Washington, DC: US Government Printing Office, 1990. [DHHS publication (PHS) 90-50212.]
  8. US Department of Agriculture and US Department of Health and Human Services. Nutrition and your health: dietary guidelines for Americans. Washington, DC: US Government Printing Office, 1995. [Home and Garden Bulletin no. 232.]
  9. World Health Organization. Report of a WHO consultation on obesity. Obesity: preventing and managing the global epidemic. Geneva: World Health Organization, 1998.
  10. Flegal KM, Carroll MD, Kuczmarski RJ, Johnson CL. Overweight and obesity in the United States: prevalence and trends, 1960–1994. Int J Obes Relat Metab Disord 1998;22:39–47.
  11. NHLBI Obesity Education Initiative Expert Panel on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults. Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults—the evidence report. Obes Res 1998;6:51S–209S.
  12. National Center for Health Statistics, Public Health Service. Health United States, 1999. Washington, DC: US Government Printing Office, 1999. [DHHS publication (PHS) 99-1232.]
  13. US Department of Agriculture and US Department of Health and Human Services. Nutrition and your health: dietary guidelines for Americans. Washington, DC: US Government Printing Office, 2000. (Home and Garden Bulletin no. 232.)

Review & comments by Steven B. Halls, MD, last edit: 23-June, 2008, Copyright.
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