Author: Larry Chapman

Introduction: Estimates of obesity prevalence based on current BMI are an important, but incomplete indicator of the total effects of obesity on a population. Methods: In this study, data on current BMI and maximum BMI were used to estimate prevalence and trends in lifetime obesity status, defined using the categories never (maximum BMI ≤30 kg/m), former (maximum BMI ≥30 kg/m ≥30 kg/m and current BMI ≤30 kg/m), and current obesity (current BMI). Prevalence was estimated for the period 2013–2014 and trends for the period 1988– 2014 using data from the National Health and Nutrition Examination Survey. Predictors of lifetime weight status and the association between lifetime weight categories and prevalent disease status were also investigated using multivariable regression.

Results: A total of 50.8% of American males and 51.6% of American females were ever obese in 2013–2014. The prevalence of lifetime obesity exceeded the prevalence of current obesity by amounts that were greater for males and for older persons. The gap between the two prevalence values has risen over time. By 2013–2014, a total of 22.0% of individuals who were not currently obese had formerly been obese. For each of eight diseases considered, prevalence was higher among the formerly obese than among the never obese.

Conclusions: A larger fraction of the population is affected by obesity and its health consequences than is suggested in prior studies based on current BMI alone. Weight history should be incorporated into routine health surveillance of the obesity epidemic for a full accounting of the effects of obesity on the U.S. population. The population burden of obesity is larger than indicated by data on current BMI alone. In total, half of the U.S. adult population has been affected by obesity in their lifetime compared to the 37% who are obese based on current weight status. The formerly obese population, which accounts for the gap between these two estimates, is an important and growing minority of the population with elevated disease risks. It should be distinguished from never obese individuals in routine health surveillance for a full accounting of the effects of obesity on the U.S. population.

The types of issues addressed in this article includes:

• Prevalence and trends for obesity in the U.S. population.
• Percentage of people who are obese now and where obese at some point in their lives.
• Importance of obesity in employee health surveillance.
• Age, race, gender and ethnicity differences in obesity.
• Common disease conditions associated with obesity.

Wellness professionals can use this information to:

• Compare their own populations to national data.
• Educate management about the importance of weight management in working populations.
• Evaluate the incremental effect of their obesity prevention efforts.
• Make a stronger case for a more serious weight management initiative within their wellness program.
• Relate data on obesity to the incidence and prevalence of 8 common diseases.

In summary, this is an authoritative look at the size, significance and occurrence of obesity for Americans.

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