The following are five points to remember about the prevalence of overweight and obesity in the United States:

1. In 1999, a data set representative of the US population was used to assess the chronic disease burden associated with increasing body mass index (BMI). It was intended to help prioritize targeting of overweight and obesity as part of the national cost-effective prevention strategies. Using the most recent National Health and Nutrition Survey (NHANES, 2007-2012), the authors updated the prevalence of increasing BMI by sex/age and race/ethnicity and compared it with that of 20 years earlier.
2. Weight was classified by the following BMI categories (kg/m²): underweight (<18.5), normal weight (18.5-24.9), overweight (25-29.9), obesity class 1 (30.0-34.9), obesity class 2 (35-39.9), and obesity class 3 (≥40). Age ranged from 25-54 years or 55 or more years.
3. Nearly 40% of men and 30% of women were overweight, and 35% of men and 36% of women were obese, which were similar for both sexes and across racial groups. The only exception was non-Hispanic white women who had a greater percentage in the normal weight than overweight category. Compared to 20 years earlier, the greatest increase in the proportion of patients in the class 3 obesity category was among non-Hispanic black women.
4. The authors contend that the rising trends in weight in all categories warrant attention from health policy and health care system decision makers. This should include those at normal weight for whom weight gain places them at risk.
5. Population-based strategies including physical environment interventions, enhancing primary care efforts to prevent and treat obesity, and altering societal normal behavior are required.

Comment: The societal challenge to control the obesity epidemic appears to be more far more difficult and important than reducing tobacco use and alcohol abuse.

Keywords: Body Mass Index, Body Weight, Chronic Disease, Cost of Illness, Health Policy, Metabolic Syndrome, Nutrition Surveys, Obesity, Overweight, Prevalence, Primary Health Care, Primary Prevention, Weight Gain

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