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January 1998, Volume 22, Number 1, Pages 39-47
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Overweight and obesity in the United States: prevalence and trends, 1960-1994
K M Flegala, M D Carroll, R J Kuczmarski and C L Johnson

National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville MD 20782, USA

aDr Katherine M Flegal, National Center for Health Statistics, 6525 Belcrest Rd, Room 900, Hyattsville MD 20782, USA.


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/m2) was calculated from measured weight and height. Overweight and obesity were defined as follows: Overweight (BMI25.0); 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 (BMI40.0).

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 (BMI30.0) 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 age20 y was 59.4% for men, 50.7% for women and 54.9% overall. The prevalence of class III obesity (BMI40.0) exceeded 10% for non-Hispanic black women aged 40-59 y.

CONCLUSIONS: Between 1976-80 and 1988-94, the prevalence of obesity (BMI30.0) increased markedly in the US. These findings are in agreement with trends seen elsewhere in the world. Use of standardized definitions facilitates international comparisons.


body weight; body mass index; obesity; health surveys; nutrition surveys; United States; whites; blacks; Mexican Americans

Received 3 March 1997; revised 10 July 1997; accepted 8 September 1997
January 1998, Volume 22, Number 1, Pages 39-47
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