Commentary: The epidemic of obesity—what's in a name?

Extract

Increases in body mass index and in the prevalence of obesity have been observed in many parts of the world. Campos et al.¹ criticize the description of obesity as ‘epidemic.’ Leaving aside for the moment the use of the word epidemic to describe obesity, they may be dismissing this phenomenon too hastily. Nationally representative data on measured heights and weights in the United States from the National Health and Nutrition Examination Survey (NHANES) programme, show that from the first Health Examination Survey in 1960–62 through the second NHANES in 1976–80, there was little change in the population.² Mean body mass index for men varied from 25.1 in 1960–62 to 25.6 in 1976–80 and for women from 24.9 to 25.3. These changes in BMI would be equivalent to a change in weight of ∼1.5 kg for men of average height and of a little over 1 kg for women.

After this 20 year period of relative stability through 1980, data from the subsequent survey (NHANES III; 1988–94) showed unanticipated increases in mean BMI and in the prevalence of overweight. As one who participated in the events leading up to the initial publication in 1994³ of these findings, I can attest that we were initially surprised by these results. We were concerned that we might have overlooked some error in data collection or processing, but no errors were found. The increases that were first noted in NHANES III have continued. Age-adjusted mean BMI for men increased to 26.8 in 1988–94 and again to 27.9 in 1999–2002. Comparable figures for women are 26.6 and 28.2. These BMI changes are equivalent to a >7 kg increase in weight since 1976–80 for both men and women of average heights.