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Questions and Answers About Obesity and Health

Q. How much should you weigh?

A. The Body Mass Index (BMI) is the most common measure used to define overweight and obesity. It is calculated as weight divided by the square of the height in inches multiplied by 703. A BMI of 19 to 24 is considered normal, a BMI of 25 to 29 is considered overweight, and people with a BMI of more than 30 are considered obese. An estimated 15% of the U.S. population has a BMI of more than 30, the largest proportion of obese people in the world.

Q. How much of a problem is obesity in America?

A. Obesity is widespread and getting worse. According to a Lou Harris poll released March 15th, most Americans view themselves as overweight:

80% of people over 25 are overweight, up from 58% in the same poll in 1983, 64% in 1990 and 71% in 1995.

One-third of Americans now are 20% or more overweight.

A report by the U.S. Surgeon General issued in 2001, The Surgeon General's Call to Action to Prevent and Decrease Overweight and Obesity, found:

Most people are overweight. In 1999, an estimated 61% of all U.S. adults were overweight or obese.

Obesity (BMI over 30) has been increasing in every state in the nation. Based on 1999 national study, 34% of adults (aged 20 to 74) are overweight, up from 32% in the late 1970's, and more disturbingly, an additional 27% are obese, up from 15% in the late 1970's.

More children are overweight than ever before. According to the 1999 data, 13% of children aged 6 to 11 years and 14% of adolescents are overweight. During the past two decades, the percentage of children who are overweight has nearly doubled, from 7% to 13%, and the percentage of adolescents who are overweight has nearly tripled, from 5% to 14%.

Q. What are the health effects of obesity?

A. Obesity contributes to disease and early death.

According to a report by the United States Surgeon General, obese individuals have a 50% to 100% increased risk of premature death. Approximately 300,000 deaths a year in the U.S. may be attributable to obesity.

Morbidity from obesity may be as great as from poverty, smoking or problem drinking.

Overweight and obesity are associated with increased risk for:

Coronary heart disease. A gain of 10 to 20 lbs. results in an increased risk of coronary heart disease of 1.25 times in women and 1.6 times in men. Weight gains of 22 lbs. in men and 44 lbs. in women result in an increased coronary heart disease risk of 1.75 to 2.65, respectively.

There's a 32% higher rate of death due to cardiovascular disease in NYC than in the nation as a while -- 376 per 100,000 compared to 257 nationally.

Type 2 diabetes. A weight gain of 11 to 18 lbs. increases the risk of developing type-2 diabetes -- the type of diabetes that affects mostly sedentary and overweight people in middle age and older -- to twice that of individuals who did not gain weight, while those who gained 44 lbs. or more have more than four times the risk of type-2 diabetes.

Endometrial, colon, postmenopausal beast and other cancers. A woman with a BMI of 34 or greater has a six times greater risk of developing endometrial cancer than a woman with a normal BMI.

Certain musculoskeletal disorders, such as knee osteoarthritis.

Overweight and obesity aggravates many chronic conditions such as high blood pressure and elevated cholesterol.

Obesity is associated with an increased risk of breathing problems, including sleep apnea and asthma.

Q. How much money is obesity costing us?

A. Obesity's economic costs are high. Direct and indirect costs to the nation are over $100 billion a year.

Direct health care costs include preventive, diagnostic and treatment services.

Indirect costs include wages lost by people unable to work because of illness or disability.

According to the Surgeon General, in 2000 the total direct and indirect costs attributable to obesity were estimated at $117 billion (about evenly split among direct and indirect costs). Most of the cost is attributed to type-2 diabetes, coronary heart disease, and high blood pressure.

Q. Why are we getting fatter?

A. It is widely reported that Americans eat more than ever. Restaurant servings are enormous. We drink more soft drinks and fruit juices, which are loaded with sugars. We eat and drink while in our cars; cars made for the American market have cup holders, European and Japanese cars usually do not.

New York University researchers looked at contemporary food serving sizes. Cooked pasta portions exceed federal dietary standards by 480% and steaks were 224% above standards.

Q. How much difference in your health can losing weight make?

A. Studies have shown that even modest weight loss for overweight people (5% to 15% of excess body weight) reduces disease risk factors, particularly for cardiovascular disease. Weight loss lowers blood pressure, blood sugar and improves lipid levels.

Clinical trials examining the direct effects of weight loss on disease and death are currently underway. But it appears likely that strong direct correlations will be established.

People want to lose weight. But if they succeed, keeping the weight off can be difficult. In the Harris poll mentioned above , 60% of adults said they would like to lose weight. And most Americans have tried: 28% said they tried once or twice, 15% said they tried three to five times, and 15% said they tried more than five times. The last time those polled tried to lose weight, 85% reported that they were successful and 13% said they were not successful.

The real challenge is keeping the weight off. Of those who said they were successful losing weight, 41% said they put most of the weight back on. 57% claim they managed to stay at the reduced weight.

And last, but certainly not least, losing weight makes us look better and feel better