1. Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults Risks and Assessment
NHLBI Obesity Education Initiative
National Heart, Lung, and Blood Institute
in cooperation with the
National Institute of Diabetes and Digestive and Kidney Diseases National Institutes of Health

2. Alarming Trends in Health of the U.S.

3. Definitions Body Mass Index (BMI) describes relative
weight for height: weight (kg)/height (m2)
Overweight = 25–29.9 BMI
Obesity = >30 BMI

4. Assessment of Overweight and Obesity
Body Mass Index (BMI):
weight (lbs) X 703
height (inches2)
Overweight = kg/m2
Obesity = > 30 kg/m2
Waist Circumference
High risk:
Men >102 cm (40 in)
Women >88 cm (35 in)
Other risk factors

6. Age-adjusted prevalence of obesity in Adults ages 20-74 by sex and survey.
(NHES, ; NHANES, , , and ). Source: Health, United States, NCHS.
Note: Obesity is defined as a BMI of 30.0 or higher.

7. Obesity Trends* Among U.S. Adults BRFSS, 1990, 1999, 2008
(*BMI 30, or about 30 lbs. overweight for 5’4” person)
1990
1999
2008
No Data <10% %–14% %–19% %–24% %–29% ≥30% 7

8. Distribution of BMI between 1976-1980 and 2005-2006, adults aged 20-74 years, U.S.

10. NHANES III Prevalence of Hypertension* According to BMI
Percent
*Defined as mean systolic blood pressure 140 mm Hg, mean diastolic 90 mm Hg, or currently taking antihypertensive medication.
Brown C et al. Body Mass Index and the Prevalence of Hypertension and Dyslipidemia. Obes Res. 2000; 8:

11. NHANES III Prevalence of High Blood Cholesterol* According to BMI
Percent
*Defined as >240 mg/dL.
Brown C et al. Body Mass Index and the Prevalence of Hypertension and Dyslipidemia. Obes Res. 2000; 8:

12. NHANES III Prevalence of Low HDL-Cholesterol* According to BMI
Percent
*Defined as <35 mg/dL in men and <45 mg/dL in women.
Brown C et al. Body Mass Index and the Prevalence of Hypertension and Dyslipidemia. Obes Res. 2000;8:

13. Health Benefits of Weight Loss
Decreased cardiovascular risk
Decreased glucose and insulin levels
Decreased blood pressure
Decreased LDL and triglycerides, increased HDL
Decreased severity of sleep apnea
Reduced symptoms of degenerative joint disease
Improved gynecological conditions

14. Care of Overweight/Obese Patients
Requires two steps:
Assessment
Management

15. Assessment of Overweight and Obesity
Body Mass Index
Weight (kg)/height (m2)
Weight (lb)/height (in2) x 703
Table
Waist Circumference
High risk:
Men >102 cm (40 in.)
Women >88 cm (35 in.)

16. Classification of Overweight and Obesity by BMI

17. Determine Absolute Risk Status
Evaluate:
Disease conditions (e.g., CHD, type 2 diabetes, sleep apnea) (+ = very high risk)
Other obesity-associated diseases (e.g., gynecological abnormalities, osteoarthritis)
Cardiovascular risk factors: smoking, hypertension, high LDL, low HDL, IGT, family hx (>3 = high risk)
Other risk factors:
Physical inactivity
High serum triglycerides (>200 mg/dL)

18. Obesity-associated Morbidities
Asthma
Urinary incontinence
Gallbladder disease
Nonalcoholic FLD
Osteoarthritis
Psychological disorders
Type 2 diabetes
Heart disease
Hypertension
Stroke
Cancer
Sleep apnea