Obesity classification
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Karol Gema Hernandez, M.D. [2]
Classification
Obesity can be defined in absolute or relative terms. In practical settings, obesity is typically evaluated in absolute terms by measuring BMI (body mass index), but also in terms of its distribution through waist circumference or waist-hip circumference ratio measurements.[1] In addition, the presence of obesity needs to be regarded in the context of other risk factors and comorbidities (other medical conditions that could influence risk of complications).[2]
BMI
BMI, or body mass index, is a simple and widely used method for estimating body fat.[3] BMI was developed by the Belgian statistician and anthropometrist Adolphe Quetelet.[4] It is calculated by dividing the subject's weight by the square of his/her height, typically expressed either in metric or US "Customary" units:
- Metric: BMI = kg/m^2
Where kg is the subject's weight in kilograms and m is the subject's height in metres.
- US/Customary: BMI=lb*703/in^2
Where lb is the subject's weight in pounds and in is the subject's height in inches.
The current definitions commonly in use establish the following values, agreed in 1997 and published in 2000:[5]
- A BMI less than 18.5 is underweight
- A BMI of 18.5–24.9 is normal weight
- A BMI of 25.0–29.9 is overweight
- A BMI of 30.0–39.9 is obese
- A BMI of 40.0 or higher is severely (or morbidly) obese
- A BMI of 35.0 or higher in the presence of at least one other significant comorbidity is also classified by some bodies as morbid obesity.[6][7]
In a clinical setting, physicians take into account race, ethnicity, lean mass (muscularity), age, sex, and other factors which can affect the interpretation of BMI. BMI overestimates body fat in persons who are very muscular, and it can underestimate body fat in persons who have lost body mass (e.g. many elderly).[2] Mild obesity as defined by BMI alone is not a cardiac risk factor, and hence BMI cannot be used as a sole clinical and epidemiological predictor of cardiovascular health.[8] According to American Heart Association, when assessing and treating CVD, and obesity- related comorbilities, waist circumference indicating increased metabolic risk is as follows: [9]
- Women: >88 cm or >35 inches
- Men: >102 cm or >40 inches
References
- ↑ Sweeting HN (2007). "Measurement and definitions of obesity in childhood and adolescence: a field guide for the uninitiated". Nutr J. 6: 32. doi:10.1186/1475-2891-6-32. PMID 17963490.
- ↑ 2.0 2.1 National Heart, Lung, and Blood Institute. Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults (PDF). International Medical Publishing, Inc. ISBN 1-58808-002-1.
- ↑ Mei Z, Grummer-Strawn LM, Pietrobelli A, Goulding A, Goran MI, Dietz WH. Validity of body mass index compared with other body-composition screening indexes for the assessment of body fatness in children and adolescents. Am J Clin Nutr 2002;75:978-85. PMID 12036802.
- ↑ Quetelet LAJ. (1871). Antropométrie ou Mesure des Différences Facultés de l'Homme. Brussels: Musquardt.
- ↑ World Health Organization Technical report series 894: "Obesity: preventing and managing the global epidemic.". Geneva: World Health Organization, 2000. PDF. ISBN 92-4-120894-5.
- ↑ "NICE issues guidance on surgery for morbid obesity". National Institute for Health and Clinical Excellence. 19th July 2002. Retrieved 2007-03-08. Check date values in:
|date=(help) - ↑ "Bariatric Surgery". USC Center for Colorectal and Pelvic Floor Disorders. University of Southern California. 2006. Retrieved 2007-03-08.
- ↑ Romero-Corral A, Montori VM, Somers VK; et al. (2006). "Association of bodyweight with total mortality and with cardiovascular events in coronary artery disease: a systematic review of cohort studies". Lancet. 368 (9536): 666–78. doi:10.1016/S0140-6736(06)69251-9. PMID 16920472.
- ↑ Jensen MD, Ryan DH, Apovian CM, Ard JD, Comuzzie AG, Donato KA; et al. (2013). "2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society". Circulation. doi:10.1161/01.cir.0000437739.71477.ee. PMID 24222017.