This article considers alternate measures of the overweight epidemic that are more robust to measurement error, continuous in the body-mass index (BMI) at the overweight threshold, and sensitive to changes in the BMI distribution. The measures suggest that prevalence rates may understate the severity of the overweight problem. Since 1971, the prevalence of overweight has increased by 37%, while the distribution-sensitive measure has increased by 173%. Furthermore, although Hispanics have the highest prevalence of overweight, the distribution-sensitive measures reveal that overweight Hispanics exceed the overweight threshold by the smallest proportion (21%), whereas overweight non-Hispanic blacks exceed the threshold by 33%, on average.
This is a preview of subscription content, access via your institution.
American Society for Clinical Nutrition. 1998. “The American Society for Clinical Nutrition Supports Obesity Guidelines.” Press release dated June 24. Available on-line at http://www.ascn.org/ascn/pr6-24-98.htm
Dietz, W.H. 2002. “Using BMI to Assess Overweight.” Atlanta, GA: Centers for Disease Control and Prevention. Available on-line at http://188.8.131.52/cdcgrowthcharts/module1/text/page3atext.htm
Flegal, K.M. and R. Troiano. 2000. “Changes in the Distribution of Body Mass Index of Adults and Children in the US Population.” International Journal of Obesity 24:807–18.
Foster, J., J. Greer, and E. Thorbecke. 1984. “A Class of Decomposable Poverty Measures.” Econometrica 52:761–65.
Gallagher, D., M. Visser, D. Sepulveda, R.N. Pierson, T. Harris, and S.B. Heymsfield. 1996. “How Useful Is Body Mass Index for Comparison of Body Fatness Across Age, Sex, and Ethnic Groups?” American Journal of Epidemiology 143:228–39.
Himes, C.L. 2000. “Obesity, Disease, and Functional Limitation in Later Life.” Demography 37:73–82.
Jolliffe, D. and A. Semykina. 1999. “Robust Standard Errors for the Foster-Greer-Thorbecke Class of Poverty Indices: SEPOV.” Stata Technical Bulletin 51:34–36.
Kenchaiah, S., J.C. Evans, D. Levy, P.W. Wilson, E.J. Benjamin, M.G. Larson, W.B. Kannel, and R.S. Vasan. 2002. “Obesity and the Risk of Heart Failure.” New England Journal of Medicine 347:305–13.
Kish, L. 1965. Survey Sampling. New York: John Wiley & Sons.
Kish, L. and M. Frankel. 1970. “Balanced Repeated Replications for Standard Errors.” Journal of the American Statistical Association 65(331):1071–94.
Kurth, T., M. Gaziano, K. Berger, C. Kase, K. Rexrode, N. Cook, J. Buring, and J. Manson. 2002. “Body Mass Index and the Risk of Stroke in Men.” Archives of Internal Medicine 162(22): 2557–62.
Lipton, M. and M. Ravallion. 1995. “Poverty and Policy.” Pp. 2551–657 in The Handbook of Development Economics, Vol. 3, edited by J. Behrman and T.N. Srinivasan. Amsterdam: Elsevier Science.
McKay, B. 2002. “Government’s Standard Lumps Hunks, Athletes With Truly Obese.” Wall Street Journal, July 23, p. B1.
Nagaya, T., H. Yoshida, H. Takahashi, Y. Matsuda, and M. Kawai. 1999. “Body Mass Index or Percentage Body Fat by Bioelectrical Impedance Analysis: Which Variable Better Reflects Serum Lipid Profile?” International Journal of Obesity 23:771–74.
National Center for Health Statistics. 2002. “Prevalence of Overweight and Obesity Among Adults: United States, 1999.” Hyattsville, MD: Center for Disease Control and Prevention. Available on-line at http://www.cdc.gov/nchs/products/pubs/pubd/hestats/obese/obse99.htm
National Heart, Lung, and Blood Institute. 1998. Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: The Evidence Report. NIH Publication No. 98-4083. Rockville, MD: National Institutes of Health.
Oliver, E. and T. Lee. 2002. “Public Opinion and the Politics of America’s Obesity Epidemic.” Research Paper Series No. RWP02-017. Cambridge, MA: Kennedy School of Government, Harvard University. Available on-line at http://papers.ssrn.com/sol3/delivery.cfm/SSRN_ID313824_code020529510.pdf?abstractid=313824
Pagan, J.A. and A. Davila. 1997. “Obesity, Occupational Attainment, and Earnings.” Social Science Quarterly 78:756–70.
Register, C.A. and D.R. Williams. 1990. “Wage Effects of Obesity Among Young Workers.” Social Science Quarterly 71:130–41.
U.S. Department of Health and Human Services. 2000. Healthy People 2010: With Understanding and Improving Health Objectives for Improving Health, 2nd ed. Washington, DC: U.S. Government Printing Office.
—. 2001. The Surgeon General’s Call to Action to Prevent and Decrease Overweight and Obesity. Rockville, MD: U.S. Department of Health and Human Services, Public Health Service, Office of the Surgeon General.
WHO Expert Committee. 1995. Physical Status: The Use and Interpretation of Anthropometry. WHO Technical Report Series, No. 854. Geneva: World Health Organization.
Willett W.C., W.H. Dietz, and G.A. Colditz. 1999. “Guidelines for Healthy Weight.” New England Journal of Medicine 341:427–34.
I thank Jay Variyam, Josh Winicki, Allison Jacknowitz, Joanne Guthrie, Berk Ozler, Deon Filmer, and Hanan Jacoby for their comments and help. The views and opinions expressed in this article do not necessarily reflect the views of the Economic Research Service of the U.S. Department of Agriculture.
About this article
Cite this article
Jolliffe, D. Continuous and robust measures of the overweight epidemic: 1971–2000. Demography 41, 303–314 (2004). https://doi.org/10.1353/dem.2004.0015
- Poverty Index
- Overweight Status
- Overweight Index
- Overweight Population
- True Health Status