NWS-9 Reduce the proportion of adults who are obese

National Data Source
National Health and Nutrition Examination Survey (NHANES); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
Yes
Measure
percent (age adjusted—see Comments)
Baseline (Year)
33.9 (2005-2008)
Target
30.5
Target-Setting Method
10 percent improvement
Numerator

Number of persons aged 20 years and over with a body mass index (BMI) equal to or greater than 30.0

Denominator
Number of persons aged 20 years and over
Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Retained from HP2010 objective
Leading Health Indicator
Nutrition, Physical Activity, and Obesity

Comments

Methodology Notes

The NHANES obtains measured weights in examination gowns and heights without shoes. BMI is calculated by dividing weight in kilograms by the square of height in meters.

In 1997, a Consultation on Obesity convened by the World Health Organization recommended standardizing the classification of overweight and obesity. Obesity was defined as a BMI of 30.0 or greater. Further classification of obesity was made as follows: 30.0-34.9 was defined as Class I obesity, 35.0-39.9 as Class II, and 40.0 or greater as Class III. The Expert Panel on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults, convened by NIH in 1998 adopted general concepts of the World Health Organization classification system and it has now been endorsed by more than 50 professional medical societies, consumer groups, and government agencies. For this objective, therefore, a BMI cut point of 30.0 was chosen for adults aged 20 years and older.

Pregnant women are excluded from the numerator and denominator.

Age Adjustment

This Indicator uses Age-Adjustment Groups for four-year data:

  • Total: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Sex: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Race/Ethnicity: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Educational Attainment: 25-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Family Income: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Country of Birth: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Disability Status: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Health Insurance Status: 20-29, 30-39, 40-49, 50-59, 60-64
  • Arthritis Status: 20-49, 50-59, 60-69, 70-79, 80+
  • Diabetes Status: 20-49, 50-59, 60-69, 70-79, 80+
  • Hypertension Status: 20-49, 50-59, 60-69, 70-79, 80+
  • Marital Status: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Veteran Status: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+

This Indicator uses Age-Adjustment Groups for two-year data:

  • Total: 20-39, 40-59, 60+
  • Sex: 20-39, 40-59, 60+
  • Race/Ethnicity: 20-39, 40-59, 60+
  • Educational Attainment: 25-39, 40-59, 60+
  • Family Income: 20-39, 40-59, 60+
  • Country of Birth: 20-39, 40-59, 60+
  • Disability Status: 20-39, 40-59, 60+
  • Health Insurance Status: 20-39, 40-59, 60-64
  • Arthritis Status: 20-39, 40-59, 60+
  • Diabetes Status: 20-39, 40-59, 60+
  • Hypertension Status: 20-39, 40-59, 60+
  • Marital Status: 20-39, 40-59, 60+
  • Veteran Status: 20-39, 40-59, 60+
Caveats and Limitations
BMI will be used as a proxy for obesity in adults until a better marker to identify increased health risk associated with increased relative weight is developed.
Trend Issues
Two-year data are used as a placeholder to provide the latest data available and will be replaced with four-year data when available. Two-year and four-year data are not comparable. Different age adjustment groups are used for the two year and four year data. Two-year estimates are generally less stable and reliable than four-year estimates.
Description of Changes Since the Healthy People 2020 Launch

The original baseline was revised from 34.0 to 33.9 due to a change in the methodology. Obesity was originally coded based on the calculated BMI variable which is rounded in NHANES. To be consistent with NHANES reports, instead of using the calculated BMI variable, BMI is now computed directly from the weight and height variables. The target was proportionately adjusted from 30.6 to 30.5 based on the original target setting method.

References and More Information

  1. National Institutes of Health. Clinical guideline on the identification, evaluation and treatment of overweight and obesity in adults - The Evidence Report. NIH. Obesity Research 6 (Suppl. 2):51S-209S, 1998.
  2. World Health Organization. Obesity: Preventing and Managing the Global Epidemic. Report of a WHO Consultation on Obesity, Geneva, June 1997. Geneva, Switzerland: WHO, 1998.