Trends in the Distribution of
Body Mass Index Among
Women of Reproductive Age
Andrea Sharma
Division of Nutrition, Physical Activity and Obesity
National Center for Chronic Disease Prevention and Health Promotion
Centers for Disease Control and Prevention
The findings and conclusions in this presentation have not been formally disseminated by
CDC and should not be construed to represent any agency determination or policy.
Presentation Overview
Describe distribution and trends in BMI among
women of reproductive age in the United States
– Adult (20-49 y) and adolescents (12-19 y)
•
•
•
•
Definitions of weight status
National prevalence and trends
By age group
By race/ethnicity
– Summary
Data Source
• National Health and Nutrition Examination
Survey (NHANES)
– US civilian, non-institutionalized population
– Height and weight measured
Classification* of adult underweight,
overweight and obesity by BMI
Obesity Class
Underweight
BMI (kg/m2)
<18.5
Normal
18.5 - 24.9
Overweight
25.0 - 29.9
Obesity
I
II
30.0 - 34.9
35.0 - 39.9
Extreme obesity
III
40+
*National Heart Lung and Blood Institute (NHLBI), 1998
Trends in obesity among U.S. women
aged 20-39 years, 1960-2006
60
55
Obesity Prevalence (%)
50
45
40
35
30
25
20
HP 2010
15
10
5
19
99
20 -0
01 0
20 02
03
20 04
05
-0
6
19
88
-9
4
19
76
-8
0
19
71
-7
4
19
60
-6
2
0
Source: NHES and NHANES: Flegal et al, JAMA 2002; Ogden et al, JAMA 2006; Ogden et al, NCHS data brief #1, 2007.
Obesity defined as BMI≥30.
Change in the distribution of BMI
between 1988-94 and 2005-06 among
U.S. women aged 20-49 years
NHANES III 1988-94
NHANES 2005-06
0.10
0.10
0.08
0.08
D
e
0.06
n
s
i 0.04
t
y
D
e
0.06
n
s
i 0.04
t
y
0.02
0.02
0.00
0.00
10
16
22
28
34
40
46
52
58
10
16
22
BM
I
28
34
40
46
BM
I
Percentile
BMI (kg/m2)
Percentile
BMI (kg/m2)
10th
19.4
10th
20.3
25th
21.3
25th
22.7
50th
24.0
50th
26.1
75th
29.1
75th
32.8
90th
35.0
90th
38.7
52
58
Prevalence of underweight, overweight and
obesity among U.S. women aged 20-49 y
100
90 22.4
80
3.9
6.2
6.2
11.5
12.3
31.2
Percent (%)
7.8
7.4
8.1
7.9
11.4
31.5
13.5
70
6.0
34.2
17.4
Obesity III
(extreme)
35.2
18.6
Obesity II
16.4
21.5
Obesity I
60
25.1
24.6
50
25.8
22.6
Overweight
40
30
52.1
39.5
20
40.6
Normal
37.3
39.1
10
0
Underweight
4.0
4.2
3.3
2.7
3.1
1988-1994
1999-2000
2001-2002
2003-2004
2005-2006
Source: NHANES, unpublished analysis
Trends in obesity among U.S. women of
reproductive age by age group, 1988-2006
60
55
Obesity Prevalence (%)
50
45
40-49 y
40
35
30-39 y
30
25
20-29 y
20
15
10
5
0
1988-94
Source: NHANES: unpublished analysis
Obesity defined as BMI≥30.
1999-00
2001-02
2003-04
2005-06
Prevalence of overweight and obesity
among U.S. women aged 20-49 years
by age group, 2005-2006
70
Percent (%)
60
50
40
37.7
35.2
41.3
Obese
23.8
30
20
10
Overweight
22.6
24.0
22.3
21.9
All
20-29 y
30-39 y
40-49 y
0
Source: NHANES: unpublished analysis
Overweight defined as BMI= 25.0-29.9; Obesity defined as BMI≥30.
Trends in obesity among U.S. women aged
20-49 years by race/ethnicity, 1988-2006
60
Obesity Prevalence (%)
55
NH black
50
45
Mexican
American
40
35
NH white
30
25
20
15
10
5
0
1988-94
Source: NHANES: unpublished analysis
Obesity defined as BMI≥30. NH=non-Hispanic.
1999-00
2001-02
2003-04
2005-06
Prevalence of overweight and obesity
among U.S. women aged 20-49 years
by race/ethnicity, 2005-2006
90
80
Percent (%)
70
60
48.6
50
40
35.2
40.7
Obese
31.7
30
20
10
22.6
20.3
All
NH white
29.5
29.4
NH black
Mexican
American
0
Source: NHANES: unpublished analysis
Overweight defined as BMI 25-29.9; Obesity defined as BMI≥30. NH=non-Hispanic.
Overweight
Prevalence of obesity among U.S. women
aged 20-49 years by age and race/ethnicity,
2003-2006
60
50
Percent (%)
20-29 y
40
30
30-39 y
20
40-49 y
10
0
All
NH white
Source: NHANES: unpublished analysis
Obesity defined as BMI≥30. NH=non-Hispanic.
NH black
Mexican
American
Prevalence of underweight
among U.S. women aged 20-49 years
by race/ethnicity, 2001-2006
5
Percent (%)
4
3
2
3.0
3.5
2.1
1
1.4
0
All
NH white
Source: NHANES: unpublished analysis
Underweight defined as BMI<18.5. NH=non-Hispanic.
NH black
Mexican
American
Classification of adolescent* underweight,
overweight and obesity by gender- and
age-specific BMI percentile
Underweight
Gender- and age-specific
BMI percentile†
<5th
Normal
5th - <85th
Overweight ‡
85th - <95th
Obesity ‡
≥95th
*Adolescent defined as 12-19 years.
† Percentiles based on CDC growth charts.
‡ Overweight formerly known as at risk for overweight. Obesity formerly known as overweight.
Trends in obesity among U.S. adolescent
girls aged 12-19 years, 1966-2006
50
Obesity Prevalence (%)
45
40
35
30
25
20
15
10
HP 2010
5
99
20 00
01
20 02
03
-0
6
19
88
-9
4
19
76
-8
0
19
71
-7
4
19
19
66
-7
0
0
Note: Obesity is defined as BMI ≥ gender- and age-specific 95th percentile from the 2000 CDC Growth Charts.
Source: NHANES: Ogden et al JAMA 2002; Ogden et al JAMA 2006; Ogden et al JAMA 2008.
Prevalence of underweight, overweight and
obesity among U.S. adolescent girls aged 12-19 y
100
10.8
90
80
16.0
16.5
16.1
15.4
14.1
15.5
Obesity
14.8
70
Percent (%)
17.5
18.9
Overweight
60
50
40
71.2
66.9
66.2
66.1
30
Normal
60.8
20
Underweight
10
0
3.2
1.7
3.3
2.3
2.8
1988-1994
1999-2000
2001-2002
2003-2004
2005-2006
Source: NHANES, unpublished analysis
Trends in obesity among U.S. adolescent girls
aged 12-19 years by race/ethnicity, 1988-2006
50
Obesity Prevalence (%)
45
40
35
30
NH black
25
20
Mexican
American
15
NH white
10
5
0
1988-94
1999-00 2001-02
Source: NHANES: MMWR 1997; Ogden et al JAMA 2006; Ogden et at JAMA 2008.
Obesity defined as BMI≥95th percentile. NH=non-Hispanic.
2003-06
Prevalence of overweight and obesity
among U.S. adolescent girls aged 12-19 years
by race/ethnicity, 2003-2006
50
45
40
Percent (%)
35
27.7
30
25
19.9
Obese
Overweight
16.8
14.5
16.5
17.2
16.8
17.2
All
NH white
NH black
Mexican
American
20
15
10
5
0
Source: NHANES: Ogden et al JAMA 2008
Overweight defined as BMI 85th-94th percentile; Obesity defined as BMI≥95th percentile. NH=non-Hispanic.
Prevalence of obesity among U.S. adolescent
girls aged 12-19 years by race/ethnicity,
2003-2006
50
45
40
Percent (%)
35
30
>=97th
Percentile
25
20
19.6
15
10
5
11.1
14.1
9.1
5.7
5.4
8.1
5.8
All
NH white
NH black
Mexican
American
0
Source: NHANES: Ogden et al JAMA 2008
Obesity defined as BMI≥95th percentile. NH=non-Hispanic.
95th to <97th
Percentile
Prevalence of underweight among U.S.
adolescent girls aged 12-19 years
by race/ethnicity, 2001-2006
5
Percent (%)
4
3
2
3.2
2.7
2.1
1
1.1
0
All
NH white
Source: NHANES: Unpublished data.
Underweight defined as BMI<5th percentile. NH=non-Hispanic.
NH black
Mexican
American
Summary
• Underweight relatively stable
• Since 1980, obesity doubled among women,
tripled among adolescent girls
• Obesity may be reaching a plateau
• Obesity higher among older populations
• Racial disparities among women and
adolescent girls
Acknowledgements
• Cathleen Gillespie, Division of Nutrition,
Physical Activity and Obesity