Adult anthropometric
measures,
overweight and
obesity
10
Rosie Sutton
Copyright © 2012, The Health and Social Care Information Centre. All rights reserved
Summary
●
This chapter reports on measurements relevant to obesity: body mass index (BMI),
prevalence of overweight and obesity, and waist circumference. As well as interviewer
measurements of height, weight and waist circumference, self-reported height and
weight estimates are examined.
●
Interviewer-measured mean height was 175.3cm for men and 161.9cm for women,
and interviewer-measured mean weight was 83.9kg for men and 71.0kg for women.
Self-reported mean height estimates were consistently higher, and mean weight
estimates consistently lower than interviewer-measured estimates.
●
Men consistently over-reported their height to a greater degree than women, with men
estimating on average that they were 1.7cm taller than the measurement taken at the
interviewer visit, and women estimating that they were 1.0cm taller. The opposite
effect was apparent for weight, with women under-reporting their weight by an
average of 2.4kg while men under-reported by 1.4kg.
●
Body mass index (BMI), defined as weight in kilograms divided by the square of the
height in metres (kg/m2), was used to assign adult participants into categories such as
overweight and obese. Mean BMI was 27.2kg/m2 in men and 27.1kg/m2 in women,
based on interviewer measures. Mean BMI calculated from self-reported height and
weight was significantly lower, by an average of 0.9kg/m2 for men and 1.2kg/m2 for
women.
●
A similar proportion of men and women were obese (24% and 26% respectively),
based on interviewer measures. However, a higher proportion of men than women was
overweight (41% compared with 33%). Thus 65% of men and 58% of women were
overweight or obese.
●
Using self-reported estimates, 17% of men and 20% of women were obese. Thus
there was a difference of 6 percentage points in the proportions who were obese
based on self-reported figures rather than interviewer-measured. The majority of
participants’ estimates placed them in the same BMI category as interviewer
measures; however, almost a quarter of overweight men and a third of overweight
women placed themselves in the ‘normal’ category by their own estimates, while a
third of obese men and a quarter of obese women placed themselves in the
overweight category by their own estimates.
●
Mean waist circumference was 97.1cm in men and 88.5cm in women. A higher
proportion of women than men had a raised waist circumference (47% and 34%
respectively). Prevalence of a raised waist circumference increased substantially
between the age groups 16-24 and 65-74 in both sexes.
●
The age standardised prevalence of obesity and raised waist circumference was
higher in households in lower quintiles than higher quintiles of equivalised household
income for both men and women. There was a similar pattern for mean BMI and mean
waist circumference among women, but not men.
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The prevalence of obesity increased with increasing levels of deprivation for both men
and women. 22% of men and 19% of women in the least deprived quintile were
obese, rising to 25% and 30% respectively in the most deprived quintile. However, the
pattern was reversed for the prevalence of overweight, which was highest among both
men and women living in the least deprived quintile.
●
National Institute for Health and Clinical Excellence (NICE) guidelines recommend a
combination of BMI and waist circumference to assess health risks from obesity. The
guidelines define low, high and very high waist measurements for men and women. A
high or very high waist circumference is associated with increased health risks for
those with a BMI below 35kg/m2; health risks are very high for those with a BMI of 35
kg/m2 or more regardless of waist circumference.
●
According to the NICE classification using combined categories of BMI and waist
circumference, 18% of men were at increased risk, 15% at high risk and 21% at very
high risk. The equivalent proportions for women were 15% at increased risk, 18% at
high risk and 26% at very high risk.
●
There has been a marked increase in the proportion who were obese between 1993
and 2011. 13% of men were categorised as obese in 1993, compared with 24% in
2011, and 16% of women were obese in 1993 compared with 26% in 2011. The rate of
increase in obesity prevalence has been slower in the second half of the period than
the first half, and there are indications that the trend may be flattening out over recent
years. However, obesity in women in 2010 and 2011 was at its highest level since
1993.
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2
●
10.1 Introduction
10.1.1
Contents of the chapter
The anthropometric measures presented in this chapter focus on measurements relevant to
obesity for adults aged 16 and over. Height and weight data have been collected in each
year of the Health Survey series, and waist circumference in most years. Interviewermeasured height and weight data were used to calculate body mass index (BMI); waist
circumference was used to assess central obesity. In 2011 the Health Survey for the first
time recorded self-reported height and weight, and these were used to calculate selfreported estimates of BMI, overweight and obesity.
Many surveys rely on self report measures of height and weight which are known to be less
accurate than interviewer-measured estimates. The HSE is one of a small number of
surveys that records actual interviewer validated measures of height and weight.
Comparisons between the two are rare; studies that have explored differences between self
report and interviewer measures show self report measures to introduce an element of
bias.1 The HSE 2011 therefore presented a good opportunity to make such comparisons,
and to identify which groups of individuals may under- or over-estimate their height and
weight when self-reporting.
As well as presenting total data for adults for the various measures, the chapter includes
breakdowns by age and sex, strategic health authority, equivalised household income and
area deprivation. Participants are classified according to the National Institute for Health
and Clinical Excellence (NICE) obesity categories for health risk using both BMI and waist
circumference.2
There has been some exploration of the factors associated with obesity measures in
previous HSE reports. The 2007 report included a regression analysis of the risk factors for
those classified as ‘most at risk’ according to the NICE health risk categories;3 the 2006
report included a regression analysis exploring the risk factors associated with a raised
waist circumference;4 and the 2003 report included a regression analysis of risk factors
associated with overweight and obesity.5
10.1.2
Overweight and obesity as health issues
Copyright © 2012, The Health and Social Care Information Centre. All rights reserved
Overweight and obesity are defined as abnormal or excessive fat accumulation that may
impair health.6 Obesity is associated with an increased risk for a number of common causes
of disease and death including diabetes, cardiovascular diseases and some cancers. For
individuals classified as obese the risk of poor health increases sharply with increasing
BMI.7 It is also evident that there are clear health inequalities in the prevalence and impact
of obesity.8
Worldwide obesity is an increasing epidemic, and rates of obesity have more than doubled
since 1980.6 England, along with the rest of the United Kingdom, has one of the highest
rates of obesity within Europe.9 Trends from the HSE series show that nationally, prevalence
of obesity has risen for all age groups between 1993 and 2010,10 although obesity trends
may have started to flatten out more recently. The current prevalence of obesity is of public
health concern not least because of the risk factors for disease and mortality. Alongside
physical ill-health, high levels of obesity have been linked to some mental conditions, lower
self esteem and reduced life prospects.11 Obesity also has a number of economic
implications because of the disproportionate use of health care and associated
expenditure.11 The recent white paper Healthy Lives, Healthy People: Our Strategy for
Public Health in England estimates that excess weight costs the NHS more than £5bn each
year.8,12
Successive governments have introduced a number of initiatives to tackle obesity in
England; some of the most recent include the Responsibility Deal and the Change4Life
campaign. The Public Health Responsibility Deal aims to work alongside businesses and
organisations to improve public health13 while The Change4Life campaign encourages
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families to become more physically active and make healthier food choices.14 In October
2011 the government published A call for action on obesity in England8 which renewed their
commitment to reduce the level of excess weight by working with a range of partners on
prevention and treatment. The call for action focuses on the idea that while physical activity
is important to weight loss, calorie control is pivotal. The national priority proposed for
adults is: ‘a downward trend in the level of excess weight averaged across all adults by
2020’.8
Part of the challenge in encouraging healthy lifestyles is the extent to which people are able
to judge their own weight as being healthy. The Change4Life campaign suggests that as
overweight becomes more common, it is even more likely to be seen as ‘normal’ and not a
cause for concern.15,16 It is therefore particularly important to understand peoples’
perceptions of their own weight. Many large-scale epidemiological studies rely on selfreported BMI for monitoring and estimating prevalence of obesity. Studies have shown that
although measured BMI and self-reported BMI correlate highly, self reports are
systematically biased.1,17,18 Specifically, height is commonly over-reported while weight is
often under-reported, with some variation according to age and sex.
This chapter examines 2011 data in detail, and looks at trends in obesity and overweight
since 1993. Trend data on adult and child obesity, and other key measures, can also be
found in Health Survey for England 2011 trend tables on the Health and Social Care
Information Centre website.19
10.2 Methods and definitions
Methods
Full details of the protocols for carrying out all the measurements are contained in Volume 2
of this report, Methods and Documentation, Appendix B, and are summarised briefly here.
Height and weight were measured during the interviewer visit while waist and hip
circumferences were measured during the nurse visit.20
Height
Height was measured using a portable stadiometer with a sliding head plate, a base plate
and connecting rods marked with a measuring scale. Participants were asked to remove
their shoes. One measurement was taken, with the participant stretching to the maximum
height and the head positioned in the Frankfort plane.21 The reading was recorded to the
nearest millimetre. Participants who were pregnant, unable to stand or were unsteady on
their feet were not measured.
Weight
New Class III Seca scales were introduced for the HSE 2011. These meet a higher
specification than previous (Class IV) scales, and measure up to a maximum of 200kg,
compared with the maximum of 130kg in the earlier models.22
For the weight measurement, participants were asked to remove their shoes and any bulky
clothing. A single measurement was recorded to the nearest 100g. Participants who were
pregnant, unable to stand, or unsteady on their feet were not weighed. Participants who
weighed more than 200kg were asked for their estimated weight because the scales are
inaccurate above this level. These estimated weights were included in the analysis.
In the analysis of height and weight, data were excluded from those who were considered
by the interviewer to have unreliable measurements, for example those who were too
stooped or wearing excessive clothing.
Self-reported height and weight
Early in the interview participants were asked to report how tall they were without shoes,
and how much they weigh without clothes or shoes. Participants could give measurements
in either imperial or metric units, and these were converted to metric units if necessary
4
HSE 2011: VOL1 | CHAPTER 10: ADULT ANTHROPOMETRIC MEASURES, OVERWEIGHT AND OBESITY
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10.2.1
(metres for height, kilograms for weight). If the participant did not know their height and/or
weight or they were unwilling to provide this information the interviewer recorded this
information.
Waist circumference
The waist was defined as the midpoint between the lower rib and the upper margin of the
iliac crest. It was measured using a tape with an insertion buckle at one end. The
measurement was taken twice, using the same tape (waist and hip measurements were
alternated), and was recorded to the nearest millimetre. Those whose two waist
measurements differed by more than 3cm had a third measurement taken. The mean of the
two valid measurements (the two out of the three measurements that were the closest to
each other, if there were three measurements) were used in the analysis.
Participants were excluded from waist measurements if they reported that they were
pregnant, had a colostomy or ileostomy, or were unable to stand. All those with
measurements considered unreliable by the nurse, for example due to excessive clothing or
movement, were also excluded from the analysis.
Response to anthropometric measures
Response rates to anthropometric measurements are shown in Table 10.1. 84% of men and
85% of women provided a valid height measurement, and 84% of both sexes a valid weight
measurement. The response for all anthropometric measures was significantly lower among
men and women aged 75 and over, reflecting a greater proportion that were unable to be
measured, rather than unwillingness.23 Response to waist measurements was very high
among every age group (98% of men and 97% of women).
Table 10.1
10.2.2
Definitions
Body mass index (BMI)
In order to define overweight or obesity, a measurement is required that allows for
differences in weight due to height. A widely accepted measure of weight for height, the
body mass index (BMI), defined as weight in kilograms divided by the square of the height
in metres (kg/m2), has been used for this purpose in the HSE series.
BMI was calculated for all those participants for whom both a valid height and weight
measurement were recorded. Adult participants were classified into the following BMI
groups according to the WHO BMI classification.24
Table 10A
Copyright © 2012, The Health and Social Care Information Centre. All rights reserved
BMI (kg/m2)
Less than 18.5
18.5 to less than 25
25 to less than 30
30 or more
40 or more
Description
Underweight
Normal
Overweight
Obese
Morbidly obese
BMI categories of overweight and obese have frequently been combined to show the
proportion who are either overweight or obese. As in previous years’ reports, a subset of the
obese category has also been defined, namely those with morbid obesity (BMI 40kg/m2 or
more), who are at highest risk of morbidity and mortality.25
Waist circumference
BMI does not distinguish between mass due to body fat and mass due to muscular
physique. It also does not take account of the distribution of fat. It has therefore been
postulated that waist circumference may be a better measure than BMI or waist to hip ratio
(WHR) to identify those with a health risk from being overweight.26
A raised waist circumference has been taken to be greater than 102cm in men and greater
than 88cm in women, in accordance with the definition of abdominal obesity used by the
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5
National Institutes of Health (USA) ATP (Adult Treatment Panel) III.27 These levels identified
people at risk of the metabolic syndrome. It has been shown recently that these levels
corresponded fairly closely to the 95th percentile of waist circumference for healthy people,
indicating that few healthy people have a waist circumference above these thresholds.28
Combined assessment of health risk from obesity
The 2006 NICE evidence-based guidelines include details on prevention, identification,
assessment and management of overweight and obesity, with one aim being to increase
health professionals’ awareness of how to manage overweight and obesity in primary care.2
The guidelines highlight the impact of overweight and obesity on risk factors for developing
other long-term health problems such as coronary heart disease, Type 2 diabetes,
osteoarthritis and some cancers. It states that risk of these co-morbidities should be
identified using both BMI and waist circumference as assessment tools in those with a BMI
less than 35kg/m2. The NICE guidance states that ‘waist circumference is a valid measure of
abdominal fat mass and disease risk in individuals with a BMI less than 35. If BMI is 35 or
more, waist circumference adds little to the absolute measure of risk provided by BMI’. The
NICE categories are defined as follows:
Table 10B
BMI classification
Normal weight (18.5 to less than 25kg/m2)
Overweight (25 to less than 30kg/m2)
Obesity I (30 to less than 35kg/m2)
Obesity II (35 to less than 40kg/m2)
Obesity III (40kg/m2 or more)
Waist circumference
Low
High
Very high
No increased risk
No increased risk
Increased risk
Very high risk
Very high risk
No increased risk
Increased risk
High risk
Very high risk
Very high risk
Increased risk
High risk
Very high risk
Very high risk
Very high risk
Source: NICE guidelines2
For men, low waist circumference in this classification is defined as less than 94cm, high as
94–102cm, and very high as greater than 102cm. For women, low waist circumference is
less than 80cm, high is 80–88cm and very high is greater than 88cm.
NICE also defines categories of Obesity II (35 to less than 40kg/m2) and Obesity III (40kg/m2
or more). For adults with a BMI of 35kg/m2 or more, risks are assumed to be very high with
any waist circumference.2
10.3 Height and weight: interviewer-measured and
self-reported estimates
Table 10.2 shows interviewer-measured and self-reported mean height and mean weight by
age and sex. Interviewer-measured mean height was 175.3cm for men and 161.9cm for
women. It was highest in the 16-44 age group for both men and women, and began to
decrease slightly with increasing age after this, with a slightly steeper drop for the oldest
group (169.5m and 156.4m respectively for men and women aged 75 and over).
Interviewer-measured mean weight was 83.9kg for men and 71.0kg for women; weight
varied by age, being significantly lower in the youngest and oldest age groups for both men
and women, and peaking in the 45-54 age group.
Self-reported measures of mean height and mean weight reflected similar patterns to the
interviewer measures of mean height and weight. However, mean height estimates were
consistently higher, and mean weight estimates consistently lower than interviewermeasured estimates.
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Note that these combined measures (shown in Table 10.12) are based on all adults with
valid height, weight and also waist circumference measurements. The data may therefore
vary slightly from those presented in Table 10.3 for mean BMI and BMI categories which are
based on adults with valid height and weight measurements.
Figure 10A shows the comparison of interviewer-measured and self-reported mean height
for men and women according to age. Men consistently over-reported their height to a
greater degree than women, with men estimating on average that they were 1.7cm taller
than the measurement taken at the interviewer visit, and women estimating that they were
1.0cm taller. There was some variation with age: the gap between self-reported and
interviewer-measured height was smaller among younger adults, but began to widen out
from around the 55-64 age group. Among those aged 75 and over, on average men
estimated that they were more than 4cm taller than their measured height, and women that
they were more than 3cm taller.
Figure 10A
Mean height, by age and sex:
interviewer-measured and self-reported
Men: Measured
Men: Self-reported
Women: Measured
Women: Self-reported
Base: Aged 16 and over
190
185
Mean height (cm)
180
175
170
165
160
155
150
145
140
16 21
26
31
36
41
46
51
56
61
66
71
76
81
86
91
Age (years)
Figure 10B shows how interviewer-measured and self-reported mean weight varied
according to age for men and women, and this time it can be seen that women were less
likely than men to estimate accurately. Overall women under-reported their weight by an
average of 2.4kg while men under-reported by 1.4kg. Again there was some variation in the
difference between interviewer-measured and self reported weight by age group. Among
men, the average gap between measured and self-reported weight was widest among
those aged 55-74 (1.8kg) and narrowest among those aged 25-44 (between 0.7kg and
1.1kg). Among women, the widest gap was in the youngest age group (3.0kg on average),
while those aged 55-74 estimated the most accurately on average (with a gap of 1.7kg to
1.9kg).
Table 10.2, Figures 10A, 10B
Mean weight, by age and sex:
interviewer-measured and self-reported
Men: Measured
Men: Self-reported
Women: Measured
Women: Self-reported
Base: Aged 16 and over
100
95
90
Mean weight (kg)
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Figure 10B
85
80
75
70
65
60
55
50
16 21
26
31
36
41
46
51
56
61
66
71
76
81
86
91
Age (years)
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10.4 Prevalence of obesity, overweight and raised waist
circumference
Prevalence of obesity, overweight and raised waist circumference,
by age and sex
Table 10.3 shows mean BMI and BMI status by age and sex, with estimates based both on
interviewer measurements and self-report. Interviewer-measured estimates are examined
first.
Interviewer-measured estimates
Mean BMI was similar for men and women (27.2kg/m2 and 27.1kg/m2 respectively). Mean
BMI rose with age during young adulthood, changing little in middle and older age (Figure
10C).
A similar proportion of men and women were obese (24% and 26% respectively). However,
a higher proportion of men than women was overweight (41% compared with 33%). Thus
65% of men and 58% of women were overweight or obese, and a lower proportion of men
than women had a BMI in the normal range (34% and 39% respectively). Figure 10C shows
the prevalence of overweight and obesity by age group. Among both men and women,
prevalence of overweight and obesity was lowest in the 16-24 age group, and generally
increased in the older groups, but as with mean BMI prevalence was slightly lower among
those aged 75 and over.
Table 10.3, Figure 10C
Figure 10C
Prevalence of overweight and obesity, by age and sex:
interviewer-measured
Overweight
Obese
Base: Aged 16 and over with valid height and weight measurements
Men
90
80
70
Percent
60
50
40
30
20
10
0
16-24
25-34
35-44
45-54
55-64
65-74
75+
55-64
65-74
75+
Women
90
80
70
60
50
40
30
20
10
0
16-24
25-34
35-44
45-54
Age group
8
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Age group
Percent
10.4.1
Comparison with self-reported estimates
Section 10.3 showed that self-reported estimates of height and weight were often
inaccurate, with both sexes tending to over-estimate their height and under-estimate their
weight; men particularly tended to over-estimate height and women to under-estimate their
weight. The effect of these inaccurate estimates leads to under-estimation of BMI, and
therefore to under-representation of the proportion who are overweight or obese.
The comparison of interviewer-measured and self-reported mean BMI shows a significant
difference of 0.9kg/m2 for men and 1.2kg/m2 for women. The biggest difference between
the estimates was for the oldest age group, with mean BMI according to self-report being
1.9kg/m2 lower among men and 2.0kg/m2 lower among women aged 75 and over. Among
women in younger age groups there was little variation, with self-reported mean BMI
between 1.0kg/m2 and 1.2kg/m2 lower than measured. Among younger men, however,
there was more variation, with the smallest difference for men aged 25-34 (0.4kg/m2), and a
steady increase up to the 65-74 age group (1.4kg/m2).
Using self-reported estimates, 17% of men and 20% of women were obese, and a further
40% and 34% respectively were overweight. Thus there was a difference of 6 percentage
points in the proportions of both men and women who were obese based on self-reported
figures rather than interviewer-measured. The proportions classified as overweight were in
fact similar in both cases, but did not represent the same groups of individuals. The pattern
of under-reporting of obesity and overweight is more clearly depicted in Table 10.7, which
cross-tabulates self-reported and interviewer-measured BMI status. The majority of
participants’ estimates placed them in the same BMI category as interviewer measures:
94% of men and 98% of women who were not overweight, 74% of men and 66% of women
who were overweight and 67% of men and 73% of women who were obese. However,
almost a quarter of overweight men and a third of overweight women placed themselves in
the ‘normal’ category by their own estimates, while a third of obese men and a quarter of
obese women placed themselves in the overweight category by their own estimates.
Interestingly, more obese women than men gave estimates which positioned them as in the
correct category (even if with some under-estimation), whereas more overweight men than
women did so.
It is clear that estimates of obesity based on self-reported measures were significantly
lower than estimates based on measurements, with different patterns of under-reporting
based on sex and age. Nevertheless, many of those who were overweight or obese did give
estimates which placed them in the appropriate BMI category. The widest gaps in
estimates, among adults aged 75 and over, may reflect substantial under-estimation of their
height loss with age, while the degree to which they under-estimated their weight was less
than among some younger or middle aged adults.
Tables 10.3, 10.7
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Waist circumference
Table 10.8 shows mean waist circumference and the prevalence of a raised waist
circumference by age and sex. Mean waist circumference was 97.1cm in men and 88.5cm
in women, and increased with age in both men sexes. Women were significantly more likely
than men to have a raised waist circumference (47% and 34% respectively). As with mean
waist circumference, prevalence of a raised waist circumference increased substantially
with age (from 10% of men and 24% of women aged 16-24 to 57% of men and 67% of
women aged 75 and over).
Table 10.8
10.4.2
Prevalence of obesity, overweight and raised waist circumference,
by strategic health authority
Table 10.4 presents the interviewer-measured observed and age-standardised prevalence
of overweight and obesity by strategic health authority (SHA). The variation in mean BMI by
SHA was marginally statistically significant, with slightly lower means for both men and
women in London and South Central SHAs than in other regions. However, there was no
significant variation for prevalence of obesity or overweight.
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The distribution of waist circumference by SHA is presented in Table 10.9. As for obesity,
there was no significant variation by SHA in the distribution of age-standardised mean waist
circumference, nor in the age-standardised prevalence of raised waist circumference.
Tables 10.4, 10.9
10.4.3
Prevalence of obesity, overweight and raised waist circumference by
equivalised household income
Mean BMI
Table 10.5 shows age-standardised BMI by equivalised household income (interviewermeasured). For women, mean BMI was higher in the two lowest income quintiles
(28.0kg/m2 in each) and lower in highest two income quintiles (26.4kg/m2 and 26.5kg/m2).
Mean BMI did not vary significantly by income in men.
Obesity and overweight
Table 10.5 and Figure 10D show how the prevalence of overweight and obesity varied by
equivalised household income (based on interviewer measures). The prevalence of obesity
followed a pattern similar to that for mean BMI among women; obesity for both men and
women was lower in the highest two quintiles (ranging from 20% to 22%), and higher in the
lower three income quintiles (ranging between 25% and 32%).
Among men, the prevalence of overweight increased with increasing income, in the
opposite direction from obesity, rising from 33% in the lowest income quintile to 48% in the
highest quintile. Among women, the prevalence of overweight varied relatively little by
income. Thus overall, the prevalence of overweight including obesity among men was
lowest in the lowest income quintile, and at a similar level in the remaining four quintiles,
while among women it was lowest in the highest two income quintiles, and similar in the
lowest three.
The prevalence of obesity based on self-reported estimates followed the same pattern as
for interviewer-measured estimates, being lower in the highest two quintiles of equivalised
household income than in the lower three quintiles.
Table 10.5, Figure 10D
Waist circumference
The prevalence of a raised waist circumference varied significantly by equivalised
household income, again following a similar pattern to that for raised waist circumference
and obesity. The prevalence was highest in the lowest two income quintiles (37% to 39%
for men, 55% in each for women) and lowest in the highest two quintiles of (31% to 35% for
men, 39% in each for women).
Table 10.10
10.4.4
Prevalence of obesity, overweight and raised waist circumference by Index of
Multiple Deprivation
The impact of area deprivation was examined by looking at mean BMI, obesity prevalence
and waist circumference by quintiles of the Index of Multiple Deprivation (IMD).
Table 10.6 shows that there was an inverse relationship between mean BMI and area
deprivation. Women in the least deprived two quintiles had lower mean BMI (26.5 kg/m2
26.7 kg/m2 respectively) than those living in the most deprived quintile (27.7kg/m2). There
was no such pattern for men.
The prevalence of obesity increased with increasing levels of deprivation for both men and
women. 22% of men and 19% of women in the least deprived quintile were obese, rising to
25% and 30% respectively in the most deprived quintile. The prevalence of overweight was
highest among both men and women living in the least deprived quintile (47% among men
10
HSE 2011: VOL1 | CHAPTER 10: ADULT ANTHROPOMETRIC MEASURES, OVERWEIGHT AND OBESITY
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Table 10.10 shows how age-standardised mean waist circumference and the prevalence of
a raised waist circumference varied by equivalised household income. For women, the
pattern was similar to that for mean BMI and obesity, with highest mean waist
circumference in the lowest two income quintiles (90.3cm to 90.9cm), and lowest means in
the highest two income quintiles (86.0cm to 86.2cm). There was little variation in mean
waist circumference by equivalised household income in men.
Figure 10D
Prevalence of overweight and obesity,
by equivalised household income and sex
Overweight
Obese
Base: Aged 16 and over with valid height and weight measurements
Men
80
70
60
Percent
50
40
30
20
10
0
Highest
2nd
3rd
4th
Lowest
Equivalised household income quintile
Women
80
70
60
Percent
50
40
30
20
10
0
Highest
2nd
3rd
4th
Lowest
Equivalised household income quintile
Copyright © 2012, The Health and Social Care Information Centre. All rights reserved
and 37% among women). Among men, overweight decreased consistently across quintiles,
to 34% in the most deprived quintile, while among women, overweight varied less in the
four more deprived quintiles of IMD.
Table 10.11 shows that for mean waist circumference and for the prevalence of a raised
waist circumference, the pattern across quintiles of IMD went in different directions for men
and women. For men, mean waist circumference was slightly higher in the two least
deprived quintiles (97.8cm and 97.9cm) than in the most deprived quintile (95.7cm). Among
women, the lowest mean waist circumference was found in the least deprived quintile
(87.0cm), and those in the three most deprived quintiles had higher mean waist
circumference (88.9cm to 89.8cm). As Figure 10E shows, a similar pattern was observed for
prevalence of a raised waist circumference, increasing from most deprived to least deprived
quintile among men (31% to 37%), and from least deprived to most deprived among
women (43% to 51%).
Tables 10.6, 10.11, Figure 10E
10.5 Health risk category with obesity, overweight and waist
circumference
NICE recommends using both BMI and waist circumference as assessment tools to identify
the risk of co-morbidities; different levels of health risk have been defined for different
combinations of these two measures (as outlined in section 10.2.2). The NICE guidance
states that for those with a BMI of 35 or more, waist circumference adds little to the
absolute measure of risk provided by BMI.2 Table 10.12 shows the proportion by age and
HSE 2011: VOL1 | CHAPTER 10: ADULT ANTHROPOMETRIC MEASURES, OVERWEIGHT AND OBESITY
11
Figure 10E
Prevalence of raised waist circumference,
by Index of Multiple Deprivation and sex
Men
Women
Base: Aged 16 and over with a valid waist measurement
60
50
Percent
40
30
20
10
0
Least deprived
4th
3rd
2nd
Most deprived
Index of Multiple Deprivation quintile
sex that were in different health risk categories, as determined by these two measures. Using
combined categories of BMI and waist circumference to assess risk, 18% of men were at
increased risk, 15% at high risk and 21% at very high risk. The equivalent proportions for
women were 15% at increased risk, 18% at high risk and 26% at very high risk. Around half of
men and two in five of women were not at increased risk (47% and 41% respectively).
Figure 10F
Prevalence of risk category based on BMI and waist
circumference, by age and sex
Base: Aged 16 and over with valid height, weight and waist measurements
Men
Not applicable
No increased risk
Increased risk
High risk
Very high risk
100
90
80
Percent
70
60
50
40
30
20
10
0
16-24
25-34
35-44
45-54
55-64
65-74
75+
55-64
65-74
75+
Women
100
90
80
Percent
70
60
50
40
30
20
10
0
16-24
12
25-34
35-44
45-54
Age group
HSE 2011: VOL1 | CHAPTER 10: ADULT ANTHROPOMETRIC MEASURES, OVERWEIGHT AND OBESITY
Copyright © 2012, The Health and Social Care Information Centre. All rights reserved
Age group
Figure 10F shows the risk categories by age. The proportion of those at high or very high
risk generally increased with age up to the 65-74 age group.
Those who were overweight and had a high waist circumference were defined as being at
increased risk of health problems from obesity. This category also included the very small
proportions who were normal weight but with a very high waist circumference (fewer than
1% of men and 3% of women), or obese I but with a low waist circumference (fewer than
1% of both men and women). Among men and women, the prevalence of increased risk
was lowest among those aged 16-24 and generally increased in the middle age groups
(20% to 22% among men, 14% to 18% among women aged 35-74); the proportion was
also relatively high among women aged 75 and over (19%).
Those who were overweight with a very high waist circumference (13% of men and 17% of
women) were defined as being at high risk of health problems. In addition small proportions
that were in the obesity I group with a high waist circumference (2% of men and 1% of
women) were also defined as high risk. Prevalence of this risk category increased with age
up to the age group 65-74.
As indicated above, those who were obese (category I) had increased health risks, even
with a low waist circumference (less than 1% of men and women). 2% of men and 1% of
women were categorised as obese I with a high waist circumference (high risk). A further
14% of men and 16% of women were categorised as obese I with a very high waist
circumference (very high risk).
People who were obese II or III (BMI 35 and over) are defined as being at very high risk of
health problems, regardless of their waist circumference. 5% of men and 7% of women
were in the obese II group; 2% of men and 3% of women were in the obese III group.
Table 10.12, Figure 10F
10.6 Trends in obesity and overweight
Mean BMI and prevalence of obesity increased significantly in both sexes between 1993
and 2011.19 Mean BMI increased from 25.9kg/m2 in 1993 to 27.2kg/m2 in 2011 among men,
and from 25.7kg/m2 in 1993 to 27.1kg/m2 in 2011 among women. Among both men and
women, there has been little change in mean BMI over the last five or six years.
Figure 10G shows the trends in obesity and overweight including obesity from 1993 to
2011, using three year moving averages to smooth out any unusually high or low values in
individual years.
Figure 10G
Overweight and obesity prevalence,
1993-2010, by sex (three year moving
averages)
70
60
50
Percent
Copyright © 2012, The Health and Social Care Information Centre. All rights reserved
Base: aged 16 and over with valid height and weight measurements
Men obese
Men overwt incl obese
Women obese
Women overwt incl obese
40
30
20
10
0
19 19 19 19 19 19 19 20 20 20 20 20 20 20 20 20 20 20 20
93 94 95 96 97 98 99 00 01 02 03 04 05 06 07 08 09 10 11
Year (mid year moving average)
Note: Data from 2003 onwards are weighted for non-response. In these moving averages, some points
combine weighted and unweighted data.
HSE 2011: VOL1 | CHAPTER 10: ADULT ANTHROPOMETRIC MEASURES, OVERWEIGHT AND OBESITY
13
There has been a marked increase in the proportion who were obese (BMI 30kg/m2 or over)
between 1993 and 2011. 13% of men were categorised as obese in 1993, compared with
24% in 2011, and 16% of women were obese in 1993 compared with 26% in 2011. The rate
of increase in obesity prevalence has been slower in the second half of the period than the
first half, and there are indications that the trend may be flattening out over recent years.
However, obesity in women in 2010 and 2011 was at its highest level since 1993.
Among men and women, the proportion who were overweight (BMI 25 to less than
30kg/m2) has changed very little between 1993 and 2011, fluctuating between 41% and
47% in men and between 31% and 34% in women.
Table 10.13, Figure 10G
10.7 Health status by obesity, overweight and waist circumference
10.7.1
Hypertension
Table 10.14 shows how survey-defined hypertension varies according to BMI status.
Hypertension is defined as those with systolic blood pressure of 140mmHg or above or
diastolic blood pressure of 90mmHg or above, or taking medication specifically prescribed
to treat high blood pressure (see Chapter 3). This includes people with doctor-diagnosed
hypertension (whether controlled so that it was below the target threshold, or uncontrolled
and above the threshold) and those with untreated hypertension.
Those who were obese were considerably more likely to have hypertension (53% of men
and 44% of women) than those with normal BMI (16% and 14% respectively). People who
were overweight fell between these two groups, with 32% of overweight men and 28% of
overweight women having hypertension.
The proportion of obese people with controlled hypertension was similar to the proportion
with undiagnosed hypertension. The picture was a little different among those who were
overweight, where more had undiagnosed than controlled hypertension. This suggests that
obese people were slightly more likely than overweight people to have doctor-diagnosed
hypertension.
There was a similar pattern for hypertension according to waist circumference. 52% of men
and 42% of women with a raised waist circumference had hypertension, compared with
20% and 15% respectively among those who did not have a raised waist circumference.
Again there is some evidence that hypertension may be diagnosed more readily in those
with ‘central obesity’ in the form of a raised waist circumference. Similar proportions had
controlled and undiagnosed hypertension among people with raised waist circumference,
while among those with a normal waist, a slightly higher proportion had undiagnosed than
controlled hypertension.
Tables 10.14, 10.15
Longstanding illness
Participants were asked whether they had any longstanding illnesses or conditions, and if
so, whether these limited their activities in any way. Those who were obese were
considerably more likely than those of normal BMI to report at least one limiting
longstanding illness (30% of obese men and 34% of obese women, compared with 14%
and 16% respectively among those of normal BMI). People who were overweight were
slightly more likely than those of normal weight to have a limiting longstanding illness (18%
of men, 23% of women).
Both those who were obese and those who were overweight were a little more likely than
those of normal BMI to have a non-limiting longstanding illness. However, there was less
difference between those who were obese (23% of men, 21% of women) and overweight
(20% and 19% respectively).
There was a similar relationship between limiting longstanding illness and waist
circumference. A higher proportion of those with a raised waist circumference had a limiting
longstanding illness (24% of men, 29% of women) than those who did not have a raised
14
HSE 2011: VOL1 | CHAPTER 10: ADULT ANTHROPOMETRIC MEASURES, OVERWEIGHT AND OBESITY
Copyright © 2012, The Health and Social Care Information Centre. All rights reserved
10.7.2
circumference (17% and 19%). However, the proportions with non-limiting longstanding
illness were similar across the two groups (among men, 22% who were obese, 18%
overweight, and among women 20% who were obese, 17% overweight). Tables 10.16, 10.17
References and notes
The author would like to acknowledge with thanks the contribution of the National Obesity Observatory to
this chapter.
1 Tipping S, Hope S, Pickering K et al. An analysis of mode effects using data from the Health Survey for
England 2006 and the Boost Survey for London. Health and Social Care Information Centre, Leeds,
2008.
2 National Institute for Health and Clinical Excellence. Obesity: guidance on the prevention, identification,
assessment and management of overweight and obesity in adults and children. NICE, London, 2006.
[On-line] www.nice.org.uk/guidance/CG43 page 4 (Accessed 20/08/2012).
3 Tabassum F. Adult anthropometric measures, overweight and obesity. Chapter 3 in Craig R, Shelton N
(eds). Health Survey for England 2007. Volume 1: Healthy lifestyles: knowledge, attitudes and behaviour.
Health and Social Care Information Centre, Leeds, 2008.
4 Hirani V, Ali A. BMI, overweight, and obesity. Chapter 5 in Craig R, Mindell J (eds). Health Survey for
England 2006, Volume 1: Cardiovascular disease and risk factors in adults. Health and Social Care
Information Centre, Leeds, 2008.
5 Hirani V. Anthropometric measures, overweight and obesity. Chapter 6 in Primatesta P, Erens B, Prior G
(eds). Health Survey for England 2003. The Stationery Office, London, 2005.
6 World Health Organisation. Fact Sheet No 311 Obesity and Overweight. WHO 2012. [Online]
www.who.int/mediacentre/factsheets/fs311/en/index.html (Accessed 22nd August 2012)
7 Butland B, Jebb S, McPherson K et al. Tackling Obesities: Future Choices – Project report. Government
Office for Science, London, 2007.
8 Department of Health. Healthy lives, healthy people: a call to action on obesity in England. HMSO,
London, 2011.
www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_130401
(Accessed 22nd August 2012)
9 European Commission, Eurostat. Overweight and obesity – BMI statistics. 2011.
http://epp.eurostat.ec.europa.eu/statistics_explained/index.php/Overweight_and_obesity__BMI_statistics (Accessed 19th October 2012)
10 www.ic.nhs.uk/pubs/hse10trends
11 Sassi, F. Obesity and the Economics of Prevention, Fit not Fat. OECD 2010.
12 HM Government. Healthy Lives, Healthy People: Our Strategy for Public Health in England. HMG,
London, 2010.
www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_127424.pdf
(Accessed 19th October 2012)
13 Department of Health. Public Health Responsibility Deal. DH, London, 2012.
www.dh.gov.uk/health/category/policy-areas/public-health/phrd/ (Accessed 23rd August 2012)
Copyright © 2012, The Health and Social Care Information Centre. All rights reserved
14 Change4Life. Department of Health, London, 2012.
www.nhs.uk/Change4Life/Pages/change-for-life-adults.aspx
www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_127424.pdf
(Accessed 19th October 2012)
15 Johnson F, Cooke L, Croker H and Wardle J. Changing perceptions of weight in Great Britain:
comparison of two population surveys. BMJ 2008;337:494.
16 Department of Health. Change4Life Marketing Campaign. In support of Healthy Weight, Healthy Lives.
DH, London, 2009. www.nhs.uk/Change4Life/supporterresources/downloads/Change4Life_Marketing%20Strategy_April09.pdf (Accessed 19th October 2012)
17 Keith SW, Fontaine KR, Pajewski NM et al. Use of self-reported height and weight biases the body mass
index-mortality association. International Journal of Obesity. 2011;35:401-8.
18 Merrill RM, Richardson JS. Validity of Self-Reported Height, Weight, and Body Mass Index: Findings from
the National Health and Nutrition Examination Survey, 2001-2006. Preventing Chronic Disease. 2009;6:110.
19 www.ic.nhs.uk/pubs/hse11trends
20 This chapter includes results of waist circumference measurements but not waist:hip ratios; details of
how hip circumference was measured are therefore not included in this chapter, but can be found in
Volume 2 Appendix B of this report.
21 The Frankfort Plane is an imaginary line passing through the external ear canal and across the top of the
lower bone of the eye socket, immediately under the eye. A participant’s head is positioned so that the
HSE 2011: VOL1 | CHAPTER 10: ADULT ANTHROPOMETRIC MEASURES, OVERWEIGHT AND OBESITY
15
Frankfort Plane is horizontal. In this position the headplate of the stadiometer will rest on the crown of the
head.
22 In May 2008 and again in March 2010, the Department of Health issued an alert regarding the need to
use Class III scales in certain settings; these include all measurements of those under the age of 18. The
National Child Measurement Programme (NCMP) moved to using Class III scales, since it was
monitoring children’s weight, and it was decided that scales in the HSE should also conform to this
standard. Class III scales are manufactured to a more stringent standard of accuracy, and can provide
accurate measurements up to 200kg.
www.dhsspsni.gov.uk/mdea_ni_2008-036.pdf (Accessed 19th October 2012)
23 See Tables 6-8 in Volume 2 of this report for reasons for non-response to measurements. Craig R, Mindell
J (eds). Health Survey for England 2011: Volume 2. Methods and documentation. Health and Social Care
Information Centre, Leeds, 2011.
www.ic.nhs.uk/pubs/hse11report
24 World Health Organisation body mass index (BMI) classification.
www.who.int/bmi/index.jsp?introPage=intro_3.html (Accessed 20/08/2012)
25 NHS Consensus Development Conference. Gastrointestinal surgery for severe obesity. Nutrition.
1996;12:397-402.
26 Lean M, Han T, Morrison C. Waist circumference as a measure for indicating need for weight
management. BMJ 1995;311:158-161.
27 National Institutes of Health. Third Report of the National Cholesterol Education Program Expert Panel on
Detection, Evaluation and Treatment of High Blood Cholesterol in adults (Adult Treatment Panel III). NIH
Publication 01-3670. NIH, Bethesda, Md, 2001.
16
HSE 2011: VOL1 | CHAPTER 10: ADULT ANTHROPOMETRIC MEASURES, OVERWEIGHT AND OBESITY
Copyright © 2012, The Health and Social Care Information Centre. All rights reserved
28 Flegal KM. Waist circumference of healthy men and women in the United States. Int J Obes. 2007;31:
1134-9.
Tables
10.1. Response to anthropometric measurements, by
age and sex
10.15. Hypertension categories (age-standardised),
by waist circumference and sex
10.2. Interviewer-measured and self-reported mean
height and weight, by age and sex
10.16. Longstanding illness (age-standardised), by
interviewer-measured body mass index (BMI)
status and sex
10.3. Interviewer-measured and self-reported body
mass index (BMI), overweight and obesity
prevalence, by age and sex
10.17. Longstanding illness (age-standardised), by
waist circumference and sex
10.4. Interviewer-measured and self-reported body
mass index (BMI), overweight and obesity
prevalence (observed and age-standardised),
by strategic health authority and sex
10.5. Interviewer-measured and self-reported body
mass index (BMI), overweight and obesity
prevalence (age-standardised), by equivalised
household income and sex
10.6. Interviewer-measured and self-reported body
mass index (BMI), overweight and obesity
prevalence (age-standardised), by Index of
Multiple Deprivation and sex
10.7. Comparison of self-reported and interviewermeasured BMI status (age-standardised), by
sex
10.8. Waist circumference, by age and sex
Copyright © 2012, The Health and Social Care Information Centre. All rights reserved
10.9. Waist circumference (observed and agestandardised), by strategic health authority and
sex
10.10. Waist circumference (age-standardised), by
equivalised household income and sex
10.11. Waist circumference (age-standardised), by
Index of Multiple Deprivation and sex
10.12. Health risk category associated with overweight
and obesity based on body mass index (BMI)
and waist circumference, by age and sex
10.13. Trends in overweight and obesity prevalence,
1993 to 2011, by age and sex
10.14. Hypertension categories (age-standardised), by
interviewer-measured body mass index (BMI)
status and sex
Notes on the tables
1. The group on which the figures in the table are based is stated
at the upper left corner of the table.
2. The data in most tables have been weighted. See Chapter 7,
Volume 2 of this report for more detail. Both unweighted and
weighted sample sizes are shown at the foot of each table.
3. Apart from tables showing age breakdowns, data have been
age-standardised to allow comparisons between groups after
adjusting for the effects of any differences in their age
distributions. See Chapter 8.3.3, Volume 2 of this report for
more detail.
4. The following conventions have been used in tables:
- no observations (zero value)
0 non-zero values of less than 0.5% and thus rounded to zero
[ ] used to warn of small sample bases, if the unweighted base
is less than 50. If a group’s unweighted base is less than 30,
data are normally not shown for that group.
5. Because of rounding, row or column percentages may not add
exactly to 100%.
6. ‘Missing values’ occur for several reasons, including refusal or
inability to answer a particular question; refusal to co-operate
in an entire section of the survey (such as the nurse visit or a
self-completion questionnaire); and cases where the question
is not applicable to the participant. In general, missing values
have been omitted from all tables and analyses.
HSE 2011: VOL1 | CHAPTER 10: ADULT ANTHROPOMETRIC MEASURES, OVERWEIGHT AND OBESITY
17
Table 10.1
Response to anthropometric measurements, by age and sex
Aged 16 and over who were interviewed/had a nurse visit
Proportion providing valid
measurements
2011
Age group
Total
16-24
25-34
35-44
45-54
55-64
65-74
75+
%
%
%
%
%
%
%
%
83
81
81
98
86
84
84
99
84
85
83
98
85
85
84
98
86
87
85
97
84
87
84
97
73
80
73
95
84
84
83
98
87
85
84
98
88
87
86
98
88
84
84
98
87
83
83
97
86
84
84
97
84
85
82
97
70
77
69
95
85
84
82
97
370
199
546
327
677
433
666
431
628
452
504
367
419
273
3810
2482
482
467
280
726
677
450
835
813
563
823
822
557
769
769
567
609
609
433
536
536
328
4780
4693
3178
Men
Height
Weight
BMI
Waist circumference
Women
Height
Weight
BMI
Waist circumference
Bases (unweighted)
Men
Height, weight, BMI (interviewed)
Waist circumference (saw nurse)
Women
Height (interviewed)
Weight, BMI (interviewed)a
Waist circumference (saw nurse)a
18
HSE 2011: VOL1 | CHAPTER 10: ADULT ANTHROPOMETRIC MEASURES, OVERWEIGHT AND OBESITY
Copyright © 2012, The Health and Social Care Information Centre. All rights reserved
a Excluding pregnant women.
Table 10.2
Interviewer-measured and self-reported mean height and weight,
by age and sex
Aged 16 and over
2011
Age group
Mean height (m)
and weight (kg)
Total
16-24
25-34
35-44
45-54
55-64
65-74
75+
176.8
177.1
176.6
175.4
174.2
173.1
169.5
0.41
0.37
0.34
0.34
0.36
0.35
0.44
0.17
178.3
178.1
177.9
177.0
176.2
175.7
173.7
177.0
Standard error of the mean
0.44
0.34
0.34
0.33
0.32
0.32
0.37
0.16
Mean weight (kg)
Interviewer-measured
75.1
82.7
85.0
88.4
87.5
85.6
80.5
83.9
Standard error of the mean
1.02
0.88
0.64
0.79
0.76
0.64
0.78
0.35
Self-reported
73.5
82.0
83.9
86.9
85.7
83.8
79.2
82.5
Standard error of the mean
0.86
0.77
0.60
0.71
0.72
0.63
0.68
0.31
163.9
163.7
163.2
162.4
160.8
159.4
156.4
161.9
0.34
0.29
0.26
0.26
0.25
0.29
0.33
0.12
164.4
164.2
164.0
163.0
162.2
160.8
159.7
162.9
Standard error of the mean
0.36
0.28
0.26
0.27
0.26
0.33
0.31
0.12
Mean weight (kg)
Interviewer-measured
65.3
70.2
72.7
74.3
72.6
71.7
68.8
71.0
Standard error of the mean
0.82
0.65
0.68
0.66
0.59
0.66
0.68
0.30
Self-reported
62.3
67.5
70.3
71.7
70.9
69.8
66.3
68.7
Standard error of the mean
0.74
0.57
0.60
0.61
0.54
0.61
0.55
0.27
313
359
307
335
474
539
470
524
579
669
584
650
569
661
572
637
538
623
545
605
423
502
437
492
307
414
336
400
3203
3767
3251
3643
426
458
403
414
644
707
593
680
734
825
691
764
720
820
692
755
658
766
643
726
510
608
518
580
377
526
412
497
4069
4710
3952
4416
526
617
515
578
610
704
601
686
640
751
648
728
619
725
623
702
528
609
535
592
366
432
378
422
235
318
257
307
3524
4155
3558
4014
536
590
509
538
608
675
557
649
673
759
631
705
644
739
617
679
550
637
537
604
399
475
403
452
315
438
343
412
3725
4312
3599
4037
Men
Mean height (m)
Interviewer-measured
Standard error of the mean
Self-reported
175.3
Women
Mean height (m)
Interviewer-measured
Standard error of the mean
Copyright © 2012, The Health and Social Care Information Centre. All rights reserved
Self-reported
Bases (unweighted)
Men
Interviewer-measured heighta
Self-reported height
Interviewer-measured weighta
Self-reported weight
Women
Interviewer-measured heighta
Self-reported height
Interviewer-measured weighta
Self-reported weight
Bases (weighted)
Men
Interviewer-measured heighta
Self-reported height
Interviewer-measured weighta
Self-reported weight
Women
Interviewer-measured heighta
Self-reported height
Interviewer-measured weighta
Self-reported weight
a Based on those with valid height measurement or valid weight measurement.
HSE 2011: VOL1 | CHAPTER 10: ADULT ANTHROPOMETRIC MEASURES, OVERWEIGHT AND OBESITY
19
Table 10.3
Interviewer-measured and self-reported body mass index (BMI), overweight
and obesity prevalence, by age and sex
Aged 16 and over
2011
BMI (kg/m2) and BMI
status (%)a
Age group
Total
16-24
25-34
35-44
45-54
55-64
65-74
75+
Interviewer-measured
Mean BMI (kg/m2)
24.0
26.2
27.1
28.6
28.6
28.5
28.1
27.2
Standard error of the mean
0.28
0.24
0.19
0.21
0.24
0.21
0.24
0.10
% Underweight
6
% Normal
62
% Overweight
23
% Obese, excluding morbidly obese
8
% Morbidly obese
1
% Overweight, including obese
32
% Obese
9
Self-reported
Mean BMI (kg/m2)
23.2
2
42
39
16
1
56
17
1
31
48
19
2
68
21
0
23
44
30
2
77
32
25
44
29
3
75
31
0
20
49
29
1
80
30
0
24
47
28
1
76
29
1
34
41
22
2
65
24
25.8
26.5
27.7
27.6
27.1
26.2
26.3
Standard error of the mean
0.24
0.21
0.18
0.20
0.21
0.20
0.19
0.09
7
69
17
6
1
23
7
1
48
35
16
1
51
16
1
38
47
13
2
61
14
0
29
46
22
2
71
24
0
31
46
22
2
69
23
1
30
48
21
1
69
22
2
41
43
15
58
15
2
41
40
16
1
58
17
Interviewer-measured
Mean BMI (kg/m2)
24.2
26.2
27.4
28.0
28.1
28.2
28.0
27.1
Standard error of the mean
0.28
0.24
0.24
0.24
0.23
0.25
0.25
0.11
% Underweight
8
% Normal
59
% Overweight
21
% Obese, excluding morbidly obese
10
% Morbidly obese
2
% Overweight, including obese
33
% Obese
12
Self-reported
Mean BMI (kg/m2)
23.1
2
53
26
17
4
46
20
1
39
36
21
4
61
25
1
33
35
27
5
66
31
2
30
36
30
3
69
32
2
28
38
29
3
70
32
1
29
39
29
3
70
32
2
39
33
23
3
58
26
25.1
26.2
27.0
27.0
27.2
26.0
25.9
Standard error of the mean
0.24
0.21
0.21
0.22
0.21
0.34
0.21
0.10
10
67
17
6
1
24
7
2
60
29
13
3
45
16
2
49
38
18
3
58
21
1
44
39
21
3
63
25
2
37
41
23
1
66
25
2
39
41
23
2
65
25
2
45
38
18
1
57
18
3
49
34
18
2
54
20
Men
% Underweight
% Normal
% Overweight
% Obese, excluding morbidly obese
% Morbidly obese
% Overweight, including obese
% Obese
% Underweight
% Normal
% Overweight
% Obese, excluding morbidly obese
% Morbidly obese
% Overweight, including obese
% Obese
a Underweight: less than 18.5
2
Bases (unweighted)
Men – interviewer-measuredb
Men – self-reported
Women – interviewer-measuredb
Women – self-reported
Bases (weighted)
Men – interviewer-measuredb
Men – self-reported
Women – interviewer-measuredb
Women – self-reported
20
307
329
401
406
467
520
587
667
573
646
688
761
562
636
686
755
531
601
639
723
420
489
500
579
306
398
371
491
3166
3619
3872
4382
515
568
503
528
597
681
552
637
633
724
628
702
612
701
612
679
522
587
534
601
364
419
391
452
234
305
310
407
3478
3986
3530
4006
kg/m
Normal weight : 18.5 to less than
25 kg/m2
Overweight: 25 to less than 30
kg/m2
Obese, excluding morbidly
obese: 30 to less than 40 kg/m2
Morbidly obese: 40 kg/m2 or
more
Overweight, including obese: 25
kg/m2 or more
Obese: 30 kg/m2 or more
b Based on those with both valid
height and weight
measurements.
HSE 2011: VOL1 | CHAPTER 10: ADULT ANTHROPOMETRIC MEASURES, OVERWEIGHT AND OBESITY
Copyright © 2012, The Health and Social Care Information Centre. All rights reserved
Women
Table 10.4
Interviewer-measured and self-reported body mass index (BMI), overweight and obesity
prevalence (observed and age-standardised), by strategic health authoritya and sex
Aged 16 and over
2011
Strategic health authoritya
BMI (kg/m2) and
BMI status (%)b
North
East
North Yorkshire
East
West
West
& the Midlands Midlands
Humber
East
of
England
London
South
East
Coast
South
Central
South
West
Men
Observed:
interviewer-measured
Mean BMI (kg/m2)
27.2
27.3
27.1
27.3
27.4
27.5
26.5
27.6
26.7
27.3
Standard error of the mean
0.37
0.29
0.27
0.39
0.31
0.40
0.23
0.43
0.30
0.27
% Underweight
2
% Normal
33
% Overweight
41
% Obese, excluding
morbidly obese
23
% Morbidly obese
2
% Overweight, including
obese
66
% Obese
25
Observed: self-reported
% Overweight, including
obese
60
% Obese
18
Standardised:
interviewer-measured
Mean BMI (kg/m2)
26.6
2
36
38
0
36
38
2
30
44
2
30
41
2
30
41
1
39
42
1
29
47
2
38
42
32
43
23
2
25
1
22
1
25
2
22
4
18
0
21
1
16
1
23
2
63
25
64
26
67
23
68
27
67
26
61
19
70
23
59
17
68
24
57
20
53
20
62
18
61
19
56
18
53
14
63
18
55
14
61
17
26.4
26.1
26.5
26.8
26.4
25.8
26.8
25.8
26.4
Standard error of the mean
0.34
0.29
0.28
0.43
0.27
0.44
0.21
0.44
0.31
0.31
2
32
41
1
36
38
0
37
38
2
31
44
2
31
40
2
31
41
1
39
41
1
27
48
2
37
44
33
44
23
2
23
2
25
1
23
1
25
2
22
4
18
0
23
1
17
1
23
1
66
25
63
25
63
25
67
23
67
27
67
26
60
19
72
24
61
18
67
24
56
16
57
19
53
19
62
18
61
17
55
18
52
14
62
15
56
13
61
16
244
295
427
488
321
369
276
316
344
390
353
410
343
411
240
262
274
309
344
369
170
195
472
545
354
415
285
329
385
435
388
447
484
579
288
310
273
323
379
407
Copyright © 2012, The Health and Social Care Information Centre. All rights reserved
% Underweight
% Normal
% Overweight
% Obese, excluding
morbidly obese
% Morbidly obese
% Overweight, including
obese
% Obese
Standardised:
self-reported
% Overweight, including
obese
% Obese
Bases (unweighted)
Interviewer-measuredc
Self-reported
Bases (weighted)
Interviewer-measuredc
Self-reported
a This table provides data for regional analysis by the configuration of strategic health authorities (SHAs) in place from July 2006.
b Underweight: less than 18.5 kg/m2
Normal weight : 18.5 to less than 25 kg/m2
Overweight: 25 to less than 30 kg/m2
Obese, excluding morbidly obese: 30 to less than 40 kg/m2
Morbidly obese: 40 kg/m2 or more
Overweight, including obese: 25 kg/m2 or more
2 or more
Obese: 30 kg/m
c Based on those with both valid height and weight measurements.
HSE 2011: VOL1 | CHAPTER 10: ADULT ANTHROPOMETRIC MEASURES, OVERWEIGHT AND OBESITY
Continued…
21
Table 10.4 continued
Aged 16 and over
2011
Strategic health authoritya
BMI (kg/m2) and
BMI status (%)b
North
East
North Yorkshire
East
West
West
& the Midlands Midlands
Humber
East
of
England
London
South
East
Coast
South
Central
South
West
Observed:
interviewer-measured
Mean BMI (kg/m2)
27.1
27.3
27.2
27.2
27.6
27.6
26.5
27.3
26.5
27.5
Standard error of the mean
0.42
0.28
0.34
0.37
0.38
0.35
0.29
0.57
0.25
0.27
% Underweight
3
% Normal
36
% Overweight
32
% Obese, excluding
morbidly obese
26
% Morbidly obese
4
% Overweight, including
obese
61
% Obese
29
Observed: self-reported
% Overweight, including
obese
51
% Obese
23
Standardised:
interviewer-measured
Mean BMI (kg/m2)
26.6
2
37
32
2
33
35
2
39
34
2
38
34
2
43
29
3
44
32
2
44
31
3
41
32
3
38
34
27
3
26
3
22
4
23
3
21
5
19
2
20
3
22
3
22
3
62
30
65
30
59
26
60
26
55
26
53
21
54
23
57
25
59
25
50
22
56
22
45
18
51
22
48
20
42
14
45
22
48
18
47
18
26.4
26.1
26.5
26.8
26.4
25.8
26.8
25.8
26.4
Standard error of the mean
0.41
0.28
0.33
0.33
0.37
0.31
0.28
0.53
0.29
0.31
3
36
32
2
37
33
2
33
35
1
43
33
1
40
35
2
45
29
3
45
32
2
44
32
3
42
31
3
39
35
25
3
25
3
26
3
20
4
21
3
20
4
18
1
19
3
22
3
21
2
61
28
61
28
65
29
56
24
59
24
53
24
52
20
54
22
56
25
58
23
51
23
50
21
55
20
46
18
47
20
46
18
43
14
44
20
49
19
47
17
306
373
490
572
412
463
355
384
392
441
425
492
423
504
319
355
330
358
420
440
171
204
451
531
377
425
319
342
359
402
400
459
482
571
318
354
267
305
387
411
% Underweight
% Normal
% Overweight
% Obese, excluding
morbidly obese
% Morbidly obese
% Overweight, including
obese
% Obese
Standardised:
self-reported
% Overweight, including
obese
% Obese
Bases (unweighted)
Interviewer-measuredc
Self-reported
Bases (weighted)
Interviewer-measuredc
Self-reported
a This table provides data for regional analysis by the configuration of strategic health authorities (SHAs) in place from July 2006.
b Underweight: less than 18.5 kg/m2
Normal weight : 18.5 to less than 25 kg/m2
Overweight: 25 to less than 30 kg/m2
Obese, excluding morbidly obese: 30 to less than 40 kg/m2
Morbidly obese: 40 kg/m2 or more
Overweight, including obese: 25 kg/m2 or more
2 or more
Obese: 30 kg/m
c Based on those with both valid height and weight measurements.
22
HSE 2011: VOL1 | CHAPTER 10: ADULT ANTHROPOMETRIC MEASURES, OVERWEIGHT AND OBESITY
Copyright © 2012, The Health and Social Care Information Centre. All rights reserved
Women
Table 10.5
Interviewer-measured and self-reported body mass index
(BMI), overweight and obesity prevalence (agestandardised), by equivalised household income and sex
Aged 16 and over
2011
BMI (kg/m2) and
BMI status (%)a
Equivalised household income quintile
Highest
2nd
3rd
4th
Lowest
Interviewer-measured
Mean BMI (kg/m2)
27.3
27.3
27.7
27.6
26.7
Standard error of the mean
0.20
0.21
0.24
0.33
0.33
1
1
1
3
2
% Normal
% Overweight
% Obese, excluding morbidly obese
% Morbidly obese
% Overweight, including obese
31
48
19
1
68
31
46
21
1
68
31
42
23
3
69
29
40
26
2
68
40
33
23
2
58
% Obese
Self-reported
% Overweight, including obese
% Obese
20
22
26
28
25
60
14
61
17
60
19
60
21
52
20
Interviewer-measured
Mean BMI (kg/m2)
26.4
26.5
27.5
28.0
28.0
Standard error of the mean
0.26
0.21
0.26
0.26
0.28
1
48
30
20
2
51
22
2
45
33
17
3
53
20
2
34
37
24
3
64
27
3
33
32
28
4
64
32
3
33
33
27
5
64
31
41
16
43
16
51
19
55
23
55
26
616
680
595
685
554
617
656
706
530
591
633
678
507
575
669
741
384
434
585
650
662
734
536
630
602
673
610
653
548
621
560
594
534
602
590
652
430
492
522
586
Men
% Underweight
Women
Copyright © 2012, The Health and Social Care Information Centre. All rights reserved
% Underweight
% Normal
% Overweight
% Obese, excluding morbidly obese
% Morbidly obese
% Overweight, including obese
% Obese
Self-reported
% Overweight, including obese
% Obese
Bases (unweighted)
Men – interviewer-measuredb
Men – self-reported
Women – interviewer-measuredb
Women – self-reported
Bases (weighted)
Men – interviewer-measuredb
Men – self-reported
Women – interviewer-measuredb
Women – self-reported
a Underweight: less than 18.5 kg/m2
Normal weight : 18.5 to less than 25 kg/m2
Overweight: 25 to less than 30 kg/m2
Obese, excluding morbidly obese: 30 to less than 40 kg/m2
Morbidly obese: 40 kg/m2 or more
Overweight, including obese: 25 kg/m2 or more
Obese: 30 kg/m2 or more
b Based on those with both valid height and weight measurements.
HSE 2011: VOL1 | CHAPTER 10: ADULT ANTHROPOMETRIC MEASURES, OVERWEIGHT AND OBESITY
23
Table 10.6
Interviewer-measured and self-reported body mass index
(BMI), overweight and obesity prevalence (agestandardised), by Index of Multiple Deprivationa and sex
Aged 16 and over
2011
BMI (kg/m2) and
BMI status (%)b
IMD quintile
Least
deprived
2nd
3rd
4th
Most
deprived
Interviewer-measured
Mean BMI (kg/m2)
27.4
27.2
27.3
27.1
26.9
Standard error of the mean
0.20
0.22
0.21
0.26
0.24
1
30
47
20
2
69
22
2
31
45
22
1
68
23
1
32
43
23
1
67
24
2
37
37
21
3
61
24
2
39
34
23
2
59
25
62
16
57
15
60
18
55
18
54
21
Interviewer-measured
Mean BMI (kg/m2)
26.5
26.7
27.3
27.4
27.7
Standard error of the mean
0.18
0.25
0.22
0.25
0.28
1
42
37
18
2
57
19
2
44
29
22
3
54
25
2
38
31
24
4
59
28
3
34
34
24
4
62
28
2
38
30
26
4
60
30
44
15
45
19
49
20
52
21
52
24
655
750
847
916
682
775
814
931
664
765
817
950
595
681
709
804
570
648
685
781
673
791
741
809
750
845
768
871
717
828
741
882
673
771
648
733
664
751
632
712
Men
% Underweight
% Normal
% Overweight
% Obese, excluding morbidly obese
% Morbidly obese
% Overweight, including obese
% Obese
Self-reported
% Overweight, including obese
% Obese
% Underweight
% Normal
% Overweight
% Obese, excluding morbidly obese
% Morbidly obese
% Overweight, including obese
% Obese
Self-reported
% Overweight, including obese
% Obese
Bases (unweighted)
Men – interviewer-measuredc
Men – self-reported
Women – interviewer-measuredc
Women – self-reported
Bases (weighted)
Men – interviewer-measuredc
Men – self-reported
Women – interviewer-measuredc
Women – self-reported
a The Index of Multiple Deprivation 2010 (IMD) combines a number of indicators, chosen to
cover a range of economic, social and housing issues, into a single deprivation score at the
small area level in England.
b Underweight: less than 18.5 kg/m2
Normal weight : 18.5 to less than 25 kg/m2
Overweight: 25 to less than 30 kg/m2
Obese, excluding morbidly obese: 30 to less than 40 kg/m2
Morbidly obese: 40 kg/m2 or more
Overweight, including obese: 25 kg/m2 or more
Obese: 30 kg/m2 or more
c Based on those with both valid height and weight measurements.
24
HSE 2011: VOL1 | CHAPTER 10: ADULT ANTHROPOMETRIC MEASURES, OVERWEIGHT AND OBESITY
Copyright © 2012, The Health and Social Care Information Centre. All rights reserved
Women
Table 10.7
Comparison of self-reported and
interviewer-measured BMI statusa
(age-standardised), by sex
Aged 16 and over with self-reported and
interviewer-measured height and weight
Self-reported
BMI status
2011
Interviewer-measured BMI status
Not Overweight
overweight
Obese
%
%
%
94
6
23
74
1
32
Men
Not overweight
Overweight
Obese
0
3
67
Overweight, including obese
6
77
99
98
2
0
2
31
66
2
69
1
25
73
99
953
1478
1315
1205
751
914
1158
1397
1374
1070
778
800
Women
Not overweight
Overweight
Obese
Overweight, including obese
Bases (unweighted)
Men
Women
Bases (weighted)
Men
Women
a Not overweight: less than 25kg/m2
Overweight: 25 to less than 30kg/m2
Obese: 30kg/m2 or more
Overweight, including obese: 25kg/m2 or more.
Table 10.8
Waist circumference, by age and sex
Aged 16 and over with a valid waist measurement
Waist circumference (cm) and
raised waist circumference (%)a
2011
Age group
Total
16-24
25-34
35-44
45-54
55-64
65-74
75+
Mean waist circumference (cm)
85.2
92.0
97.3
100.5
102.9
104.0
103.6
97.1
Standard error of the mean
0.98
0.70
0.68
0.60
0.62
0.58
0.69
0.38
10
18
28
43
48
56
57
34
Mean waist circumference (cm)
80.4
83.5
88.1
90.9
91.9
93.0
94.2
88.5
Standard error of the mean
1.01
0.61
0.64
0.72
0.62
0.71
0.69
0.33
24
29
46
52
58
62
67
47
193
273
325
442
425
549
424
542
439
552
357
420
259
312
2422
3090
409
383
462
417
491
486
469
476
393
411
276
302
201
279
2701
2754
Men
Copyright © 2012, The Health and Social Care Information Centre. All rights reserved
% with raised waist circumference
Women
% with raised waist circumference
Bases (unweighted)
Men
Women
Bases (weighted)
Men
Women
a Raised waist circumference: greater than 102cm in men and greater than 88cm in women.
HSE 2011: VOL1 | CHAPTER 10: ADULT ANTHROPOMETRIC MEASURES, OVERWEIGHT AND OBESITY
25
Table 10.9
Waist circumference (observed and age-standardised), by strategic health authoritya and sex
Aged 16 and over with a valid waist measurement
Waist circumference
(cm) and raised waist
circumference (%)b
2011
Strategic health authority
North
East
North Yorkshire
East
West
West
& the Midlands Midlands
Humber
East
of
England
London
South
East
Coast
South
Central
South
West
Men
Observed
Mean waist
circumference (cm)
97.3
97.1
97.0
97.3
97.3
98.6
94.7
99.9
95.9
97.0
Standard error of the mean
1.31
1.47
0.97
1.15
1.11
1.30
0.74
0.91
1.45
1.14
% with raised waist
circumference
Standardised
Mean waist
circumference (cm)
32
34
34
35
35
39
29
41
26
37
97.4
97.6
97.0
96.8
97.7
97.9
96.2
98.2
96.2
96.2
Standard error of the mean
1.31
1.34
0.99
1.29
0.98
1.35
0.76
1.04
1.40
1.26
32
35
34
34
36
37
34
36
27
35
Observed
Mean waist
circumference (cm)
88.0
89.9
90.9
87.0
89.4
88.9
87.2
88.3
88.5
87.0
Standard error of the mean
0.86
0.75
0.85
0.88
1.09
0.89
0.90
1.82
0.72
0.98
% with raised waist
circumference
Women
% with raised waist
circumference
Standardised
Mean waist
circumference (cm)
48
51
53
40
50
50
46
44
48
41
88.1
89.7
90.6
87.0
89.5
88.8
88.4
87.4
88.1
86.5
Standard error of the mean
0.85
0.75
0.93
0.87
1.09
0.87
0.93
1.69
0.81
1.00
48
50
52
40
50
49
50
40
47
40
216
275
299
365
266
345
234
317
260
301
269
336
233
321
174
245
194
257
277
328
139
139
366
354
284
289
221
252
301
271
296
305
383
403
212
249
216
216
283
275
% with raised waist
circumference
Bases (unweighted)
Men
Women
Bases (weighted)
Men
Women
26
HSE 2011: VOL1 | CHAPTER 10: ADULT ANTHROPOMETRIC MEASURES, OVERWEIGHT AND OBESITY
Copyright © 2012, The Health and Social Care Information Centre. All rights reserved
a This table provides data for regional analysis by the configuration of strategic health authorities (SHAs) in place from July 2006.
b Raised waist circumference: greater than 102cm in men and greater than 88cm in women.
Table 10.10
Waist circumference (age-standardised), by equivalised
household income and sex
Aged 16 and over with a valid waist measurement
Waist circumference (cm)
and raised waist
circumference (%)a
2011
Equivalised household income quintile
Highest
2nd
3rd
4th
Lowest
Mean waist circumference (cm)
96.9
96.8
98.5
98.0
96.6
Standard error of the mean
0.81
0.67
0.84
1.05
1.36
35
31
35
37
39
Mean waist circumference (cm)
86.0
86.2
89.5
90.3
90.9
Standard error of the mean
0.75
0.62
0.70
0.73
0.86
39
39
49
55
55
481
506
440
533
427
519
400
548
282
449
505
426
473
468
441
433
432
480
344
416
Men
% with raised waist circumference
Women
% with raised waist circumference
Bases (unweighted)
Men
Women
Bases (weighted)
Men
Women
a Raised waist circumference: greater than 102cm in men and greater than 88cm in women.
Table 10.11
Waist circumference (age-standardised), by Index of
Multiple Deprivationa and sex
Aged 16 and over with a valid waist measurement
2011
IMD quintile
Waist circumference
(cm) and raised waist
circumference (%)b
Least
deprived
2nd
3rd
4th
Most
deprived
Mean waist circumference (cm)
97.8
97.9
96.9
97.0
95.7
Standard error of the mean
0.65
0.67
0.70
1.07
0.90
37
36
35
31
31
Mean waist circumference (cm)
87.0
87.7
89.8
88.9
89.5
Standard error of the mean
0.58
0.73
0.59
0.65
0.87
43
44
49
50
51
534
687
527
683
537
646
427
560
397
514
541
572
583
631
593
571
496
507
488
474
Men
% with raised waist circumference
Women
Copyright © 2012, The Health and Social Care Information Centre. All rights reserved
% with raised waist circumference
Bases (unweighted)
Men
Women
Bases (weighted)
Men
Women
a The Index of Multiple Deprivation 2010 (IMD) combines a number of indicators, chosen to
cover a range of economic, social and housing issues, into a single deprivation score at the
small area level in England.
b Raised waist circumference: greater than 102cm in men and greater than 88cm in women.
HSE 2011: VOL1 | CHAPTER 10: ADULT ANTHROPOMETRIC MEASURES, OVERWEIGHT AND OBESITY
27
Table 10.12
Health risk category associated with overweight and obesity based on body mass
index (BMI) and waist circumference, by age and sex
Aged 16 and over with valid height, weight and waist circumference measurementsa
2011
BMIb and waist circumference
classificationc
Total
Health risk
categoryd
Age group
16-24
25-34
35-44
45-54
55-64
65-74
75+
%
%
%
%
%
%
%
%
8
-
2
-
1
-
0
-
-
0
-
-
2
-
8
2
1
0
-
0
-
2
No increased risk
No increased risk
Increased risk
60
3
62
41
1
42
25
4
29
18
3
21
19
6
1
25
10
7
1
18
15
7
1
23
29
4
0
33
No increased risk
Increased risk
High risk
12
5
4
9
17
18
6
40
18
22
9
49
12
21
14
47
8
19
16
43
5
21
27
53
6
15
26
47
12
17
13
42
Increased risk
High risk
Very high risk
3
3
5
3
9
12
3
13
16
3
19
22
2
20
22
0
24
24
1
0
22
23
0
2
14
17
Very high risk
Very high risk
Very high risk
Very high risk
3
3
0
3
3
4
4
8
8
7
7
4
4
5
5
0
5
5
1
1
8
75
5
6
6
1
1
2
59
18
9
13
2
2
1
47
22
12
19
2
2
0
33
21
17
28
3
3
32
20
19
30
1
1
0
22
21
27
29
1
1
28
17
26
28
2
2
2
45
18
15
21
181
295
400
390
403
321
215
2205
385
413
460
433
362
250
165
2469
Underweight
Low waist circumference
High waist circumference
Very high waist circumference
All underweight
Normal
Low waist circumference
High waist circumference
Very high waist circumference
All normal
Overweight
Low waist circumference
High waist circumference
Very high waist circumference
All overweight
Obesity I
Low waist circumference
High waist circumference
Very high waist circumference
All obese I
Obesity II
Low waist circumference
High waist circumference
Very high waist circumference
All obese II
Obesity III
Low waist circumference
High waist circumference
Very high waist circumference
All obese III
Men – Overall riskd
Not applicable
Not applicable
Not applicable
Very high risk
Very high risk
Very high risk
Very high risk
Not applicable
No increased risk
Increased risk
High risk
Very high risk
Bases (unweighted)
Men
Bases (weighted)
Men
a Percentages and bases in this table are based on those who have a valid measurement for waist circumference, in addition to valid
measurements of height and weight. Therefore subtotals for BMI categories by age and sex in this table are not definitive and may vary
from estimates shown in Table 10.2.
b BMI categories according to National Institute for Health and Clinical Excellence (NICE) guidelines: Underweight: Less than 18.5kg/m2,
Normal: 18.5 to less than 25kg/m2’, Overweight: 25 to less than 30kg/m2, Obesity I: 30 to less than 35kg/m2, Obesity II: 35 to less than
2, Obesity III: 40kg/m2 or more.
40kg/m
c Waist circumference categories according to NICE guidelines:
Low
High
Very high
Men
less than 94cm
94–102cm
more than 102cm
Women
less than 80cm
80–88cm
more than 88cm
d Health risk category according to NICE Guidelines. See note 2.
28
Continued…
HSE 2011: VOL1 | CHAPTER 10: ADULT ANTHROPOMETRIC MEASURES, OVERWEIGHT AND OBESITY
Copyright © 2012, The Health and Social Care Information Centre. All rights reserved
Men
Table 10.12 continued
Aged 16 and over with valid height, weight and waist circumference measurementsa
2011
BMIb and waist circumference
classificationc
Total
Health risk
categoryd
Age group
16-24
25-34
35-44
45-54
55-64
65-74
75+
%
%
%
%
%
%
%
%
6
6
2
2
1
1
1
1
2
2
3
3
1
1
2
2
No increased risk
No increased risk
Increased risk
49
7
2
58
39
10
2
51
25
9
2
36
21
10
2
33
15
11
4
30
10
11
4
26
12
11
8
31
26
10
3
39
No increased risk
Increased risk
High risk
4
10
8
22
7
12
9
28
4
16
17
37
5
12
18
35
2
11
24
37
3
11
26
39
1
11
24
36
4
12
17
33
Increased risk
High risk
Very high risk
1
7
8
1
9
10
0
1
14
15
1
18
19
0
1
20
21
0
21
22
0
24
25
0
1
16
16
Very high risk
Very high risk
Very high risk
Very high risk
3
3
0
6
6
0
7
8
8
8
8
8
8
8
6
6
0
7
7
3
3
6
60
12
9
13
3
3
2
56
14
10
18
4
4
1
38
18
17
26
4
4
1
36
14
19
31
2
2
2
28
15
25
30
3
3
3
24
15
26
32
3
3
1
24
19
24
32
3
3
2
39
15
18
26
256
412
512
488
495
375
253
2791
356
386
451
429
368
268
228
2486
Women
Copyright © 2012, The Health and Social Care Information Centre. All rights reserved
Underweight
Low waist circumference
High waist circumference
Very high waist circumference
All underweight
Normal
Low waist circumference
High waist circumference
Very high waist circumference
All normal
Overweight
Low waist circumference
High waist circumference
Very high waist circumference
All overweight
Obesity I
Low waist circumference
High waist circumference
Very high waist circumference
All obese I
Obesity II
Low waist circumference
High waist circumference
Very high waist circumference
All obese II
Obesity III
Low waist circumference
High waist circumference
Very high waist circumference
All obese III
Women – Overall riskd
Not applicable
Not applicable
Not applicable
Very high risk
Very high risk
Very high risk
Very high risk
Not applicable
No increased risk
Increased risk
High risk
Very high risk
Bases (unweighted)
Women
Bases (weighted)
Women
a Percentages and bases in this table are based on those who have a valid measurement for waist circumference, in addition to valid
measurements of height and weight. Therefore subtotals for BMI categories by age and sex in this table are not definitive and may vary
from estimates shown in Table 10.2.
b BMI categories according to National Institute for Health and Clinical Excellence (NICE) guidelines: Underweight: Less than 18.5kg/m2,
Normal: 18.5 to less than 25kg/m2’, Overweight: 25 to less than 30kg/m2, Obesity I: 30 to less than 35kg/m2, Obesity II: 35 to less than
2, Obesity III: 40kg/m2 or more.
40kg/m
c Waist circumference categories according to NICE guidelines:
Low
High
Very high
Men
less than 94cm
94–102cm
more than 102cm
Women
less than 80cm
80–88cm
more than 88cm
d Health risk category according to NICE Guidelines. See note 2.
HSE 2011: VOL1 | CHAPTER 10: ADULT ANTHROPOMETRIC MEASURES, OVERWEIGHT AND OBESITY
29
Table 10.13
Trends in overweight and obesity prevalence, 1993 to 2011,
by age and sex
Aged 16 and over with both valid height and weight measurements
BMI status
Men
1993
Overweight
Obese
1994
Overweight
Obese
1995
Overweight
Obese
1996
Overweight
Obese
1997
Overweight
Obese
1998
Overweight
Obese
1999
Overweight
Obese
2000
Overweight
Obese
2001
Overweight
Obese
2002
Overweight
Obese
2003b
Overweight
Obese
2004
Overweight
Obese
2005
Overweight
Obese
2006
Overweight
Obese
2007
Overweight
Obese
2008
Overweight
Obese
1993-2011
Age group
Total
16-24
25-34
35-44
45-54
55-64
65-74
75+
%
%
%
%
%
%
%
%
21
5
39
10
48
14
52
17
51
20
54
15
46
11
44
13
25
40
46
51
51
53
48
44
6
10
16
17
18
18
15
14
24
6
40
12
47
16
49
19
51
22
50
18
49
14
44
15
22
6
43
13
48
16
49
21
51
24
52
20
47
16
45
16
22
5
43
13
48
18
52
22
47
27
56
18
50
12
45
17
23
5
40
16
48
17
52
21
52
23
55
21
48
16
46
17
21
6
39
16
46
21
49
23
52
21
49
22
52
18
44
19
18
9
41
20
48
21
49
25
53
26
50
24
52
17
45
21
27
10
44
16
48
23
51
26
51
27
52
24
52
18
47
21
21
9
42
18
47
24
48
28
47
28
52
26
52
19
43
22
23
9
41
18
47
25
48
28
50
27
49
29
50
21
43
22
23
8
41
18
50
25
48
30
48
30
48
28
54
19
44
23
24
8
44
17
46
27
47
28
47
29
47
28
49
17
43
22
25
9
41
21
48
25
48
28
47
33
49
31
51
18
43
24
24
9
39
16
47
25
40
35
48
31
49
28
50
22
41
24
25
8
41
18
46
26
44
31
44
34
50
33
49
23
42
24
a Overweight: 25 to less than 30kg/m2; Obese, including morbidly obese: 30kg/m2 or more.
b From 2003 onwards, data have been weighted for non-response.
Continued…
30
HSE 2011: VOL1 | CHAPTER 10: ADULT ANTHROPOMETRIC MEASURES, OVERWEIGHT AND OBESITY
Copyright © 2012, The Health and Social Care Information Centre. All rights reserved
a
Table 10.13 continued
Aged 16 and over with both valid height and weight measurements
BMI statusa
2009
Overweight
Obese
2010
Overweight
Obese
2011
Overweight
Obese
1993-2011
Age group
Total
16-24
25-34
35-44
45-54
55-64
65-74
75+
%
%
%
%
%
%
%
%
29
6
38
13
50
21
45
34
49
32
52
30
49
23
44
22
22
13
37
19
49
28
44
35
44
37
53
28
50
26
42
26
23
9
39
17
48
21
44
32
44
31
49
30
47
29
41
24
20
8
25
11
29
17
37
19
39
24
41
22
42
16
32
16
20
8
25
13
28
17
36
18
39
26
41
25
36
16
31
17
19
8
25
13
31
17
36
22
42
23
45
24
41
17
33
18
19
8
28
15
30
18
39
19
41
28
43
25
40
20
34
18
19
9
27
15
32
18
36
23
37
30
44
25
41
22
33
20
17
11
27
16
30
21
36
24
39
29
41
29
35
21
32
21
19
10
27
16
34
19
35
26
40
29
40
30
40
20
33
21
22
9
27
16
31
19
36
24
41
29
41
30
41
23
34
21
22
12
26
19
31
22
36
28
38
31
41
30
41
20
33
23
21
11
27
21
34
23
38
25
36
29
38
28
43
22
34
23
18
13
28
18
33
22
33
26
39
28
41
30
40
26
33
23
24
12
31
17
30
24
36
27
37
32
40
29
46
21
34
23
19
12
27
19
30
25
35
28
37
28
42
34
40
26
32
24
Copyright © 2012, The Health and Social Care Information Centre. All rights reserved
Women
1993
Overweight
Obese
1994
Overweight
Obese
1995
Overweight
Obese
1996
Overweight
Obese
1997
Overweight
Obese
1998
Overweight
Obese
1999
Overweight
Obese
2000
Overweight
Obese
2001
Overweight
Obese
2002
Overweight
Obese
2003b
Overweight
Obese
2004
Overweight
Obese
2005
Overweight
Obese
a Overweight: 25 to less than 30kg/m2; Obese, including morbidly obese: 30kg/m2 or more.
b From 2003 onwards, data have been weighted for non-response.
Continued…
HSE 2011: VOL1 | CHAPTER 10: ADULT ANTHROPOMETRIC MEASURES, OVERWEIGHT AND OBESITY
31
Table 10.13 continued
Aged 16 and over with both valid height and weight measurements
1993-2011
Age group
Total
16-24
25-34
35-44
45-54
55-64
65-74
75+
%
%
%
%
%
%
%
%
20
12
29
18
30
24
35
27
36
30
38
35
42
27
32
24
22
10
25
19
35
24
32
30
37
31
37
32
40
27
32
24
20
14
27
19
31
25
35
29
38
31
38
33
40
26
32
25
23
17
27
16
29
24
36
27
39
29
44
31
35
26
33
24
21
11
28
21
30
26
34
30
39
32
37
37
37
27
32
26
21
12
26
20
36
25
35
31
36
32
38
32
39
32
33
26
Bases (unweighted)
Men 1993
990
Men 1994
935
Men 1995
869
Men 1996
908
Men 1997
476
Men 1998
825
Men 1999
389
Men 2000
400
Men 2001
757
Men 2002
1553
Men 2003
686
Men 2004
255
Men 2005
367
Men 2006
577
Men 2007
321
Men 2008
695
Men 2009
210
Men 2010
334
Men 2011
307
Women 1993
1020
Women 1994
990
Women 1995
979
Women 1996
1016
Women 1997
510
Women 1998
903
Women 1999
459
Women 2000
362
Women 2001
856
Women 2002
1719
Women 2003
788
1444
1373
1309
1290
710
1261
566
591
1051
464
962
388
463
762
383
848
245
431
467
1544
1524
1521
1500
816
1433
647
674
1221
513
1088
1313
1288
1296
1348
714
1229
626
662
1220
629
1178
478
505
1084
518
1071
337
553
573
1459
1418
1394
1493
780
1449
744
778
1513
737
1452
1231
1076
1078
1247
667
1197
579
528
1112
485
1001
390
531
933
463
959
306
533
562
1306
1227
1258
1385
766
1373
689
632
1331
590
1142
1020
925
919
938
511
910
466
469
958
445
997
424
501
986
436
1053
301
552
531
1060
988
1028
1007
552
1043
465
509
1038
519
1194
841
816
820
831
414
745
383
376
766
329
736
319
355
735
370
737
281
446
420
991
1048
936
986
479
853
410
422
871
403
810
408
382
416
435
193
433
195
234
403
203
406
190
208
446
231
490
160
295
306
657
689
613
677
351
676
285
326
584
300
616
7247
6795
6707
6997
3685
6600
3204
3260
6267
2969
5966
2444
2930
5523
2722
5853
1840
3144
3166
8037
7884
7729
8064
4254
7730
3699
3703
7414
3509
7090
2006
Overweight
Obese
2007
Overweight
Obese
2008
Overweight
Obese
2009
Overweight
Obese
2010
Overweight
Obese
2011
Overweight
Obese
a Overweight: 25 to less than 30kg/m2; Obese, including morbidly obese: 30kg/m2 or more.
b From 2003 onwards, data have been weighted for non-response.
Continued…
32
HSE 2011: VOL1 | CHAPTER 10: ADULT ANTHROPOMETRIC MEASURES, OVERWEIGHT AND OBESITY
Copyright © 2012, The Health and Social Care Information Centre. All rights reserved
BMI statusa
Table 10.13 continued
Aged 16 and over with both valid height and weight measurements
BMI statusa
Women 2004
Women 2005
Women 2006
Women 2007
Women 2008
Women 2009
Women 2010
Women 2011
Bases (weighted)
Men 2003
Men 2004
Men 2005
Men 2006
Men 2007
Men 2008
Men 2009
Men 2010
Men 2011
Women 2003
Women 2004
Women 2005
Women 2006
Women 2007
Women 2008
Women 2009
Women 2010
Women 2011
1993-2011
Age group
Total
16-24
25-34
35-44
45-54
55-64
65-74
75+
%
%
%
%
%
%
%
%
294
385
679
324
787
233
387
401
453
531
935
474
1026
299
559
587
649
668
1308
632
1309
426
693
688
527
614
1125
559
1176
342
750
686
538
588
1106
522
1196
343
613
639
393
364
776
415
828
286
460
500
281
259
575
281
661
192
381
371
3135
3409
6504
3207
6983
2121
3843
3872
960
418
491
930
461
1029
334
564
515
912
378
432
866
405
935
297
500
503
1194
481
552
991
499
1068
346
611
597
1085
460
524
942
466
1020
315
544
552
1316
573
620
1246
603
1243
389
651
633
1289
564
628
1207
599
1241
393
643
628
1073
465
521
993
514
1059
343
619
612
1073
459
517
996
497
1057
346
631
612
943
399
462
888
446
968
291
516
522
982
425
489
914
452
985
313
529
534
664
276
311
599
296
610
207
368
364
694
295
322
637
312
663
216
378
391
369
160
187
368
189
409
147
235
234
536
231
272
511
252
549
166
297
310
6519
2772
3144
6014
3008
6385
2055
3563
3478
6570
2812
3184
6074
2983
6450
2045
3523
3530
Copyright © 2012, The Health and Social Care Information Centre. All rights reserved
a Overweight: 25 to less than 30kg/m2; Obese, including morbidly obese: 30kg/m2 or more.
b From 2003 onwards, data have been weighted for non-response.
HSE 2011: VOL1 | CHAPTER 10: ADULT ANTHROPOMETRIC MEASURES, OVERWEIGHT AND OBESITY
33
Table 10.14
Hypertension categories (age-standardised), by interviewermeasured body mass index (BMI) status and sex
Aged 16 and over with three valid BP measurements and valid
height and weight measurementsa
Hypertension
categoriesb
2011
c
Totala
BMI status
Underweight
Normal Overweight
Obese
%
%
%
%
%
Normotensive untreated
Hypertensive controlled
Hypertensive uncontrolled
Hypertensive untreated
d
d
d
d
84
4
3
9
68
11
5
16
47
20
12
21
69
11
6
14
All with hypertension
d
16
32
53
31
[91]
[3]
[1]
[5]
[9]
86
4
3
7
14
72
9
6
13
28
56
18
10
17
44
72
10
6
11
28
20
47
508
887
856
811
489
656
2070
2683
32
45
603
821
866
721
493
584
2194
2411
Men
Women
Normotensive untreated
Hypertensive controlled
Hypertensive uncontrolled
Hypertensive untreated
All with hypertension
Bases (unweighted)
Men
Women
Bases (weighted)
Men
Women
a The total column includes those without a valid height or weight measurement, and corresponds
with the totals shown in Table 3.6 in Chapter 3.
b Normotensive untreated: Systolic blood pressure (SBP) less than 140mmHg and diastolic blood
pressure (DBP) less than 90mmHg and not taking medication prescribed for high blood pressure
Hypertensive controlled: SBP less than 140mmHg and DBP less than 90mmHg and taking
medication prescribed for high blood pressure
Hypertensive uncontrolled: SBP at least 140mmHg or DBP at least 90mmHg and taking
medication prescribed for high blood pressure
Hypertensive untreated: SBP at least 140mmHg or DBP at least 90mmHg and not taking
medication prescribed for high blood pressure
All with hypertension: SBP at least 140mmHg or DBP at least 90mmHg or taking medication
prescribed for high blood pressure.
c Underweight: less than 18.5kg/m2
Normal weight: 18.5 to less than 25kg/m2
Overweight: 25 to less than 30kg/m2
Obese, including morbidly obese: 30kg/m2 or more.
d Data not shown because the base is too small.
34
HSE 2011: VOL1 | CHAPTER 10: ADULT ANTHROPOMETRIC MEASURES, OVERWEIGHT AND OBESITY
Copyright © 2012, The Health and Social Care Information Centre. All rights reserved
[ ] Results in brackets should be treated with caution because of the small base size.
Table 10.15
Hypertension categories (age-standardised), by
waist circumference and sex
Aged 16 and over with three valid BP measurements
and a valid waist measurementa
Hypertension
categoriesb
Waist circumference
2011
c
Totala
Non raised
Raised
waist
waist
circumference circumference
%
%
%
Normotensive untreated
Hypertensive controlled
80
5
48
20
69
11
Hypertensive uncontrolled
Hypertensive untreated
3
11
12
20
6
14
All with hypertension
20
52
31
85
4
3
8
15
58
16
9
16
42
72
10
6
11
28
1220
1355
808
1263
2070
2683
1367
1245
786
1108
2194
2411
Men
Women
Normotensive untreated
Hypertensive controlled
Hypertensive uncontrolled
Hypertensive untreated
All with hypertension
Bases (unweighted)
Men
Women
Bases (weighted)
Men
Women
a The total column includes those without a valid waist measurement, and
corresponds with the totals shown in Table 3.6 in Chapter 3.
b Normotensive untreated: Systolic blood pressure (SBP) less than 140mmHg and
diastolic blood pressure (DBP) less than 90mmHg and not taking medication
prescribed for high blood pressure
Hypertensive controlled: SBP less than 140mmHg and DBP less than 90mmHg
and taking medication prescribed for high blood pressure
Hypertensive uncontrolled: SBP at least 140mmHg or DBP at least 90mmHg
and taking medication prescribed for high blood pressure
Hypertensive untreated:§SBP at least 140mmHg or DBP at least 90mmHg and
not taking medication prescribed for high blood pressure
All with hypertension: SBP at least 140mmHg or DBP at least 90mmHg or taking
medication prescribed for high blood pressure.
Copyright © 2012, The Health and Social Care Information Centre. All rights reserved
c Raised waist circumference: greater than 102cm in men and greater than 88cm
in women.
HSE 2011: VOL1 | CHAPTER 10: ADULT ANTHROPOMETRIC MEASURES, OVERWEIGHT AND OBESITY
35
Table 10.16
Longstanding illness (age-standardised), by interviewer-measured
body mass index (BMI) status and sex
Aged 16 and over with valid height and weight measurementsa
Longstanding
illness
2011
BMI statusb
Underweight
Totala
Normal Overweight
Obese
%
%
%
%
%
[11]
[19]
[70]
14
14
73
18
20
62
30
23
47
21
18
62
19
13
68
16
15
69
23
19
58
34
21
45
24
17
59
33
78
965
1474
1374
1285
793
1034
3820
4785
50
78
1167
1391
1440
1146
820
914
4219
4384
Men
Limiting longstanding illness
Non-limiting longstanding illness
No longstanding illness
Women
Limiting longstanding illness
Non-limiting longstanding illness
No longstanding illness
Bases (unweighted)
Men
Women
Bases (weighted)
Men
Women
a The total column includes those without a valid height or weight measurement.
b Underweight: less than 18.5kg/m2
Normal weight: 18.5 to less than 25kg/m2
Overweight: 25 to less than 30kg/m2
Obese, including morbidly obese: 30kg/m2 or more.
36
HSE 2011: VOL1 | CHAPTER 10: ADULT ANTHROPOMETRIC MEASURES, OVERWEIGHT AND OBESITY
Copyright © 2012, The Health and Social Care Information Centre. All rights reserved
[ ] Results in brackets should be treated with caution because of the small base size.
Table 10.17
Longstanding illness (age-standardised), by waist
circumference and sex
Aged 16 and over with valid waist measurementa
Longstanding
illness
2011
Waist circumferenceb
Totala
Non raised
Raised
waist
waist
circumference circumference
%
%
%
17
18
65
24
22
54
21
18
62
19
17
64
29
20
51
24
17
59
1485
1591
937
1498
3820
4785
1780
1452
921
1301
4219
4384
Men
Limiting longstanding illness
Non-limiting longstanding illness
No longstanding illness
Women
Limiting longstanding illness
Non-limiting longstanding illness
No longstanding illness
Bases (unweighted)
Men
Women
Bases (weighted)
Men
Women
a The total column includes those without a valid waist measurement.
b Raised waist circumference: greater than 102cm in men and greater than 88cm
Copyright © 2012, The Health and Social Care Information Centre. All rights reserved
in women.
HSE 2011: VOL1 | CHAPTER 10: ADULT ANTHROPOMETRIC MEASURES, OVERWEIGHT AND OBESITY
37

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