US adults recommended for weight reduction by 1998 and 2013 obesity guidelines, NHANES 2007-2012

Abstract

Objective: To determine the number and proportion of American adults recommended for weight loss treatment under the 1998 and 2013 guidelines on the management of overweight and obesity in adults and to compare characteristics of individuals recommended for treatment.

Methods: A total of 6,692 adult, non-pregnant participants in the National Health and Nutrition Examination Survey 2007-2012 with complete data on demographics, anthropometrics, and biomedical measures were analyzed.

Results: Compared to the 1998 guidelines, the 2013 guidelines increased the number of adults recommended for weight loss treatment by 20.9% from 116.0 million to 140.2 million, making 64.5% of non-pregnant, non-institutionalized US adults candidates for treatment. The new guidelines recommended treatment for a larger proportion of those overweight, having only one risk factor, or having a large waist circumference. Up to 53.4% of adults could be considered for pharmacologic therapy in addition to lifestyle therapy, and up to 14.7% could be considered for bariatric surgery.

Conclusions: The 2013 guidelines increased the number of adults to be treated with weight loss by 24.2 million, with the increases spread across groups that differ in socio demographic characteristics.