Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020 Apr;21(4):e12986.
doi: 10.1111/obr.12986. Epub 2020 Feb 4.

Rising prevalence of BMI ≥40 kg/m2 : A high-demand epidemic needing better documentation

Kath Williamson  1   2 , Amy Nimegeer  3 , Michael Lean  1
Affiliations
Review

Rising prevalence of BMI ≥40 kg/m2 : A high-demand epidemic needing better documentation

Kath Williamson et al. Obes Rev. 2020 Apr.

Abstract

Whilst previously rare, some surveys indicate substantial increases in the population with body mass index (BMI) ≥40 kg/m2 since the 1980s. Clinicians report emerging care challenges for this population, often with high resource demands. Accurate prevalence data, gathered using reliable methods, are needed to inform health care practice, planning, and research. We searched digitally for English language sources with measured prevalence data on adult BMI ≥40 collected since 2010. The search strategy included sources identified from recent work by NCD-RisC (2017), grey sources, a literature search to find current sources, and digital snowball searching. Eighteen countries, across five continents, reported BMI ≥40 prevalence data in surveys since 2010: 12% of eligible national surveys examined. Prevalence of BMI ≥40 ranged from 1.3% (Spain) to 7.7% (USA) for all adults, 0.7% (Serbia) to 5.6% (USA) for men, and 1.8% (Poland) to 9.7% (USA) for women. Limited trend data covering recent decades support significant growth of BMI ≥40 population. Methodological limitations include small samples and data collection methods likely to exclude people with very high BMIs. BMI ≥40 data are not routinely reported in international surveys. Lack of data impairs surveillance of population trends, understanding of causation, and societal provision for individuals living with higher weights.

Keywords: BMI ≥40; data quality; prevalence; severe obesity.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing financial interests in relation to this work.

Figures

Figure 1
Figure 1
Search strategy (A) part 1 and 2: NCD‐RisC sources and grey sources, (B) part 3 & 4: literature search
Figure 2
Figure 2
International body mass index (BMI) ≥40 prevalence rates by country: (A) all adults, (B) men, and (C) women
Figure 3
Figure 3
Changes in the distribution of body mass index (BMI) between 1976‐1980 and 2005‐2006, adults aged 20 to 74 years: United States.63 Data are age adjusted by the direct method to the year US Census 2000 estimates using age groups 20 to 39, 40 to 59, and 60 to 74. Overweight is BMI of 25.0 to 29.9 kg/m2; obesity is BMI at or above 30.0 kg/m2; and severe obesity is BMI at or above 40.0 kg/m2. Pregnant women are excluded from the analysis. Sources: NCHS, National Health Examination Survey, and National Health and Nutrition Examination Surveys
See this image and copyright information in PMC

References

    1. Finkelstein EA, Khavjou OA, Thompson H, et al. Obesity and severe obesity forecasts through 2030. Am J Prev Med. 2012;42(6):563‐570. - PubMed
    1. Sturm R. Increases in morbid obesity in the USA: 2000‐2005. Public Health. 2007;121(7):492‐496. - PMC - PubMed
    1. NCD‐Risk Factor Collaboration (NCD‐RisC). Trends in adult body‐mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population based measurement studies with 19.2 million participants. Lancet 2016;387(10026):1377‐1396. - PMC - PubMed
    1. Lumley E, Homer CV, Palfreyman S, Shackley P, Tod AM. A qualitative study to explore the attitude of clinical staff to the challenges of caring for obese patients. J Clin Nurs. 2015;Dec;24(23‐24):3594‐3604. - PubMed
    1. Wiggerman N, Smith K, Kumpar D. What bed size does a patient need? The relationship between body mass index and space required to turn in bed. Nurs Res. 2017;66(6):483‐489. - PMC - PubMed

Publication types

LinkOut - more resources