DOCSLIB.ORG

Evidence Based Review of Weight Loss Medicines

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Evidence Based Review of Weight Loss Medicines NZHTA REPORT August 2004 Volume 7 Number 6 Evidence Based Review of Weight Loss Medicines: A report commissioned by the New Zealand Accident Compensation Corporation (ACC) Pamela Smartt New Zealand Health Technology Assessment Department of Public Health and General Practice Christchurch School of Medicine Christchurch, NZ. Division of Health Sciences, University of Otago NEW ZEALAND HEALTH TECHNOLOGY ASSESSMENT (NZHTA) Department of Public Health and General Practice Christchurch School of Medicine, Christchurch, New Zealand Evidence Based Review of Weight Loss Medicines: A report commissioned by the New Zealand Accident Compensation Corporation (ACC) Pamela Smartt NZHTA REPORT August 2004 Volume 7 Number 6 This report should be referenced as follows: Smartt, P. Evidence based review of weight loss medicines: a report commissioned by the New Zealand Accident Compensation Corporation (ACC). NZHTA Report 2004 ; 7(6) . 2004 New Zealand Health Technology Assessment (NZHTA) ISBN 1-877235-70-9 ISSN 1174-5142 i Acknowledgements This report was prepared by Dr Pamela Smartt (Principal Investigator) who conducted the critical appraisals and prepared the project report. Dr Ray Kirk (NZHTA Director until February 2005) also provided comment on various drafts and coordinated the overall project. Dr Robert Weir (NZHTA Acting Director from February 2005) coordinated the project from February 2005. Ms Margaret Paterson (NZHTA Information Specialist) developed and undertook the search strategy and coordinated retrieval of documents. Mrs Ally Reid (NZHTA Administrative Secretary) provided document formatting. The Canterbury Medical Library assisted with the retrieval of articles. NZHTA is a Research Unit of the University of Otago funded under contract to the Ministry of Health. Disclaimer New Zealand Health Technology Assessment (NZHTA) takes great care to ensure the information supplied within the project timeframe is accurate, but neither NZHTA, the University of Otago, nor the contributors involved can accept responsibility for any errors or omissions. The reader should always consult the original database from which each abstract is derived along with the original articles before making decisions based on a document or abstract. All responsibility for action based on any information in this report rests with the reader. NZHTA and the University of Otago accept no liability for any loss of whatever kind, or damage, arising from reliance in whole or part, by any person, corporate or natural, on the contents of this report. This document is not intended as personal health advice. People seeking individual medical advice are referred to their physician. The views expressed in this report are those of NZHTA and do not necessarily represent those of the University of Otago or the New Zealand Ministry of Health. Copyright Copyright © to Accident Compensation Corporation 2005. All rights reserved. No part of this report may be reproduced or distributed by any person without prior written permission and/or licence from the Accident Compensation Corporation. http://www.acc.co.nz/ EVIDENCE BASED REVIEW OF WEIGHT LOSS MEDICINES: A REPORT COMMISSIONED BY THE NEW ZEALAND ACC ii Contact details New Zealand Health Technology Assessment (NZHTA) Department of Public Health and General Practice Christchurch School of Medicine and Health Sciences PO Box 4345 Christchurch New Zealand Tel: +64 3 364 3696 Fax: +64 3 364 3697 Email: [email protected] Web Site: http://nzhta.chmeds.ac.nz/ EVIDENCE BASED REVIEW OF WEIGHT LOSS MEDICINES: A REPORT COMMISSIONED BY THE NEW ZEALAND ACC iii Contents Contents ..................................................................................................................iii Executive Summary ............................................................................................... vii Recommendations ................................................................................................ viii Background...............................................................................................................1 Definition and measurement of obesity........................................................................1 The health consequences of obesity..............................................................................1 Factors influencing body weight....................................................................................2 Clinically significant weight reduction...........................................................................3 Obesity and Injury............................................................................................................3 Obesity trends in NZ.......................................................................................................3 The economic cost of obesity.........................................................................................4 Benefits associated with weight loss..............................................................................4 Review questions ..................................................................................................... 7 Pharmacological treatments for obesity .................................................................. 9 Pharmacological interventions registered in New Zealand........................................9 Phentermine (Duromine TM , Umine Timedcaps)..........................................................9 Diethylpropion hydrochloride (Tenuate Dospan).....................................................10 Sibutramine hydrochloride (Reductil ®, Meridia ®) ......................................................11 Orlistat (Xenical ®)...........................................................................................................12 Meal replacement plans..................................................................................................14 Methodology ...........................................................................................................15 Systematic review............................................................................................................15 Search strategy and information sources ....................................................................16 Study selection criteria...................................................................................................17 Methods of the review...................................................................................................17 Levels of evidence..........................................................................................................18 Results.....................................................................................................................19 Meal replacement plans: weight loss and co-morbidity risk reduction...................19 Phentermine hydrochloride: weight loss and co-morbidity risk reduction............20 Diethylpropion: weight loss and co-morbidity risk reduction.................................22 Orlistat: weight loss and co-morbidity risk reduction...............................................23 Sibutramine: weight loss and co-morbidity risk reduction.......................................28 Comparative drug studies..............................................................................................34 Combined drug studies..................................................................................................39 Safety/Side effects ..................................................................................................41 Safety and side effects of sibutramine therapy...........................................................41 Safety and side effects of orlistat therapy ...................................................................42 Safety and side effects of phentermine therapy .........................................................43 EVIDENCE BASED REVIEW OF WEIGHT LOSS MEDICINES: A REPORT COMMISSIONED BY THE NEW ZEALAND ACC iv Safety and side effects of diethylpropion therapy......................................................43 Summary of potential harms of pharmacotherapy intervention .............................44 Safety and side effects of meal replacement programs.............................................44 Practice recommendations and guidelines ............................................................47 National Institute of Health, USA...............................................................................47 The National Institute for Clinical Excellence (NICE), UK ...................................47 High profile clinical trials.......................................................................................49 Completed studies..........................................................................................................49 Childhood obesity ..........................................................................................................49 Ongoing trials..................................................................................................................50 Other anti-obesity therapies ...................................................................................51 Horizon Scan ..........................................................................................................53 Economic considerations .......................................................................................55 The direct cost of medication.......................................................................................55
Load more

Recommended publications
  • Revealing the Burden of Obesity Using Weight Histories
    Revealing the burden of obesity using weight histories Andrew Stokesa,1 and Samuel H. Prestonb,1 aDepartment of Global Health and Center for Global Health and Development, Boston University School of Public Health, Boston, MA 02118; and bDepartment of Sociology and Population Studies Center, University of Pennsylvania, Philadelphia, PA 19104 Contributed by Samuel H. Preston, December 4, 2015 (sent for review August 4, 2015; reviewed by David B. Allison and John Bongaarts) Analyses of the relation between obesity and mortality typically effects (41–43) and may be inadequate in light of evidence that evaluate risk with respect to weight recorded at a single point in weight loss often begins many years before death (44). A limitation time. As a consequence, there is generally no distinction made of the second approach is that it fails to capture undiagnosed or between nonobese individuals who were never obese and non- subclinical illnesses (44). Both strategies eliminate large propor- obese individuals who were formerly obese and lost weight. We tions of observations, thereby reducing power and the external introduce additional data on an individual’s maximum attained validity of results (45). Finally, both approaches risk eliminating weight and investigate four models that represent different com- observations in which disease is a product of obesity itself, pro- binations of weight at survey and maximum weight. We use data ducing a classic instance of “overadjustment bias” (46). from the 1988–2010 National Health and Nutrition Examination A recently developed approach that avoids these pitfalls is Survey, linked to death records through 2011, to estimate param- to replace BMI at survey with one’s maximum historical BMI.
    [Show full text]
  • 1557.Full-Text.Pdf
    AMERICAN ACADEMY OF PEDIATRICS POLICY STATEMENT Organizational Principles to Guide and Define the Child Health Care System and/or Improve the Health of All Children Committee on Sports Medicine and Fitness Promotion of Healthy Weight-Control Practices in Young Athletes ABSTRACT. Children and adolescents are often in- voluntary dehydration (Table 1). Voluntary dehydra- volved in sports in which weight loss or weight gain is tion practices include fluid restriction, spitting, and perceived as an advantage. This policy statement de- the use of laxatives and diuretics, rubber suits, steam scribes unhealthy weight-control practices that may be baths, and saunas. Weight loss becomes a problem harmful to the health and/or performance of athletes. when nutritional needs are not met or adequate hy- Healthy methods of weight loss and weight gain are dration is not maintained. discussed, and physicians are given resources and recom- mendations that can be used to counsel athletes, parents, Athletes may practice weight-control methods coaches, and school administrators in discouraging inap- during the sports season only or year-round. These propriate weight-control behaviors and encouraging practices can impair athletic performance and in- healthy methods of weight gain or loss, when needed. crease injury risk. They also may result in medical Pediatrics 2005;116:1557–1564; athlete, weight gain, weight complications including delayed physical matura- loss, wrestling, eating disorders. tion; oligomenorrhea and amenorrhea in female ath- letes; development of eating disorders; potential per- ABBREVIATION. NWCA, National Wrestling Coaches’ Association. manent growth impairment; an increased incidence of infectious diseases; changes in the cardiovascular, INTRODUCTION endocrine, gastrointestinal, renal and thermoregula- 1,4,6–9 ith the growth and advancement of youth tory systems; and depression.
    [Show full text]
  • Prevalence, Magnitude, and Methods of Rapid Weight Loss Among Judo Competitors
    Prevalence, Magnitude, and Methods of Rapid Weight Loss among Judo Competitors GUILHERME GIANNINI ARTIOLI1,2, BRUNO GUALANO1, EMERSON FRANCHINI2, FERNANDA BAEZA SCAGLIUSI3, MARIANE TAKESIAN1, MARINA FUCHS1, and ANTONIO HERBERT LANCHA JR1 1Laboratory of Applied Nutrition and Metabolism, School of Physical Education and Sports, University of Sa˜o Paulo, Sa˜o Paulo, BRAZIL; 2Martial Arts and Combat Sports Research Group, School of Physical Education and Sports, University of Sa˜o Paulo, Sa˜o Paulo, BRAZIL; and 3Department of Health Sciences, Federal University of Sa˜o Paulo, Sa˜o Paulo, BRAZIL ABSTRACT ARTIOLI, G. G., B. GUALANO, E. FRANCHINI, F. B. SCAGLIUSI, M. TAKESIAN, M. FUCHS, and A. H. LANCHA. Prevalence, Magnitude, and Methods of Rapid Weight Loss among Judo Competitors. Med. Sci. Sports Exerc., Vol. 42, No. 3, pp. 436–442, 2010. Purpose: To identify the prevalence, magnitude, and methods of rapid weight loss among judo competitors. Methods: Athletes (607 males and 215 females; age = 19.3 T 5.3 yr, weight = 70 T 7.5 kg, height = 170.6 T 9.8 cm) completed a previously validated questionnaire developed to evaluate rapid weight loss in judo athletes, which provides a score. The higher the score obtained, the more aggressive the weight loss behaviors. Data were analyzed using descriptive statistics and frequency analyses. Mean scores obtained in the questionnaire were used to compare specific groups of athletes using, when appropriate, Mann–Whitney U-test or general linear model one-way ANOVA followed by Tamhane post hoc test. Results: Eighty-six percent of athletes reported that have already lost weight to compete.
    [Show full text]
  • Characteristics of Bariatric Patients on Home Parenteral Nutrition Theresa Bergholz a Thesis Submitted in Partial Fulfillment Of
    Characteristics of Bariatric Patients on Home Parenteral Nutrition Theresa Bergholz A thesis submitted in partial fulfillment of the requirements for the degree of Master of Science University of Washington 2017 Committee: Lingtak-Neander Chan Shirley Paski Program Authorized to Offer Degree: Nutritional Sciences Program, School of Public Health ©Copyright 2017 Theresa Bergholz University of Washington Abstract Characteristics of Bariatric Patients on Home Parenteral Nutrition Theresa Bergholz Chair of the Supervisory Committee: Lingtak-Neander Chan, PharmD, BCNSP Professor and Vice Chair, Department of Pharmacy Interdisciplinary Faculty, Graduate Program in Nutritional Sciences Background: Corresponding to rising obesity rates, bariatric surgery is becoming a common intervention for obesity. Due to surgical or nutritional complications, some bariatric surgery patients may end up requiring nutritional support in the form of parental nutrition (PN). Historically, PN has been utilized by patients with intestinal failure to increase energy intake for weight gain or weight maintenance, and home parenteral nutrition (HPN) is indicated for patients requiring long-term PN. Few studies have explored the characterization of bariatric patients receiving HPN. There is no established clinical guidelines or consensus on how to provide optimal nutrition support to this patient population. The primary aim of this study is to characterize the population of bariatric surgery patients on HPN. The secondary aim is to analyze nutrient provision in the bariatric patient on HPN and to determine if nutrient provision differs across BMI categories. Methods: Data were accessed from the American Society for Parenteral and Enteral Nutrition’s (ASPEN) prospective HPN patient care data registry, the Sustain™ Registry. The Sustain™ Registry enrolled 1251 subjects from 29 academic medical center, hospital, and home care service sites between 2011 and 2014.
    [Show full text]
  • Ihsaa Wrestling 2019-20
    IHSAA WRESTLING 2019-20 Each member wrestling school receives several copies of the National Federation of State High School Associations Wrestling Rule Book. Unless the Board of Control adopts other rules, member schools will follow the wrestling rules published in the National Federation Wrestling Rule Book. REGULATIONS PERTAINING TO WRESTLING PRACTICE AND CONTESTS Year First Practice: Week/Date First Contest: Week/Date 2019-20 Week 20/November 18 Week 22/December 2 2020-21 Week 20/November 16 Week 22/November 30 2021-22 Week 20/November 15 Week 22/November 29 2022-23 Week 20/November 14 Week 22/November 28 WRESTLING REGULATIONS 1. A coach may have one team meeting with his wrestlers to hand out informational materials before the start of the season. This meeting shall not be used as a practice session. See the section on “Weight Management Philosophy” later in this handbook for information about the two meetings that may be held to discuss body composition assessment and weight management. 2. Schools competing in football play-offs are entitled to 10 days of practice, excluding Sundays and Thanksgiving Day, before their first wrestling contest. Schools may wrestle before they have had 10 days of practice, but they are not required to do so. The IHSAA will work with these schools and their opponent(s) if schedule changes are required. 3. A school’s practice sessions may take place at any facility designated by the school’s administration. For complete information on the practice facility rule, coaches should visit with their school’s administration. 4. IHSAA rules require wrestlers to wear protective ear guards in practice any time wrestling is taking place.
    [Show full text]
  • Building Java Programs
    Building Java Programs Chapter 4 Lecture 4-3: Procedural design; Strings reading: 3.3; 4.3; 4.5 Copyright 2010 by Pearson Education Nested if/else question BMI Weight class Formula for body mass indexbelow (BMI): 18.5 underweight weight 18.5 - 24.9 normal BMI = × 703 height2 25.0 - 29.9 overweight 30.0 and up obese y Write a program that produces output like the following: This program reads data for two people and computes their body mass index (BMI) and weight status. Enter next person's information: height (in inches)? 73.5 weight (in pounds)? 230 BMI = 29.93 2 Copyrightoverweight 2010 by Pearson Education One-person, no methods import java.util.*; public class BMI { public static void main(String[] args) { System.out.println("This program reads ... (etc.)"); Scanner console = new Scanner(System.in); System.out.println("Enter next person's information:"); System.out.print("height (in inches)? "); double height = console.nextDouble(); System.out.print("weight (in pounds)? "); double weight = console.nextDouble(); double bmi = weight * 703 / height / height; System.out.printf("BMI = %.2f\n", bmi); if (bmi < 18.5) { System.out.println("underweight"); } else if (bmi < 25) { System.out.println("normal"); } else if (bmi < 30) { System.out.println("overweight"); } else { System.out.println("obese"); } } 3 } Copyright 2010 by Pearson Education "Chaining" y main should be a concise summary of your program. y It is bad if each method calls the next without ever returning (we call this chaining): main methodA methodB methodC methodD y A better structure has main make most of the calls. y Methods must return values to main to be passed on later.
    [Show full text]
  • Treating Obesity During the COVID-19 Pandemic
    cASE STUDY Weighing in onTreating obesity duringObesity the COVID-19 pandemic By Elizabeth Ciemins, Ph.D., M.P.H., M.A. he COVID-19 pandemic has had a profound impact on of adults in the U.S.1 Obesity is associated with serious com- the treatment of patients with chronic diseases, and plications, such as diabetes, cardiovascular disease, chronic those with obesity are especially at risk. AMGA mem- obstructive pulmonary disease (COPD), and sleep apnea and bers were the vanguard of obesity treatment before is associated with direct and indirect costs nearing $2 tril- Tthe public health crisis, and the strategies and processes lion.2 The COVID-19 pandemic has exacerbated the issue. they have put in place are enabling them to continue to pro- With ambulatory visits for chronic disease management down, vide valuable care to this vulnerable population. people who are working to manage their obesity are not get- While chronic disease management is clearly taking a hit ting the care they need. Making things worse, obesity is one during the COVID-19 pandemic, it remains a crucial area of of the most common comorbidities of hospitalized COVID-19 focus for population health improvement as healthcare orga- patients, along with hypertension and type 2 diabetes.3,4 nizations take on more risk in the movement to value-based While the current situation may look bleak, before the care. Diseases like obesity are associated with numerous pandemic, AMGA members were making significant strides comorbid conditions that result in high costs to health in the identification, treatment, and management of people systems, payers, patients, and employers—not only direct with obesity.
    [Show full text]
  • Safe Weight Loss and Maintenance Practices in Sport and Exercise Paula Sammarone Turocy, Edd, ATC (Chair)*; Bernard F
    Journal of Athletic Training 2011:46(3):322–336 © by the National Athletic Trainers’ Association, Inc position statement www.nata.org/jat National Athletic Trainers’ Association Position Statement: Safe Weight Loss and Maintenance Practices in Sport and Exercise Paula Sammarone Turocy, EdD, ATC (Chair)*; Bernard F. DePalma, MEd, PT, ATC†; Craig A. Horswill, PhD‡; Kathleen M. Laquale, PhD, ATC, LDN§; Thomas J. Martin, MD||; Arlette C. Perry, PhD¶; Marla J. Somova, PhD#; Alan C. Utter, PhD, MPH, FACSM** *Duquesne University, Pittsburgh, PA; †Cornell University, Ithaca, NY; ‡University of Illinois at Chicago and Trinity International University, Deerfield, IL; §Bridgewater State University, MA; ||Hershey Medical Center, PA; ¶University of Miami, FL; #Carlow University, Pittsburgh, PA; **Appalachian State University, Boone, NC Objective: To present athletic trainers with recommenda- practices, and methods to change body composition. Body tions for safe weight loss and weight maintenance practices composition assessments should be done in the most scientifi- for athletes and active clients and to provide athletes, clients, cally appropriate manner possible. Reasonable and individual- coaches, and parents with safe guidelines that will allow ath- ized weight and body composition goals should be identified by letes and clients to achieve and maintain weight and body appropriately trained health care personnel (eg, athletic trainers, composition goals. registered dietitians, physicians). In keeping with the American Background: Unsafe weight management practices can Dietetics Association (ADA) preferred nomenclature, this docu- compromise athletic performance and negatively affect health. ment uses the terms registered dietitian or dietician when refer- Athletes and clients often attempt to lose weight by not eat- ring to a food and nutrition expert who has met the academic ing, limiting caloric or specific nutrients from the diet, engaging and professional requirements specified by the ADA’s Commis- in pathogenic weight control behaviors, and restricting fluids.
    [Show full text]
  • Prevalence of Obesity in Adult Population of Former College Rowers
    Prevalence of Obesity in Adult Population of J Am Board Fam Pract: first published as on 1 November 2002. Downloaded from Former College Rowers John W. O’Kane, MD, Carol C. Teitz, MD, Santana M. Fontana, MD, and Bonnie K. Lind, MS Background: The prevalence of adolescent and adult obesity in the United States is increasing at an alarming rate. This study examined the prevalence of obesity in adults aged 20 through 60 years, com- paring established national norms with a selected population of former college rowers. Methods: Selected for study were 4,680 male and female former intercollegiate rowing athletes who graduated in 1928 through 1998. The participants were surveyed regarding duration of rowing career and training methods, current and college height and weight, and questions regarding lifetime episodes of back pain. After two mailings, 2,165 (46%) questionnaires were returned. Our study data were com- pared with national cross-sectional survey data obtained through the National Health and Nutritional Examination Survey III (NHANES III). Results: Male and female former rowers had a significantly lower prevalence of obesity than the gen- eral population both in college and through their lifetime (P < .001). For rowers of both sexes, there was a trend of slightly higher body mass index (BMI) in each older age-group (P < .001). Conclusions: Former collegiate rowers were less obese than the general population. BMI increases with age, and encouraging athleticism for those who are of college age and younger might be an effec- tive method to decrease adult obesity. (J Am Board Fam Pract 2002;15:451–6.) Obesity has become an American epidemic.
    [Show full text]
  • Is Obesity Associated with Reduced Health-Related Quality of Life in Latino, Black and White Children in the Community?
    International Journal of Obesity (2013) 37, 920–925 OPEN & 2013 Macmillan Publishers Limited All rights reserved 0307-0565/13 www.nature.com/ijo PEDIATRIC ORIGINAL ARTICLE Is obesity associated with reduced health-related quality of life in Latino, black and white children in the community? JL Wallander1, S Kerbawy2, S Toomey3, R Lowry4, MN Elliott5, SL Escobar-Chaves6, L Franzini6 and MA Schuster3,5 OBJECTIVE: Few studies have examined the impact of obesity on health-related quality of life (HRQOL) in non-clinical community samples of children, and methodological limitations have hindered drawing firm conclusions, especially whether the impact is similar across racial/ethnic groups. The present aims were to examine at what levels of non-normal weight, school-aged children experience lower HRQOL and whether this differs among racial/ethnic groups, when controlling for socioeconomic status (SES) differences. DESIGN: Cross-sectional community cohort survey. SUBJECTS AND METHODS: Data are from the Healthy Passages, reporting on 4824 Latino, black and white 5th graders in a population-based survey conducted in three United States metropolitan areas. Children’s weight status was classified from measured weight and height into underweight (1%), normal weight (52%), overweight (19%), obese (13%) and extremely obese (14%). Children reported their own HRQOL using the Pediatric Quality of Life Inventory and additional scales addressing global self-worth, physical appearance and body satisfaction. Parents reported children’s overall health status. RESULTS: Each increment in higher non-healthy weight class—overweight to obese to extremely obese—was associated with significantly lower scores in more domains of psychosocial HRQOL compared with that in normal weight.
    [Show full text]
  • An Adoption Study of Human Obesity
    The New England Journal of Medicine ©Copyright, 1986, by the Massachusetts Medical Society Volume 314 JANUARY 23, 1986 Number 4 AN ADOPTION STUDY OF HUMAN OBESITY ALBERT J. STUNKARD, M.D., THoRKILD I.A. SorENSEN, Dr.MEp., Craic Hanis, Px.D., Tuomas W. TEASDALE, M.A., RANajIr CHAKRABORTY, PH.D., WiLLiaM J. SCHULL, PH.D., AND FIn1I SCHULSINGER, Dr.MED. Abstract We examined the contributions of genetic fac- of parents showed similar results; there was a strong rela- tors and the family environment to human fatness in a tion between the body-mass index of biologic parents and sample of 540 adult Danish adoptees who were selected adoptee weight class and no relation between the index of from a population of 3580 and divided into four weight adoptive parents and adoptee weight class. Furthermore, classes: thin, median weight, overweight, and obese. the relation between biologic parents and adoptees was There was a strong relation between the weight class of not confined to the obesity weight class, but was present the adoptees and the body-mass index of their biologic across the whole range of body fatness — from very thin parents — for the mothers, P<0.0001; for the fathers, to very fat. We conclude that genetic influences have an P<0.02. There was no relation between the weight class important role in determining human fatness in adults, of the adoptees and the body-mass index of their adoptive whereas the family environment alone has no apparent parents. Cumulative distributions of the body-mass index effect. (N Engl J Med 1986; 314:193-8.) ECENT studies of twins suggest that human official records of every nonfamilial adoption granted in Denmark obesity and fatness are highly heritable.! This between 1924 and 1947.
    [Show full text]
  • Current and Future Prevalence of Obesity and Severe Obesity in the United States By: Christopher J
    Current and Future Prevalence of Obesity and Severe Obesity in the United States By: Christopher J. Ruhm Ruhm, C. (2007). Current and Future Prevalence of Obesity and Severe Obesity in the United States, Forum for Health Economics and Policy, Vol. 10(2): 1-26. Made available courtesy of The Berkeley Electronic Press. Copyright ©2007. ***Note: Figures may be missing from this format of the document ***Note: Footnotes and endnotes indicated with parentheses Abstract: This study examines past patterns and projects future prevalence rates of obesity and severe obesity among US adults. Trends in body mass index (BMI), overweight (BMI 25), obesity (BMI 30), class 2 obesity (BMI 35), class 3 obesity (BMI 40) and class 4 obesity (BM 45) of 20-74 year olds are obtained using data from the first National Health Examination Survey and the National Health and Nutrition Examination Surveys. Quantile regression methods are then used to forecast future prevalence rates through 2020. By that year, 77.6% of men are predicted to be overweight and 40.2% obese, with class 2, 3 and 4 obesity prevalence rates projected at 16.4%, 6.3% and 3.1%. The corresponding forecasts for women are 71.1%, 43.3%, 25.3%, 12.8% and 5.6%. The large growth predicted for severe obesity represents a major public health challenge, given the accompanying high medical expenditures and elevated risk of mortality and morbidity. Combating severe obesity is likely to require strategies targeting the particularly large weight gains of the heaviest individuals. KEYWORDS: adiposity, obesity, body mass index, trends, future prevalence Article: Americans are gaining weight.
    [Show full text]