Body Mass Index: Obesity, BMI, and Health: A Critical Review

Frank Q Nuttall, Frank Q Nuttall

Abstract

The body mass index (BMI) is the metric currently in use for defining anthropometric height/weight characteristics in adults and for classifying (categorizing) them into groups. The common interpretation is that it represents an index of an individual's fatness. It also is widely used as a risk factor for the development of or the prevalence of several health issues. In addition, it is widely used in determining public health policies.The BMI has been useful in population-based studies by virtue of its wide acceptance in defining specific categories of body mass as a health issue. However, it is increasingly clear that BMI is a rather poor indicator of percent of body fat. Importantly, the BMI also does not capture information on the mass of fat in different body sites. The latter is related not only to untoward health issues but to social issues as well. Lastly, current evidence indicates there is a wide range of BMIs over which mortality risk is modest, and this is age related. All of these issues are discussed in this brief review.

Conflict of interest statement

The author has no conflicts of interest to disclose.

Figures

FIGURE.
FIGURE.
Distribution of BMI in Adult American Men and Women (Carnegie Institute of Washington, Publ No 329. 1923). Adapted from Rony., p192

References

    1. Singh D. Body shape and women’s attractiveness: the critical role of waist-to-hip ratio. Human Nature. 1993; 4( 3): 297– 321.
    1. Katzmarzyk PT, Perusse L, Rao DC, Bouchard C. Familial risk of overweight and obesity in the Canadian population using the WHO/NIH criteria. Obes Res. 2000; 8( 2): 194– 197.
    1. Wardle J, Carnell S, Haworth CM, Plomin R. Evidence for a strong genetic influence on childhood adiposity despite the force of the obesogenic environment. Am J Clin Nutr. 2008; 87( 2): 398– 404.
    1. Katzmarzyk PT, Hebebrand J, Bouchard C. Spousal resemblance in the Canadian population: implications for the obesity epidemic. Int J Obes Relat Metab Disord. 2002; 26( 2): 241– 246.
    1. Rogers O. Build as a Factor Influencing Longevity. In Proceedings of the Association of Life Insurance Medical Directors of America from Organization to and including the 10th annual meeting: 12th annual meeting held at the Hunt Memorial Building of the Hartford Medical Society; May 29, 1901; Hartford, CT. New York: Knickerbocker Press; 1901: 280– 288.
    1. The Association of Life Insurance Medical Directors and the Actuarial Society of America. Medico-Actuarial Mortality Investigation. Vol 1–3 New York, NY: 1912–1913.
    1. Metropolitan Life Insurance Company. New weight standards for men and women. Stat Bull. 1959; 40: 1– 4.
    1. Metropolitan Life Insurance Company. Mortality record for 1959. Stat Bull. 1960; 41( February): 1– 11.
    1. Metropolitan Life Insurance Company. Mortality among overweight women. Stat Bull. 1960; 41( March): 1– 11.
    1. Metropolitan Life Insurance Company. 1983 Metropolitan height and weight tables for men and women, according to frame, ages 25–29. Stat Bull. 1983; 64( Jan–June): 2– 9.
    1. Burton BT, Foster WR, Hirsch J, Van Itallie TB. Health implications of obesity: an NIH Consensus Development Conference. Int J Obes. 1985; 9( 3): 155– 170.
    1. Health implications of obesity. National Institutes of Health Consensus Development Conference; February 11–13, 1985. Ann Intern Med. 1985; 103( 6 (pt 2)): 977– 1077.
    1. Blackburn H, Parlin RW. Antecedents of disease. Insurance mortality experience. Ann N Y Acad Sci. 1966; 134: 965– 1017.
    1. Khosla T, Lowe CR. Indices of obesity derived from body weight and height. Br J Prev Soc Med. 1967; 21( 3): 122– 128.
    1. Himes JH, Bouchard C. Do the new Metropolitan Life Insurance weight-height tables correctly assess body frame and body fat relationships? Am J Public Health. 1985; 75( 9): 1076– 1079.
    1. Keys A, Fidanza F, Karvonen MJ, Kimura N, Taylor HL. Indices of relative weight and obesity. J Chron Dis. 1972; 25( 6): 329– 343.
    1. Watson PE, Watson ID, Batt RD. Obesity indices. Am J Clin Nutr. 1979; 32( 4): 736– 737.
    1. Benn RT. Some mathematical properties of weight-for-height indices used as measures of adiposity. Br J Prev Soc Med. 1971; 25( 1): 42– 50.
    1. Eknoyan G. Adolphe Quetelet (1796-1874)—the average man and indices of obesity. Nephrol Dial Transplant. 2008; 23( 1): 47– 51.
    1. Quetelet LAJ. Physique Sociale. Vol 2 Brussels, Belgium: C. Muquardt; 1869: 92.
    1. Jelliffe DB, Jelliffe EF. Underappreciated pioneers. Quetelet: man and index. Am J Clin Nutr. 1979; 32( 12): 2519– 2521.
    1. Kuczmarski RJ, Flegal KM, Campbell SM, Johnson CL. Increasing prevalence of overweight among US adults. The National Health and Nutrition Examination Surveys, 1960 to 1991. JAMA. 1994; 272( 3): 205– 211.
    1. Manson JE, Stampfer MJ, Hennekens CH, Willett WC. Body weight and longevity. A reassessment. JAMA. 1987; 257( 3): 353– 358.
    1. Must A, Dallal GE, Dietz WH. Reference data for obesity: 85th and 95th percentiles of body mass index (wt/ht2) and triceps skinfold thickness. Am J Clin Nutr. 1991; 53( 4): 839– 846.
    1. WHO. Physical Status: The Use and Interpretation of Anthropometry: Report of a World Health Organization (WHO) Expert Committee. Geneva, Switzerland: World Health Organization; 1995.
    1. Flegal KM, Carroll MD, Kuczmarski RJ, Johnson CL. Overweight and obesity in the United States: prevalence and trends, 1960–1994. Int J Obes Relat Metab Disord. 1998; 22( 1): 39– 47.
    1. Rony H. The homeostatic body weight regulation. Obesity and Leanness. Philadelphia, PA: Lea & Febiger; 1940: 192– 209.
    1. Leiter LA, Marliss EB. Survival during fasting may depend on fat as well as protein stores. JAMA. 1982; 248( 18): 2306– 2307.
    1. Salans LB, Horton ES, Sims EA. Experimental obesity in man: cellular character of the adipose tissue. J Clin Invest. 1971; 50( 5): 1005– 1011.
    1. Forbes GB, Welle SL. Lean body mass in obesity. Int J Obes. 1983; 7( 2): 99– 107.
    1. Garrow JS, Webster J. Quetelet’s index (W/H2) as a measure of fatness. Int J Obes. 1985; 9( 2): 147– 153.
    1. Garrow JS. Treat Obesity Seriously: A Clinical Manual. Edinburgh, Scotland: Churchill Livingstone; 1981.
    1. Rosenbaum S, Skinner RK, Knight IB, Garrow JS. A survey of heights and weights of adults in Great Britain, 1980. Ann Hum Biol. 1985; 12( 2): 115– 127.
    1. Najjar MF, Rowland M. Anthropometric reference data and prevalence of overweight, United States, 1976-80. Vital Health Stat 11. 1987;( 238): 1– 73.
    1. National Institutes of Health, National Heart, Lung, and Blood Institute. Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: The Evidence Report. Bethesda, MD: National Institutes of Health; 1998.
    1. WHO. Managing the global epidemic of obesity. Report of the World Health Organization (WHO) consultation on obesity. Paper presented at the International Obesity Task Force; June 3–5, 1997; Geneva, Switzerland.
    1. International Obesity Task Force. Managing the Global Epidemic of Obesity. Report of the World Health Organization (WHO) Consultation on Obesity; June 5–7, 1997; Geneva, Switzerland.
    1. WHO. Obesity: Preventing and Managing the Global Epidemic. Geneva, Switzerland: WHO; 2000.
    1. Wellens RI, Roche AF, Khamis HJ, Jackson AS, Pollock ML, Siervogel RM. Relationships between the body mass index and body composition. Obes Res. 1996; 4( 1): 35– 44.
    1. Ogden CL, Fryar CD, Carroll MD, Flegal KM. Mean body weight, height, and body mass index, United States 1960–2002. Adv Data. 2004;( 347): 1– 17.
    1. Strain GW, Zumoff B. The relationship of weight-height indices of obesity to body fat content. J Am Coll Nutr. 1992; 11( 6): 715– 718.
    1. Segal KR, Dunaif A, Gutin B, Albu J, Nyman A, Pi-Sunyer FX. Body composition, not body weight, is related to cardiovascular disease risk factors and sex hormone levels in men. J Clin Invest. 1987; 80( 4): 1050– 1055.
    1. Romero-Corral A, Somers VK, Sierra-Johnson J, et al. Normal weight obesity: a risk factor for cardiometabolic dysregulation and cardiovascular mortality. Eur Heart J. 2010; 31( 6): 737– 746.
    1. Garn SM, LaVelle M, Rosenberg KR, Hawthorne VM. Maturational timing as a factor in female fatness and obesity. Am J Clin Nutr. 1986; 43( 6): 879– 883.
    1. Norgan NG. Relative sitting height and the interpretation of the body mass index. Ann Hum Biol. 1994; 21( 1): 79– 82.
    1. Flegal KM, Shepherd JA, Looker AC, et al. Comparisons of percentage body fat, body mass index, waist circumference, and waist-stature ratio in adults. Am J Clin Nutr. 2009; 89( 2): 500– 508.
    1. Garn SM, Leonard WR, Hawthorne VM. Three limitations of the body mass index. Am J Clin Nutr. 1986; 44( 6): 996– 997.
    1. Heitmann BL, Erikson H, Ellsinger BM, Mikkelsen KL, Larsson B. Mortality associated with body fat, fat-free mass and body mass index among 60-year-old swedish men-a 22-year follow-up. The study of men born in 1913. Int J Obes Relat Metab Disord. 2000; 24( 1): 33– 37.
    1. Borkan GA, Hults DE, Gerzof SG, Robbins AH, Silbert CK. Age changes in body composition revealed by computed tomography. J Gerontol. 1983; 38( 6): 673– 677.
    1. Kuczmarski RJ. Prevalence of overweight and weight gain in the United States. Am J Clin Nutr. 1992; 55( Suppl 2): 495S– 502S.
    1. Romero-Corral A, Somers VK, Sierra-Johnson J, et al. Accuracy of body mass index in diagnosing obesity in the adult general population. Int J Obes (Lond). 2008; 32( 6): 959– 966.
    1. Rice CL, Cunningham DA, Paterson DH, Lefcoe MS. Arm and leg composition determined by computed tomography in young and elderly men. Clin Physiol. 1989; 9( 3): 207– 220.
    1. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004; 363: 157– 163.
    1. Deurenberg P, Yap M, van Staveren WA. Body mass index and percent body fat: a meta analysis among different ethnic groups. Int J Obes Relat Metab Disord. 1998; 22( 12): 1164– 1171.
    1. Wang J, Thornton JC, Russell M, Burastero S, Heymsfield S, Pierson RN., Jr Asians have lower body mass index (BMI) but higher percent body fat than do whites: comparisons of anthropometric measurements. Am J Clin Nutr. 1994; 60( 1): 23– 28.
    1. Smalley KJ, Knerr AN, Kendrick ZV, Colliver JA, Owen OE. Reassessment of body mass indices. Am J Clin Nutr. 1990; 52( 3): 405– 408.
    1. National Institutes of Health. Understanding Adult Obesity. Bethesda, MD: National Institutes of Health; 2008.
    1. Flegal KM, Carroll MD, Ogden CL, Curtin LR. Prevalence and trends in obesity among US adults, 1999-2008. JAMA 20; 303( 3): 235– 241.
    1. Park SW, Goodpaster BH, Lee JS, et al. Excessive loss of skeletal muscle mass in older adults with type 2 diabetes. Diabetes Care. 2009; 32( 11): 1993– 1997.
    1. Morant GM. A discussion on the measurement of growth and form; secular changes in the heights of British people. Proc R Soc Lond B Biol Sci. 1950; 137( 889): 443– 452.
    1. Fogel RW. The Escape From Hunger and Premature Death, 1700-2100. Cambridge, UK: The Press Syndicate of the University of Cambridge; 2004.
    1. Vague J. The degree of masculine differentiation of obesities: a factor determining predisposition to diabetes, atherosclerosis, gout, and uric calculous disease. Am J Clin Nutr. 1956; 4( 1): 20– 34.
    1. Kissebah AH, Freedman DS, Peiris AN. Health risks of obesity. Med Clin North Am. 1989; 73( 1): 111– 138.
    1. Kissebah AH, Vydelingum N, Murray R, et al. Relation of body fat distribution to metabolic complications of obesity. J Clin Endocrinol Metab. 1982; 54( 2): 254– 260.
    1. Ohlson LO, Larsson B, Svardsudd K, et al. The influence of body fat distribution on the incidence of diabetes mellitus. 13.5 years of follow-up of the participants in the study of men born in 1913. Diabetes. 1985; 34( 10): 1055– 1058.
    1. Lapidus L, Bengtsson C, Larsson B, Pennert K, Rybo E, Sjostrom L. Distribution of adipose tissue and risk of cardiovascular disease and death: a 12 year follow up of participants in the population study of women in Gothenburg, Sweden. Br Med J (Clin Res Ed). 1984; 289( 6454): 1257– 1261.
    1. Fox KA, Despres JP, Richard AJ, Brette S, Deanfield JE. Does abdominal obesity have a similar impact on cardiovascular disease and diabetes? A study of 91,246 ambulant patients in 27 European countries. Eur Heart J. 2009; 30( 24): 3055– 3063.
    1. Wajchenberg BL, Giannella-Neto D, da Silva ME, Santos RF. Depot-specific hormonal characteristics of subcutaneous and visceral adipose tissue and their relation to the metabolic syndrome. Horm Metab Res. 2002; 34(11–12): 616– 621.
    1. Nguyen-Duy TB, Nichaman MZ, Church TS, Blair SN, Ross R. Visceral fat and liver fat are independent predictors of metabolic risk factors in men. Am J Physiol Endocrinol Metab. 2003; 284( 6): E1065– E1071.
    1. Despres JP, Moorjani S, Lupien PJ, Tremblay A, Nadeau A, Bouchard C. Regional distribution of body fat, plasma lipoproteins, and cardiovascular disease. Arteriosclerosis. 1990; 10( 4): 497– 511.
    1. Pouliot MC, Despres JP, Lemieux S, et al. Waist circumference and abdominal sagittal diameter: best simple anthropometric indexes of abdominal visceral adipose tissue accumulation and related cardiovascular risk in men and women. Am J Cardiol. 1994; 73( 7): 460– 468.
    1. Pouliot MC, Despres JP, Nadeau A, et al. Associations between regional body fat distribution, fasting plasma free fatty acid levels and glucose tolerance in premenopausal women. Int J Obes. 1990; 14( 4): 293– 302.
    1. Lemieux S, Prud’homme D, Tremblay A, Bouchard C, Despres JP. Anthropometric correlates to changes in visceral adipose tissue over 7 years in women. Int J Obes Relat Metab Disord. 1996; 20( 7): 618– 624.
    1. Wildman RP, Muntner P, Reynolds K, et al. The obese without cardiometabolic risk factor clustering and the normal weight with cardiometabolic risk factor clustering: prevalence and correlates of 2 phenotypes among the US population (NHANES 1999–2004). Arch Intern Med. 2008; 168( 15): 1617– 1624.
    1. Stefan N, Kantartzis K, Machann J, et al. Identification and characterization of metabolically benign obesity in humans. Arch Intern Med. 2008; 168( 15): 1609– 1616.
    1. Savage DB, Petersen KF, Shulman GI. Disordered lipid metabolism and the pathogenesis of insulin resistance. Physiol Rev. 2007; 87( 2): 507– 520.
    1. Lemieux S, Prud’homme D, Bouchard C, Tremblay A, Despres JP. A single threshold value of waist girth identifies normal-weight and overweight subjects with excess visceral adipose tissue. Am J Clin Nutr. 1996; 64( 5): 685– 693.
    1. Lemieux S, Prud’homme D, Nadeau A, Tremblay A, Bouchard C, Despres JP. Seven-year changes in body fat and visceral adipose tissue in women. Association with indexes of plasma glucose-insulin homeostasis. Diabetes Care. 1996; 19( 9): 983– 991.
    1. Toth MJ, Tchernof A, Sites CK, Poehlman ET. Effect of menopausal status on body composition and abdominal fat distribution. Int J Obes Relat Metab Disord. 2000; 24( 2): 226– 231.
    1. Skerlj B. Age changes in fat distribution in the female body. Acta Anat (Basel). 1959; 38: 56– 63.
    1. Tanner JM. Growth at Adolescence. Oxford: Blackwell Scientific Publications; 1955.
    1. Bjorntorp P. The android woman—a risky condition. J Intern Med. 1996; 239( 2): 105– 110.
    1. Davidson JM, Chen JJ, Crapo L, Gray GD, Greenleaf WJ, Catania JA. Hormonal changes and sexual function in aging men. J Clin Endocrinol Metab. 1983; 57( 1): 71– 77.
    1. Malis C, Rasmussen EL, Poulsen P, et al. Total and regional fat distribution is strongly influenced by genetic factors in young and elderly twins. Obes Res. 2005; 13( 12): 2139– 2145.
    1. Bouchard C, Despres JP, Mauriege P. Genetic and nongenetic determinants of regional fat distribution. Endocr Rev. 1993; 14( 1): 72– 93.
    1. Larsson I, Lindroos AK, Peltonen M, Sjostrom L. Potassium per kilogram fat-free mass and total body potassium: predictions from sex, age, and anthropometry. Am J Physiol Endocrinol Metab. 2003; 284( 2): E416– E423.
    1. Garn SM. Anthropometry in clinical appraisal of nutritional status. Am J Clin Nutr. 1962; 11: 418– 432.
    1. Borkan GA, Hults DE, Gerzof SG, Robbins AH. Comparison of body composition in middle-aged and elderly males using computed tomography. Am J Phys Anthropol. 1985; 66( 3): 289– 295.
    1. Sims EA. Are there persons who are obese, but metabolically healthy? Metabolism. 2001; 50( 12): 1499– 1504.
    1. Ruderman NB, Schneider SH, Berchtold P. The “metabolically-obese,” normal-weight individual. Am J Clin Nutr. 1981; 34( 8): 1617– 1621.
    1. Pisinger C, Jorgensen T. Waist circumference and weight following smoking cessation in a general population: the Inter99 study. Prev Med. 2007; 44( 4): 290– 295.
    1. McPherson R. Chromosome 9p21 and coronary artery disease. N Engl J Med. 2010; 362( 18): 1736– 1737.
    1. Nuttall FQ. Diet and the diabetic patient. Diab Care. 1983; 6: 197– 207.
    1. Chaudhry ZW, Gannon MC, Nuttall FQ. Stability of body weight in type 2 diabetes. Diabetes Care. 2006; 29( 3): 493– 497.
    1. Forbes GB, Reina JC. Adult lean body mass declines with age: some longitudinal observations. Metabolism. 1970; 19: 653– 663.
    1. Srikanthan P, Karlamangla AS. Relative muscle mass is inversely associated with insulin resistance and prediabetes. Findings from the third National Health and Nutrition Examination Survey. J Clin Endocrinol Metab. 2011; 96( 9): 2898– 2903.
    1. Keys A, Aravanis C, Blackburn H, et al. Coronary heart disease: overweight and obesity as risk factors. Ann Intern Med. 1972; 77( 1): 15– 27.
    1. Chapman JM, Massey FJ., Jr The interrelationship of serum cholesterol, hypertension, body weight, and risk of coronary disease. results of the first ten years’ follow-up in the Los Angeles Heart Study. J Chron Dis. 1964; 17: 933– 949.
    1. Kip KE, Marroquin OC, Kelley DE, et al. Clinical importance of obesity versus the metabolic syndrome in cardiovascular risk in women: a report from the Women’s Ischemia Syndrome Evaluation (WISE) study. Circulation. 2004; 109( 6): 706– 713.
    1. St-Pierre AC, Cantin B, Mauriege P, et al. Insulin resistance syndrome, body mass index and the risk of ischemic heart disease. CMAJ. 2005; 172( 10): 1301– 1305.
    1. Keys A. Overweight and the risk of sudden heart attack and sudden death NIH; 1973: 215– 223.
    1. Preis SR, Pencina MJ, Hwang SJ, et al. Trends in cardiovascular disease risk factors in individuals with and without diabetes mellitus in the Framingham Heart Study. Circulation. 2009; 120( 3): 212– 220.
    1. Filozof C, Fernandez Pinilla MC, Fernandez-Cruz A. Smoking cessation and weight gain. Obes Rev. 2004; 5( 2): 95– 103.
    1. Flegal KM. The effects of changes in smoking prevalence on obesity prevalence in the United States. Am J Public Health. 2007; 97( 8): 1510– 1514.
    1. Yeh HC, Duncan BB, Schmidt MI, Wang NY, Brancati FL. Smoking, smoking cessation, and risk for type 2 diabetes mellitus: a cohort study. Ann Intern Med 5; 152( 1): 10– 17.
    1. O’Hara P, Connett JE, Lee WW, Nides M, Murray R, Wise R. Early and late weight gain following smoking cessation in the Lung Health Study. Am J Epidemiol. 1998; 148( 9): 821– 830.
    1. Flegal KM, Graubard BI, Williamson DF, Gail MH. Excess deaths associated with underweight, overweight, and obesity. JAMA. 2005; 293( 15): 1861– 1867.
    1. Romero-Corral A, Montori VM, Somers VK, et al. Association of bodyweight with total mortality and with cardiovascular events in coronary artery disease: a systematic review of cohort studies. Lancet. 2006; 368( 9536): 666– 678.
    1. Pischon T, Boeing H, Hoffmann K, et al. General and abdominal adiposity and risk of death in Europe. N Engl J Med. 2008; 359( 20): 2105– 2120.
    1. Adams KF, Schatzkin A, Harris TB, et al. Overweight, obesity, and mortality in a large prospective cohort of persons 50 to 71 years old. N Engl J Med. 2006; 355( 8): 763– 778.
    1. Troiano RP, Frongillo EA, Jr, Sobal J, Levitsky DA. The relationship between body weight and mortality: a quantitative analysis of combined information from existing studies. Int J Obes Relat Metab Disord. 1996; 20( 1): 63– 75.
    1. Zhu S, Heo M, Plankey M, Faith MS, Allison DB. Associations of body mass index and anthropometric indicators of fat mass and fat free mass with all-cause mortality among women in the first and second National Health and Nutrition Examination Surveys follow-up studies. Ann Epidemiol. 2003; 13( 4): 286– 293.
    1. Katzmarzyk PT, Craig CL, Bouchard C. Original article underweight, overweight and obesity: relationships with mortality in the 13-year follow-up of the Canada Fitness Survey. J Clin Epidemiol. 2001; 54( 9): 916– 920.
    1. Andres R. Effect of obesity on total mortality. Int J Obes. 1980; 4( 4): 381– 386.
    1. Whitlock G, Lewington S, Sherliker P, et al. Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies. Lancet. 2009; 373( 9669): 1083– 1096.
    1. National Task Force on the Prevention and Treatment of Obesity. Weight cycling. JAMA. 1994; 272( 15): 1196– 1202.
    1. Gaesser GA. Thinness and weight loss: beneficial or detrimental to longevity? Med Sci Sports Exerc. 1999; 31( 8): 1118– 1128.
    1. National Task Force on the Prevention and Treatment of Obesity. Weight cycling. JAMA. 1994; 272( 15): 1196– 1201.
    1. Danforth E, Jr, Sims EA. Obesity and efforts to lose weight. N Engl J Med. 1992; 327( 27): 1947– 1948.
    1. Hamm P, Shekelle RB, Stamler J. Large fluctuations in body weight during young adulthood and twenty-five-year risk of coronary death in men. Am J Epidemiol. 1989; 129( 2): 312– 318.
    1. Lissner L, Odell PM, D’Agostino RB, et al. Variability of body weight and health outcomes in the Framingham population. N Engl J Med. 1991; 324( 26): 1839– 1844.
    1. Gregg EW, Gerzoff RB, Thompson TJ, Williamson DF. Trying to lose weight, losing weight, and 9-year mortality in overweight U.S. adults with diabetes. Diabetes Care. 2004; 27( 3): 657– 662.
    1. Sorensen TI, Rissanen A, Korkeila M, Kaprio J. Intention to lose weight, weight changes, and 18-y mortality in overweight individuals without co-morbidities. PLoS Med. 2005; 2( 6): e171.
    1. Blair SN, Shaten J, Brownell K, Collins G, Lissner L. Body weight change, all-cause mortality, and cause-specific mortality in the Multiple Risk Factor Intervention Trial. Ann Intern Med. 1993; 119( 7 Pt 2): 749– 757.
    1. Dulloo AG. Human pattern of food intake and fuel-partitioning during weight recovery after starvation: a theory of autoregulation of body composition. Proc Nutr Soc. 1997; 56( 1A): 25– 40.
    1. Keys A, Brozek J, Henshel O, Mickleson O, Taylor HL. The Biology of Human Starvation. Minneapolis, MN: University of Minnesota Press; 1950.
    1. Mann T, Tomiyama AJ, Westling E, Lew AM, Samuels B, Chatman J. Medicare’s search for effective obesity treatments: diets are not the answer. Am Psychol. 2007; 62( 3): 220– 233.
    1. Drenick EJ, Bale GS, Seltzer F, Johnson DG. Excessive mortality and causes of death in morbidly obese men. JAMA. 1980; 243( 5): 443– 445.
    1. Sjostrom L, Narbro K, Sjostrom CD, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007; 357( 8): 741– 752.
    1. Shah M, Simha V, Garg A. Review: long-term impact of bariatric surgery on body weight, comorbidities, and nutritional status. J Clin Endocrinol Metab. 2006; 91( 11): 4223– 4231.
    1. National Center for Health Statistics. Health, United States, 2009: In Brief. Hyattsville, MD; 2010. . Accessed April 28, 2015.
    1. Rodu B, Cole P. We’re living longer healthier lives. St Paul Pioneer Press. January 30, 2007.
    1. Harper AE. Dietary goals - a skeptical view. Am J Clin Nutr. 1978; 31: 310– 321.
    1. Gregg EW, Cheng YJ, Cadwell BL, et al. Secular trends in cardiovascular disease risk factors according to body mass index in US adults. JAMA. 2005; 293( 15): 1868– 1874.
    1. Kim S, Popkin BM. Commentary: understanding the epidemiology of overweight and obesity—a real global public health concern. Int J Epidemiol. 2006; 35( 1): 60– 67 discussion 62–81.
    1. Brownell KD, Farley T, Willett WC, et al. The public health and economic benefits of taxing sugar-sweetened beverages. N Engl J Med. 2009; 361( 16): 1599– 1605.
    1. Nestle M, Jacobson MF. Halting the obesity epidemic: a public health policy approach. Public Health Rep. 2000; 115( 1): 12– 24.
    1. Battle EK, Brownell KD. Confronting a rising tide of eating disorders and obesity: treatment vs. prevention and policy. Addict Behav. 1996; 21( 6): 755– 765.
    1. Olshansky SJ, Passaro DJ, Hershow RC, et al. A potential decline in life expectancy in the United States in the 21st century. N Engl J Med. 2005; 352( 11): 1138– 1145.
    1. Preston SH. Deadweight? The influence of obesity on longevity. N Engl J Med. 2005; 352( 11): 1135– 1137.
    1. Couzin-Frankel J. A pitched battle over life span. Science. 29; 333( 6042): 549– 550.

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