• David S Freedman, KhanLaura KettelLK, Mary K Serdula, Deborah A Galuska, and William H Dietz.
• Division of Nutrition and Physical Activity, Centers for Disease Control and Prevention, Mailstop K-26, 4770 Buford Hwy, Atlanta, GA 30341-3717, USA. DFreedman@Cdc.gov
• JAMA. 2002 Oct 9; 288 (14): 175817611758-61.

ContextAlthough the prevalence of obesity has markedly increased among US adults, health risks vary according to the severity of obesity. Persons with class 3 obesity (body mass index [BMI] > or = 40) are at greatest risk, but there is little information about this subgroup.ObjectiveTo examine correlates of class 3 obesity and secular trends.Design, Setting, And ParticipantsAdults (aged > or = 18 years) in the United States who participated in the Behavioral Risk Factor Surveillance System telephone survey between 1990 (75,600 persons) and 2000 (164,250 persons).Main Outcome MeasureBody mass index calculated from self-reported weight and height.ResultsThe prevalence of class 3 obesity increased from 0.78% (1990) to 2.2% (2000). In 2000, class 3 obesity was highest among black women (6.0%), persons who had not completed high school (3.4%), and persons who are short. During the 11-year period, the median BMI level increased by 1.2 units and the 95th percentile increased by 3.2 units.ConclusionThe prevalence of class 3 obesity is increasing rapidly among adults. Because these extreme BMI levels are associated with the most severe health complications, the incidence of various diseases will increase substantially in the future.

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