obesity, excessive accumulation of body fat, usually caused by the consumption of more calories than

the body can use. The excess calories are then stored as fat, or adipose tissue. Overweight, if moderate,
is not necessarily obesity, particularly in muscular or large-boned individuals.

Defining obesity

body mass index for adults

body mass index for adults

Obesity was traditionally defined as an increase in body weight that was greater than 20 percent of an
individual’s ideal body weight—the weight associated with the lowest risk of death, as determined by
certain factors, such as age, height, and gender. Based on these factors, overweight could then be
defined as a 15–20 percent increase over ideal body weight. However, today the definitions of
overweight and obesity are based primarily on measures of height and weight—not morbidity. These
measures are used to calculate a number known as body mass index (BMI). This number, which is
central to determining whether an individual is clinically defined as obese, parallels fatness but is not a
direct measure of body fat. Interpretation of BMI numbers is based on weight status groupings, such as
underweight, healthy weight, overweight, and obese, that are adjusted for age and sex. For all adults
over age 20, BMI numbers correlate to the same weight status designations; for example, a BMI
between 25.0 and 29.9 equates with overweight and 30.0 and above with obesity. Morbid obesity (also
known as extreme, or severe, obesity) is defined as a BMI of 40.0 or higher. (See nutritional disease: Diet
and chronic disease.)

The obesity epidemic

Body weight is influenced by the interaction of multiple factors. There is strong evidence of genetic
predisposition to fat accumulation, and obesity tends to run in families. However, the rise in obesity in
populations worldwide since the 1980s has outpaced the rate at which genetic mutations are normally
incorporated into populations on a large scale. In addition, growing numbers of persons in parts of the
world where obesity was once rare have also gained excessive weight. According to the World Health
Organization (WHO), which considered global obesity an epidemic, in 2016 more than 1.9 billion adults
(age 18 or older) worldwide were overweight and 650 million, representing 13 percent of the world’s
adult population, were obese.

The prevalence of overweight and obesity varied across countries, across towns and cities within
countries, and across populations of men and women. In China and Japan, for instance, the obesity rate
for men and women was about 5 percent, but in some cities in China it had climbed to nearly 20
percent. In 2005 it was found that more than 70 percent of Mexican women were obese. WHO survey
data released in 2010 revealed that more than half of the people living in countries in the Pacific Islands
region were overweight, with some 80 percent of women in American Samoa found to be obese.

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Childhood obesity

Childhood obesity has become a significant problem in many countries. Overweight children often face
stigma and suffer from emotional, psychological, and social problems. Obesity can negatively impact a
child’s education and future socioeconomic status. In 2004 an estimated nine million American children
over age six, including teenagers, were overweight, or obese (the terms were typically used
interchangeably in describing excess fatness in children). Moreover, in the 1980s and 1990s the
prevalence of obesity had more than doubled among children age 2 to 5 (from 5 percent to 10 percent)
and age 6 to 11 (from 6 percent to 15 percent). By 2015, 20 percent of children age 6 to 19 were obese
in the United States. Further estimates in some rural areas of the country indicated that more than 30
percent of school-age children suffered from obesity. Similar increases were seen in other parts of the
world. In the United Kingdom, for example, the prevalence of obesity among children age 2 to 10 had
increased from 10 percent in 1995 to 14 percent in 2003, and data from a study conducted there in 2007
indicated that 23 percent of children age 4 to 5 and 32 percent of children age 10 to 11 were overweight
or obese. By 2016, WHO data indicated, worldwide some 41 million children age 5 or under were
overweight or obese.

In 2005 the American Academy of Pediatrics called obesity “the pediatric epidemic of the new
millennium.” Overweight and obese children were increasingly diagnosed with high blood pressure,
elevated cholesterol, and type II diabetes mellitus—conditions once seen almost exclusively in adults. In
addition, overweight children experience broken bones and problems with joints more often than
normal-weight children. The long-term consequences of obesity in young people are of great concern to
pediatricians and public health experts because obese children are at high risk of becoming obese
adults. Experts on longevity have concluded that today’s American youth might “live less healthy and
possibly even shorter lives than their parents” if the rising prevalence of obesity is left unchecked.

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Curbing the rise in childhood obesity was the aim of the Alliance for a Healthier Generation, a
partnership formed in 2005 by the American Heart Association, former U.S. president Bill Clinton, and
the children’s television network Nickelodeon. The alliance intended to reach kids through a vigorous
public-awareness campaign. Similar projects followed, including American first lady Michelle Obama’s
Let’s Move! program, launched in 2010, and campaigns against overweight and obesity were made in
other countries as well.

Efforts were also under way to develop more-effective childhood obesity-prevention strategies,
including the development of methods capable of predicting infants’ risk of later becoming overweight
or obese. One such tool reported in 2012 was found to successfully predict newborn obesity risk by
taking into account newborn weight, maternal and paternal BMI, the number of members in the
newborn’s household, maternal occupational status, and maternal smoking during pregnancy.

Causes of obesity

Learn about the discovery of the leptin protein in mice and its benefit for diabetes and obesity
treatment in humans

Learn about the discovery of the leptin protein in mice and its benefit for diabetes and obesity
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The discovery of the leptin protein in mice and its connection to diabetes and obesity.

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Listen to how the study of rare conditions like lipodystrophy help understand the genomic factors
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In European and other Caucasian populations, genome-wide association studies have identified genetic
variations in small numbers of persons with childhood-onset morbid obesity or adult morbid obesity. In
one study, a chromosomal deletion involving 30 genes was identified in a subset of severely obese
individuals whose condition manifested in childhood. Although the deleted segment was found in less
than 1 percent of the morbidly obese study population, its loss was believed to contribute to aberrant
hormone signaling, namely of leptin and insulin, which regulate appetite and glucose metabolism,
respectively. Dysregulation of these hormones is associated with overeating (or hyperphagy) and with
tissue resistance to insulin, increasing the risk of type II diabetes. The identification of genomic defects
in persons affected by morbid obesity has indicated that, at least for some individuals, the condition
arises from a genetic cause.

For most persons affected by obesity, however, the causes of their condition are more complex,
involving the interaction of multiple factors. Indeed, the rapid rise in obesity worldwide is likely due to
major shifts in environmental factors and changes in behaviour rather than a significant change in
human genetics. For example, early feeding patterns imposed by an obese mother upon her offspring
may play a major role in a cultural, rather than genetic, transmission of obesity from one generation to
the next. Likewise, correlations between childhood obesity and practices such as infant birth by
cesarean section, which has risen substantially in incidence worldwide, indicate that environment and
behaviour may have a much larger influence on the early onset of obesity than previously thought. More
generally, the distinctive way of life of a nation and the individual’s behavioral and emotional reaction to
it may contribute significantly to widespread obesity. Among affluent populations, an abundant supply
of readily available high-calorie foods and beverages, coupled with increasingly sedentary living habits
that markedly reduce caloric needs, can easily lead to overeating. The stresses and tensions of modern
living also cause some individuals to turn to foods and alcoholic drinks for “relief.” Indeed, researchers
have found that the cause of obesity in all countries shares distinct similarities—diets rich in sweeteners
and saturated fats, lack of exercise, and the availability of inexpensive processed foods.