An Evidence-Based Assessment of Federal Guidelines for Overweight and Obesity as They Apply to Elderly Persons

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Abstract
THE FIRST US Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults,1 released by the National Institutes of Health, National Heart, Lung, and Blood Institute, in June 1998, identified overweight and obesity as major risk factors for increased morbidity and mortality. In earlier official documents (the National Institutes of Health Consensus Conference on Health Implications of Obesity in 1985 and the 1990 Dietary Guidelines for Americans from the Department of Agriculture), overweight was defined as a body mass index (BMI; defined as weight in kilograms divided by the square of height in meters) of 27.8 or greater and 27.3 for men and women 35 years or older, respectively. Those documents recommended age-specific ranges of weight for height, with heavier weight standards indicated with increased age, and adapted the obesity and overweight terms interchangeably without clear distinction.2,3 In contrast, the recent national guidelines, in agreement with the 1995 Dietary Guidelines for Americans, defined overweight as a BMI of 25 to 29.9 and obesity as a BMI of 30 or more for adults 18 years or older, without recommending age-specific cut points.1,4 According to the current definitions, the percentage of overweight and obese adults 20 years or older in the United States is estimated to be 54.9%.5