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Over the last two decades, the incidence of obesity among adults in the United States has escalated by roughly 30 percent. More concerning is the dramatic rise—approximately 210 percent—in individuals classified with the most severe obesity, defined as having a body mass index (BMI) exceeding 60 kg/m². A recent research letter published in The Lancet: Diabetes & Endocrinology documents this alarming trend by analyzing national health data from 2001 to 2023, revealing a surge in severe obesity cases.
Dr. Philip Schauer, a prominent figure at Pennington Biomedical, explained, “While general obesity, starting at a BMI of 30 kg/m², garners considerable attention, the prevalence of extreme obesity—those exceeding 60 BMI—receives far less focus. This category is associated with significant clinical complications, hindered mobility, and soaring healthcare costs.” He emphasized that this study is groundbreaking in categorizing the rise in this extreme form of obesity, acknowledging the heightened health risks and comorbidities associated with it.
To provide perspective, a person with a BMI of 30 kg/m² is typically classified as being 30 to 40 pounds overweight, while someone with a BMI of 60 kg/m² carries more than 200 pounds of excess weight. The research titled “Disproportionate Increase in BMI of ≥60 kg/m² in the USA” notes that extreme obesity, once thought to be rare, was poorly understood due to previous studies grouping all individuals with a BMI of 30 kg/m² and higher without differentiating severity.
This investigation also marks a significant observation regarding individuals with BMIs between 50.0 and 59.9 kg/m², indicating that while these individuals are less severe than those above 60 kg/m², they still face heightened health issues. Many individuals in the extreme obesity category require mobility aids or face limitations in physical function, frequently necessitating hospitalizations for severe health conditions and are often unable to participate in the workforce.
The increase in cases exceeding a BMI of 60 kg/m² parallels the rise of GLP-1-based medications. Although these treatments show promise for addressing obesity, their efficacy in this severely obese demographic remains largely untested, as clinical trials have predominantly included participants with average BMIs around 37 to 38 kg/m².
With current estimates suggesting more than 850,000 individuals in the U.S. exhibit extreme obesity, the implications for the healthcare system are profound. Patients in this category often surpass typical weight limits for medical apparatus, complicating procedures such as imaging, anesthesia, and surgical interventions. The limitations of medical equipment can hinder care delivery to a population already at an elevated risk for various health complications.
The study “Disproportionate Increase in BMI of ≥60 kg/m² in the USA” was co-authored by Dr. Michael Kachmar, Dr. Vance Albaugh, and Dr. Schauer, alongside a team from Pennington Biomedical and the CDC. Research letters like this, published within the Correspondence section, provide preliminary insights that are externally peer-reviewed.
Dr. John Kirwan, the Executive Director of Pennington Biomedical, stated, “The rapid increase in cases of obesity with a BMI of 60 or greater serves as a critical alert for healthcare providers and policymakers to forge resources and infrastructure to combat the challenges posed by this condition.” He commended the research team for illuminating the growth of this public health concern, emphasizing a commitment at Pennington Biomedical to develop comprehensive solutions that address these pressing societal issues.
The research team utilized direct measurements of weight and height gathered from the National Health and Nutrition Examination Survey (NHANES). Their analysis, which tracked BMI trends from 2001 to 2023, focused on non-pregnant adults aged 18 and over, examining data in four-year intervals. Notably, while instances of obesity, defined as individuals with a BMI of 30 kg/m² or more, increased by 29.5 percent, the proportions of those categorized as having normal weight (BMI of 18.5 to 24.9 kg/m²) and those classified as overweight (BMI of 25.0 to 29.9 kg/m²) saw a decline during the same timeframe.
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