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(Circulation. 2009;119:3263-3271.)
© 2009 American Heart Association, Inc.

AHA Science Advisory

Mortality, Health Outcomes, and Body Mass Index in the Overweight Range

A Science Advisory From the American Heart Association

Cora E. Lewis, MD, MSPH, FAHA, Chair; Kathleen M. McTigue, MD, MPH; Lora E. Burke, PhD, MPH, FAHA; Paul Poirier, MD, PhD, FRCPC, FAHA; Robert H. Eckel, MD, FAHA; Barbara V. Howard, PhD, FAHA; David B. Allison, PhD; Shiriki Kumanyika, PhD, MPH, FAHA; F. Xavier Pi-Sunyer, MD, FAHA

Key Words: AHA Science Advisory • obesity • overweight • mortality • cardiovascular diseases

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
Health hazards of obesity have been recognized for centuries, appearing, for example, in writings attributed to Hippocrates. From the later decades of the 20th century through the present, there have been numerous epidemiological studies of the relationship between excess weight and the total, or all-cause, mortality rate,¹ a critical cumulative measure of the public health impact of any health condition. Using body mass index (BMI), an indicator of relative weight for height (weight [kg]/height [m]²) and a frequently used surrogate for assessment of excess body fat, these studies have found linear, U-shaped, or J-shaped relationships between total mortality and BMI. That is, in some studies, both the thin and the obese were more likely to die than those in between. There is, however, always a point at which increasing BMI is associated with increasing mortality risk, but the BMI at which this occurs varies across studies and populations.²

Currently,³ overweight in adults is defined as a BMI of 25.0 to <30.0 kg/m² and obesity as a BMI of 30.0 kg/m² (Table 1). A number of studies have found no significant relationship between BMI in the overweight range and mortality rate⁴ and have shown the nadir of mortality risk to be in the overweight range. In particular, commentaries in both the lay press^5–7 and scientific literature^2,8,9 subsequent to recent reports from National Health and Nutrition Examination Surveys (NHANES)^10,11 have highlighted the confusion and controversy regarding this issue. Some have interpreted the recent data to mean that overweight is . . . [Full Text of this Article]

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