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overweight

A term used in reference to individuals with body mass index (BMI)* 26-29 kg/m2 * ideal body weight corresponds to a BMI of 22-25 kg/m2; obesity corresponds to a BMI of > 30 kg/m2 Etiology: - risk factors - see obesity - exposure to antibiotics in the first 6 months of life or repeatedly during infancy (conflicting reports) [4] Epidemiology: - fewer overweight people trying to lose weight 1988-2014 [13] Special laboratory: - measurement of body mass index (BMI) - measurement of waist circumference* * indicator of risk for metabolic syndrome [8] - cost-effective cardiovascular risk stratification tool [8] Complications: - excess risk of cancer (4%) [3] - colorectal cancer, esophageal cancer - breast cancer, ovarian cancer, uterine cancer in women - BMI-cancer link higher among women than men - increased risk of meningioma (20%) [6] - excess risk of cardiovascular disease [1] - higher BMI in late adolescence (even within normal range) is associated with increased cardiovascular mortality in midlife [7] - increased risk for cerebral palsy in offspring in women overweight or obese prior to pregnancy - all-cause mortality is lowest with a BMI of 20-25 (normal weight) but increases beginning at a BMI of 25.0-27.4 (RR=1.07) [11] - overweight or obesity at any time in life is associated with excess risk of mortality [14] Management: - lifestyle interventions including diet, exercise & behavioral therapy [8] - correction of hypertension, hypercholesterolemia, & hyperglycemia may reduce excess risk of coronary heart disease by 50% & excess risk of stroke by 75% associated with high BMI [1] - maintenance of optimum bodyweight is needed for full benefit [1] - walking, cycling, or public transportation to work is associated with healthier body weights than commuting by car [2] - strategies that target both parent & child may benefit overweight adolescents [5] - weight reduction interventions for children may be just as effective when only parents attend treatment sessions as when children also attend [15] - also see weight reduction

Interactions

disease interactions

Related

body mass index increased weight gain

Specific

obesity

General

nutritional disorder (malnutrition) sign/symptom

References

  1. The Global Burden of Metabolic Risk Factors for Chronic Diseases Collaboration. Metabolic mediators of the effects of body-mass index, overweight, and obesity on coronary heart disease and stroke: a pooled analysis of 97 prospective cohorts with 1.8 million participants. The Lancet, Early Online Publication, 22 November 2013 PMID: 24269108 http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2813%2961836-X/abstract
  2. Flint E et al. Associations between active commuting, body fat, and body mass index: Population based, cross sectional study in the United Kingdom. BMJ 2014 Aug 19; 349:g4887 PMID: 25139861 http://www.bmj.com/content/349/bmj.g4887
  3. Arnold M et al Global burden of cancer attributable to high body-mass index in 2012: a population-based study. The Lancet Oncology, Early Online Publication, 26 November 2014 PMID: 25467404 http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045%2814%2971123-4/abstract - Cairns BJ The Lancet Oncology, Early Online Publication, 26 November 2014 Cancer and high body-mass index: global burden, global effort? PMID: 25467405 http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045%2814%2970373-0/fulltext
  4. Saari A et al. Antibiotic exposure in infancy and risk of being overweight in the first 24 months of life. Pediatrics 2015 Apr; 135:617. PMID: 25825533 http://pediatrics.aappublications.org/content/135/4/617 - Gerber JS, Bryan M, Ross RK et al Antibiotic Exposure During the First 6 Months of Life and Weight Gain During Childhood. JAMA. 2016;315(12):1258-1265. PMID: 27002447 http://jama.jamanetwork.com/article.aspx?articleid=2504812
  5. Berge JM et al Parent/Adolescent Weight Status Concordance and Parent Feeding Practices. Pediatrics. Aug 24, 2015 PMID: 26304822 http://pediatrics.aappublications.org/content/early/2015/08/18/peds.2015-0326
  6. Niedermaier T et al Body mass index, physical activity, and risk of adult meningioma and glioma. Neurology. September 16, 2015 PMID: 26377253 http://www.neurology.org/content/early/2015/09/16/WNL.0000000000002020
  7. Twig G, Yaniv G, Levine H et al Body-Mass Index in 2.3 Million Adolescents and Cardiovascular Death in Adulthood. N Engl J Med. 2016 Apr 13. PMID: 27074389
  8. Medical Knowledge Self Assessment Program (MKSAP) 17, American College of Physicians, Philadelphia 2015
  9. Rucker D, Padwal R, Li SK, Curioni C, Lau DC. Long term pharmacotherapy for obesity and overweight: updated meta-analysis. BMJ. 2007 Dec 8;335(7631):1194-9. Epub 2007 Nov 15. PMID: 18006966 Free PMC Article
  10. Jensen MD, Ryan DH, Apovian CM et al 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. J Am Coll Cardiol. 2014 Jul 1;63(25 Pt B):2985-3023. PMID: 24239920 Free Article
  11. The Global BMI Mortality Collaboration Body-mass index and all-cause mortality: individual-participant- data meta-analysis of 239 prospective studies in four continents. Lancet. July 13, 2016 PMID: 27423262 Free Article http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)30175-1/abstract
  12. Heymsfield SB, Wadden TA Mechanisms, Pathophysiology, and Management of Obesity. N Engl J Med 2017; 376:254-266. January 19, 2017 PMID: 28099824 http://www.nejm.org/doi/full/10.1056/NEJMra1514009
  13. Snook KR, Hansen AR, Duke CH et al Change in Percentages of Adults With Overweight or Obesity Trying to Lose Weight, 1988-2014. JAMA. 2017;317(9):971-973. PMID: 28267846 http://jamanetwork.com/journals/jama/article-abstract/2608211
  14. Yu E, Ley SH, Manson JE et al Weight History and All-Cause and Cause-Specific Mortality in Three Prospective Cohort Studies. Ann Intern Med. April 4, 2017. PMID: 28384755 http://annals.org/aim/article/2615810/weight-history-all-cause-cause-specific-mortality-three-prospective-cohort - Despres JP Overweight: The Body Mass Index Category With an Identity Crisis. Ann Intern Med. April 4, 2017. PMID: 28384686 http://annals.org/aim/article/2615812/overweight-body-mass-index-category-identity-crisis
  15. Boutelle KN, Rhee KE, Liang J et al Effect of Attendance of the Child on Body Weight, Energy Intake, and Physical Activity in Childhood Obesity Treatment. A Randomized Clinical Trial. JAMA Pediatr. Published online May 30, 2017 PMID: 28558104 http://jamanetwork.com/journals/jamapediatrics/fullarticle/2629358