Over the past 20 years, the average rate of obesity among U.S. adults has increased by nearly 30%. However, the prevalence of the most extreme forms of obesity—defined as having a body mass index (BMI) of 60 kg/m² or higher—has risen by a staggering 210%.
Scientists from Pennington Biomedical Research Center analysed national health data from 2001 through 2023 and revealed a dramatic increase in individuals affected by this severe level of obesity.
Study researchers point out that while public health efforts often focus on general obesity—typically defined as a BMI of 30 or more—less attention has been paid to those with a BMI of 60 or greater. This category of obesity is linked with significantly greater clinical challenges, including impaired mobility, high healthcare costs, and increased risk for serious comorbidities.
This extreme obesity category was previously thought to be extremely rare. However, earlier data grouped all individuals with a BMI of 30 or more together, obscuring distinctions among severity levels.
The research also highlighted a significant increase in people with BMIs between 50.0 and 59.9 kg/m². Still, the subset with BMIs of 60 or greater faces the most significant health risks. Many individuals in this category struggle with mobility, often requiring assistive devices or motorised carts, and face frequent hospitalisations due to related illnesses. Many are unable to work due to disability.
The increase in extremely high BMI cases coincides with the broader use of GLP-1-based medications, which have shown effectiveness in treating obesity. However, most clinical trials for these drugs include participants with average BMIs around 37–38 kg/m², leaving their efficacy for patients with BMI ≥60 largely unknown.
Currently, more than 850,000 Americans fall into this extreme obesity category. Their weight often exceeds the design limits of standard medical equipment, complicating diagnostic imaging, surgical procedures, and anaesthesia administration. These limitations can hinder routine medical care and exacerbate the health risks already faced by this vulnerable population.
This steep rise in extreme obesity should serve as a wake-up call for healthcare providers and policymakers. Study researchers emphasise the need for infrastructure, resources, and research dedicated to addressing the unique and pressing needs of this group.
The researchers used objective measurements of weight and height from the National Health and Nutrition Examination Survey (NHANES), focusing on non-pregnant adults aged 18 and older. Data was analysed in four-year intervals between 2001 and 2023. While general obesity (BMI ≥30) rose by 29.5 percent during that period, the proportions of adults with normal weight (BMI 18.5–24.9) and those classified as overweight (BMI 25.0–29.9) both declined.
Source: Pennington Biomedical Research Center
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