Overweight: The Body Mass Index Category With an Identity Crisis
Authors: Jean-Pierre Després
Journal: Annals of Internal Medicine (2017)

Editorials2 May 2017Overweight: The Body Mass Index Category With an Identity CrisisJean-Pierre Després, PhDJean-Pierre Després, PhDFrom Québec Heart and Lung Institute Research Centre, Université Laval, Québec, Québec, Canada.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M17-0566 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Decades of epidemiologic research have shown that body mass index (BMI), the most commonly used anthropometric index of adiposity, is associated with risk for death (1). In addition, BMI has been a simple and useful metric to document the growth in prevalence of overweight and obesity worldwide (2). Both ends of the BMI spectrum (underweight [BMI <18.5 kg/m2] and obesity [BMI ≥30 kg/m2]) are clearly associated with increased risk for death, resulting in the often-illustrated J-shaped curve between BMI and mortality. However, uncertainty remains about the optimal BMI associated with the lowest risk for death. This debate was further fueled ...References1. Berrington de Gonzalez A, Hartge P, Cerhan JR, Flint AJ, Hannan L, MacInnis RJ, et al. Body-mass index and mortality among 1.46 million white adults. N Engl J Med. 2010;363:2211-9. [PMID: 21121834] doi:10.1056/NEJMoa1000367 CrossrefMedlineGoogle Scholar2. NCD Risk Factor Collaboration (NCD-RisC). Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19.2 million participants. Lancet. 2016;387:1377-96. [PMID: 27115820] doi:10.1016/S0140-6736(16)30054-X CrossrefMedlineGoogle Scholar3. Flegal KM, Kit BK, Orpana H, Graubard BI. Association of all-cause mortality with overweight and obesity using standard body mass index categories: a systematic review and meta-analysis. JAMA. 2013;309:71-82. [PMID: 23280227] doi:10.1001/jama.2012.113905 CrossrefMedlineGoogle Scholar4. Yu E, Ley SH, Manson JE, Willett W, Satija A, Hu FB, et al. Weight history and all-cause and cause-specific mortality in three prospective cohort studies. Ann Intern Med. 2017;166:613-20. doi:10.7326/M16-1390 LinkGoogle Scholar5. Sahakyan KR, Somers VK, Rodriguez-Escudero JP, Hodge DO, Carter RE, Sochor O, et al. Normal-weight central obesity: implications for total and cardiovascular mortality. Ann Intern Med. 2015;163:827-35. [PMID: 26551006]. doi:10.7326/M14-2525 LinkGoogle Scholar6. Cerhan JR, Moore SC, Jacobs EJ, Kitahara CM, Rosenberg PS, Adami HO, et al. A pooled analysis of waist circumference and mortality in 650,000 adults. Mayo Clin Proc. 2014;89:335-45. [PMID: 24582192] doi:10.1016/j.mayocp.2013.11.011 CrossrefMedlineGoogle Scholar7. Després JP. Body fat distribution and risk of cardiovascular disease: an update. Circulation. 2012;126:1301-13. [PMID: 22949540] doi:10.1161/CIRCULATIONAHA.111.067264 CrossrefMedlineGoogle Scholar8. Després JP. Obesity and cardiovascular disease: weight loss is not the only target. Can J Cardiol. 2015;31:216-22. [PMID: 25661557] doi:10.1016/j.cjca.2014.12.009 CrossrefMedlineGoogle Scholar9. Khaw KT, Jakes R, Bingham S, Welch A, Luben R, Day N, et al. Work and leisure time physical activity assessed using a simple, pragmatic, validated questionnaire and incident cardiovascular disease and all-cause mortality in men and women: The European Prospective Investigation into Cancer in Norfolk prospective population study. Int J Epidemiol. 2006;35:1034-43. [PMID: 16709620] MedlineGoogle Scholar10. Harmon BE, Boushey CJ, Shvetsov YB, Ettienne R, Reedy J, Wilkens LR, et al. Associations of key diet-quality indexes with mortality in the Multiethnic Cohort: the Dietary Patterns Methods Project. Am J Clin Nutr. 2015;101:587-97. [PMID: 25733644] doi:10.3945/ajcn.114.090688 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Québec Heart and Lung Institute Research Centre, Université Laval, Québec, Québec, Canada.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M17-0566.Corresponding Author: Jean-Pierre Després, PhD, Québec Heart and Lung Institute, 2725, chemin Sainte-Foy, A2087, Québec, Québec G1V 4G5, Canada; e-mail, Jean-Pierre.[email protected]ulaval.ca.This article was published at Annals.org on 4 April 2017. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoWeight History and All-Cause and Cause-Specific Mortality in Three Prospective Cohort Studies Edward Yu , Sylvia H. Ley , JoAnn E. Manson , Walter Willett , Ambika Satija , Frank B. Hu , and Andrew Stokes Metrics 2 May 2017Volume 166, Issue 9Page: 671-672KeywordsAdipose tissueBody mass indexExerciseHealth surveysMorbidityMortalityNutritionObesityOverweightQuestionnaires ePublished: 4 April 2017 Issue Published: 2 May 2017 Copyright & PermissionsCopyright © 2017 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...