Can the Year 2000 objective for reducing overweight in the United States be reached?: a simulation study of the required changes in body weight.
AIM: The purpose of this analysis was to estimate the magnitude of weight change required in the six-year period between 1994 and the Year 2000 if Americans are to reach the Healthy People 2000 goal for reduction of overweight among those ages 20-74 to no more than 20% among all adults and no more than 30% among black women. Prevention of weight gain among the non-overweight is compared with that of weight loss among the overweight as strategies for reaching this goal. DESIGN: Data from the First National Health and Nutrition Examination Survey (NHANES I) and the Nutrition Examination Survey Epidemiologic Follow-up Study (NHEFS) were used to estimate 6-year weight change of persons aged 20 to 72 at the Year 2000. Men, white women, and black women were examined in addition to the overall population. Given a baseline prevalence of 24.7%, overweight in the year 2000 was projected for three simulated interventions: no weight gain among non-overweight persons (prevention-only), weight loss among overweight persons (weight-loss-only), and prevention-plus-weight-loss. In addition, the Year 2000 overweight prevalence was projected under different baseline prevalence scenarios of 26% and 34%. OUTCOME MEASURE: Prevalence of overweight; overweight determined by body mass index (> or = 27.3 kg/m2 for women and > or = 27.8 kg/m2 for men). RESULTS: Prevention-only was successful in reducing the overall prevalence of overweight from 24.7% to 20%. Weight-loss-only required a 5.3 kg weight loss to achieve the overall goal of 20% and 8.4 kg weight loss to achieve the goal within all three race-sex strata. Prevention-plus-weight-loss required only 3.8 kg of weight loss to achieve the goals within the three race-sex strata. Prevention-only was not successful in reducing the overall prevalence of overweight to 20% when the 26% and 34% baseline scenarios were used. Weight-loss-only required 6.3 and 11.2 kg; prevention-plus-weight-loss required 1.2 and 6.6 kg of weight loss using the 26% and 34% baselines, respectively. CONCLUSIONS: Prevention of weight gain among those who are not already overweight could achieve substantial changes in the prevalence of overweight, even in a 6-year time period. However, given the increasing trend in overweight, the Year 2000 goal for the reduction in prevalence of overweight will not be reached.