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Member Research & Reports

Member Research & Reports

Brown: Obesity Classification isn’t as Easy as “One-Size-Fits-All”

Public health reporting, randomized trials, and epidemiologic studies of obesity tend to consider obesity as a homogeneous entity. However, obesity may represent a heterogeneous condition according to demographic, clinical, and behavioral factors. Thus, this study assessed the heterogeneity of individuals with obesity in the United States.

[Photo: Ms. Marcia P. Jimenez]

This study, conducted by lead author Ms. Marcia P. Jimenez, PhD candidate in the department of epidemiology at Brown University School of Public Health, analyzed data from the 2011 – 2012 wave of the National Health and Nutrition Examination Survey, a nationally representative sample of adults in the United States with detailed physical examination and clinical data (n = 1380). Cluster analysis was used to identify subgroups classified as obese according to demographic factors, clinical conditions, and behavioral characteristics.

The authors found significant heterogeneity among participants with obesity according to six distinct clusters (P < .001): affluent men with sleep disorders (16 percent of sample); older smokers with cardiovascular disease (16 percent); older women with high comorbidity (20 percent); healthy white women (13 percent); healthy non-white women (14 percent); and active men who drink higher amounts of alcohol (21 percent).

Obesity in the United States is not a homogeneous condition. Current research and treatment may fail to account for complex and interrelated factors, with implications for prevention strategies and diverse risks of obesity.

A demographic, clinical, and behavioral typology of obesity in the United States: an analysis of National Health and Nutrition Examination Survey 2011-2012” was published in Annals of Epidemiology, February 2018.