Clinically severe obesity is even more common than noted by Sturm1 based on telephone data. The Health Appraisal Center at Kaiser Permanente, San Diego, Calif, performs a comprehensive physical examination on more than 36 000 individuals between the ages of 18 and 65 years annually.2 Sturm noted 1 in 5 Americans self-reporting a body mass index (BMI; calculated as weight in kilograms divided by the square of height in meters) of 30 or higher, and 1 in 50 self-reported a BMI of 40 or higher in 2000. He also commented that underreporting weight may increase with increasing weight. In 2001, a measured BMI of 30 or higher was noted in fully 30.2% (10 919 of 36 133) and a BMI of 40 or higher was noted in 4.4% (1606 of 36 133) of the patients attending our Health Appraisal Center. This is occurring in a city noted for having a health- and weight-conscious population.
Macy E, Blau E. People Are Fatter Than They Think. Arch Intern Med. 2004;164(6):677-678. doi:10.1001/archinte.164.6.677-b