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Hales  CM, Fryar  CD, Carroll  MD, Freedman  DS, Ogden  CL.  Trends in obesity and severe obesity prevalence in US youth and adults by sex and age, 2007-2008 to 2015-2016.  JAMA. 2018;319(16):1723-1725. doi:10.1001/jama.2018.3060PubMedGoogle ScholarCrossref
Zheng  Y, Manson  JE, Yuan  C,  et al.  Associations of weight gain from early to middle adulthood with major health outcomes later in life.  JAMA. 2017;318(3):255-269. doi:10.1001/jama.2017.7092PubMedGoogle ScholarCrossref
Magkos  F, Fraterrigo  G, Yoshino  J,  et al.  Effects of moderate and subsequent progressive weight loss on metabolic function and adipose tissue biology in humans with obesity.  Cell Metab. 2016;23(4):591-601. doi:10.1016/j.cmet.2016.02.005PubMedGoogle ScholarCrossref
Leung  AWY, Chan  RSM, Sea  MMM, Woo  J.  An overview of factors associated with adherence to lifestyle modification programs for weight management in adults.  Int J Environ Res Public Health. 2017;14(8):922. doi:10.3390/ijerph14080922PubMedGoogle ScholarCrossref
Haynes  A, Kersbergen  I, Sutin  A, Daly  M, Robinson  E.  A systematic review of the relationship between weight status perceptions and weight loss attempts, strategies, behaviours and outcomes.  Obes Rev. 2018;19(3):347-363. doi:10.1111/obr.12634PubMedGoogle ScholarCrossref
Lim  HJ, Kang  HT, Lee  JW.  Recent trends in weight loss attempts: data from the Korea National Health and Nutrition Examination Survey.  Asia Pac J Public Health. 2018;30(5):447-457. doi:10.1177/1010539518770464PubMedGoogle ScholarCrossref
Nicklas  JM, Huskey  KW, Davis  RB, Wee  CC.  Successful weight loss among obese U.S. adults.  Am J Prev Med. 2012;42(5):481-485. doi:10.1016/j.amepre.2012.01.005PubMedGoogle ScholarCrossref
Mozumdar  A, Liguori  G.  Corrective equations to self-reported height and weight for obesity estimates among U.S. adults: NHANES 1999-2008.  Res Q Exerc Sport. 2016;87(1):47-58. doi:10.1080/02701367.2015.1124971PubMedGoogle ScholarCrossref
National Center for Health Statistics. About the National Health and Nutrition Examination Survey. https://www.cdc.gov/nchs/nhanes/about_nhanes.htm. Accessed September 16, 2019.
Martin  CB, Herrick  KA, Sarafrazi  N, Ogden  CL.  Attempts to lose weight among adults in the United States, 2013-2016.  NCHS Data Brief. 2018;313(313):1-8.PubMedGoogle Scholar
Rust  K.  Variance estimation for complex estimators in sample surveys.  J Off Stat. 1996;1(4):381-397. http://bayanbox.ir/download/5066036695274464742/6.1-Sampling-errors-Rust-JoS-1-4-1985.pdf.Google Scholar
Johnson  CL, Paulose-Ram  R, Ogden  CL,  et al.  National health and nutrition examination survey: analytic guidelines, 1999-2010.  Vital Health Stat 2. 2013;(161):1-24.PubMedGoogle Scholar
Kant  AK.  Interaction of body mass index and attempt to lose weight in a national sample of US adults: association with reported food and nutrient intake, and biomarkers.  Eur J Clin Nutr. 2003;57(2):249-259. doi:10.1038/sj.ejcn.1601549PubMedGoogle ScholarCrossref
Allaz  AF, Bernstein  M, Rouget  P, Archinard  M, Morabia  A.  Body weight preoccupation in middle-age and ageing women: a general population survey.  Int J Eat Disord. 1998;23(3):287-294. doi:10.1002/(SICI)1098-108X(199804)23:3<287::AID-EAT6>3.0.CO;2-FPubMedGoogle ScholarCrossref
Andela  S, Burrows  TL, Baur  LA, Coyle  DH, Collins  CE, Gow  ML.  Efficacy of very low-energy diet programs for weight loss: a systematic review with meta-analysis of intervention studies in children and adolescents with obesity.  Obes Rev. 2019;20(6):871-882. doi:10.1111/obr.12830PubMedGoogle ScholarCrossref
Harper  C, Maher  J, Grunseit  A, Seimon  RV, Sainsbury  A.  Experiences of using very low energy diets for weight loss by people with overweight or obesity: a review of qualitative research.  Obes Rev. 2018;19(10):1412-1423. doi:10.1111/obr.12715PubMedGoogle ScholarCrossref
Ryan  DH, Kahan  S.  Guideline recommendations for obesity management.  Med Clin North Am. 2018;102(1):49-63. doi:10.1016/j.mcna.2017.08.006PubMedGoogle ScholarCrossref
Matthews  CE.  Physical activity in the United States measured by accelerometer: comment.  Med Sci Sports Exerc. 2008;40(6):1188. doi:10.1249/MSS.0b013e31817057daPubMedGoogle ScholarCrossref
Lobelo  F, Rohm Young  D, Sallis  R,  et al; American Heart Association Physical Activity Committee of the Council on Lifestyle and Cardiometabolic Health; Council on Epidemiology and Prevention; Council on Clinical Cardiology; Council on Genomic and Precision Medicine; Council on Cardiovascular Surgery and Anesthesia; and Stroke Council.  Routine assessment and promotion of physical activity in healthcare settings: a scientific statement from the American Heart Association.  Circulation. 2018;137(18):e495-e522. doi:10.1161/CIR.0000000000000559PubMedGoogle ScholarCrossref
Daniels  MC, Popkin  BM.  Impact of water intake on energy intake and weight status: a systematic review.  Nutr Rev. 2010;68(9):505-521. doi:10.1111/j.1753-4887.2010.00311.xPubMedGoogle ScholarCrossref
Mozaffarian  D, Hao  T, Rimm  EB, Willett  WC, Hu  FB.  Changes in diet and lifestyle and long-term weight gain in women and men.  N Engl J Med. 2011;364(25):2392-2404. doi:10.1056/NEJMoa1014296PubMedGoogle ScholarCrossref
Ramage  S, Farmer  A, Eccles  KA, McCargar  L.  Healthy strategies for successful weight loss and weight maintenance: a systematic review.  Appl Physiol Nutr Metab. 2014;39(1):1-20. doi:10.1139/apnm-2013-0026PubMedGoogle ScholarCrossref
Johnston  BC, Kanters  S, Bandayrel  K,  et al.  Comparison of weight loss among named diet programs in overweight and obese adults: a meta-analysis.  JAMA. 2014;312(9):923-933. doi:10.1001/jama.2014.10397PubMedGoogle ScholarCrossref
Kruger  J, Galuska  DA, Serdula  MK, Jones  DA.  Attempting to lose weight: specific practices among U.S. adults.  Am J Prev Med. 2004;26(5):402-406. doi:10.1016/j.amepre.2004.02.001PubMedGoogle ScholarCrossref
Yanovski  SZ, Yanovski  JA.  Toward precision approaches for the prevention and treatment of obesity.  JAMA. 2018;319(3):223-224. doi:10.1001/jama.2017.20051PubMedGoogle ScholarCrossref
Severin  R, Sabbahi  A, Mahmoud  AM, Arena  R, Phillips  SA.  Precision medicine in weight loss and healthy living.  Prog Cardiovasc Dis. 2019;62(1):15-20. doi:10.1016/j.pcad.2018.12.012PubMedGoogle ScholarCrossref
Chang  VW, Christakis  NA.  Self-perception of weight appropriateness in the United States.  Am J Prev Med. 2003;24(4):332-339. doi:10.1016/S0749-3797(03)00020-5PubMedGoogle ScholarCrossref
Casey  VA, Dwyer  JT, Berkey  CS, Coleman  KA, Gardner  J, Valadian  I.  Long-term memory of body weight and past weight satisfaction: a longitudinal follow-up study.  Am J Clin Nutr. 1991;53(6):1493-1498. doi:10.1093/ajcn/53.6.1493PubMedGoogle ScholarCrossref
Wooley  SC, Garner  DM.  Obesity treatment: the high cost of false hope.  J Am Diet Assoc. 1991;91(10):1248-1251.PubMedGoogle Scholar
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    Original Investigation
    Diabetes and Endocrinology
    November 13, 2019

    Trends in Self-perceived Weight Status, Weight Loss Attempts, and Weight Loss Strategies Among Adults in the United States, 1999-2016

    Author Affiliations
    • 1School of Medicine, Department of Epidemiology, Zhejiang Provincial Key Laboratory of Pathophysiology, Ningbo University, Ningbo, Zhejiang Province, China
    • 2School of Public Health and Tropical Medicine, Department of Epidemiology, Tulane University, New Orleans, Louisiana
    • 3School of Public Health, Kunming Medical University, Kunming City, Yunnan Province, China
    • 4School of Medicine, Department of Epidemiology, Jinan University, Guangzhou, Guangdong Province, China
    • 5Population Wellbeing and Environment Research Lab, School of Health and Society, Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales, Australia
    • 6Menzies Centre for Health Policy, University of Sydney, Sydney, New South Wales, Australia
    • 7School of Public Health, Peking Union Medical College, The Chinese Academy of Medical Sciences, Beijing, China
    • 8Clinical and Translational Epidemiology Unit, Division of Gastroenterology, Massachusetts General Hospital, Boston
    • 9Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
    • 10Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
    JAMA Netw Open. 2019;2(11):e1915219. doi:10.1001/jamanetworkopen.2019.15219
    Key Points español 中文 (chinese)

    Question  What were the trends in current measured body mass index and weight, self-perceived weight status, weight loss attempts, and weight loss strategies in adults in the United States from 1999 to 2016?

    Findings  In this cross-sectional study with data from 48 026 participants in the National Health and Nutrition Examination Survey, increasing trends were observed in current measured body mass index and weight; adjusted, self-reported, prior-year weight; and the difference between current measured weight and adjusted, self-reported, prior-year weight. The proportion of participants who attempted to lose weight increased during the study period.

    Meaning  In this study, an increased trend in the proportion of participants who attempted to lose weight was observed, despite increased trends in current and historical weight.


    Importance  The self-perception of weight and weight loss attempts might promote weight loss and maintenance.

    Objective  To examine trends in current measured body mass index (BMI) and weight, self-reported weight, self-perceived weight status, weight loss attempts, and weight loss strategies among adults in the United States.

    Design, Setting, and Participants  This national cross-sectional study used data from continuous National Health and Nutrition Examination Survey (NHANES) data sets (1999-2000 to 2015-2016). Participants were US residents older than 20 years. Data were analyzed from January 2018 to December 2018.

    Main Outcomes and Measures  Current measured BMI and weight, self-reported weight, self-perceived weight status, weight loss attempts, and applied weight loss strategies. Adjusted, self-reported, prior-year weight was calculated using correction equations that considered age, sex, race/ethnicity, and quartile of self-reported prior-year weight.

    Results  Data were collected from 48 026 participants (19 792 [41.2%] aged 40-64 years; 24 255 [50.5%] women; 21 725 [45.2%] white) through 9 surveys from 1999-2000 to 2015-2016. Increasing trends were observed in current measured BMI (difference, 1.20; 95% CI, 0.92-1.47; P for trend < .001), current measured weight (difference 2.77 kg; 95% CI, 1.92-3.61 kg; P for trend < .001), adjusted, self-reported, prior-year weight (difference, 2.36 kg; 95% CI, 1.52-3.21 kg; P for trend < .001), and the difference between measured and adjusted self-reported weight (difference 0.70 kg; 95% CI, 0.34-1.07 kg; P for trend < .001). During this period, the proportion of overall participants who had attempted to lose weight increased from 34.3% to 42.2% (difference, 8.0%; 95% CI, 4.1%-10.5%; P for trend < .001). The most commonly reported weight loss strategies with the most rapidly increasing prevalence during the study period were reduced food consumption (21.2%-31.9%; difference, 11.1%; 95% CI, 8.2%-13.3%; P for trend < .001), exercise (18.2%-31.5%; difference, 14.4%; 95% CI, 11.3%-16.9%; P for trend < .001), and frequent water intake (0.2%-26.3%; difference, 26.2%; 95% CI, 24.1%-29.0%; P for trend < .001). Between 2005-2006 and 2015-2016, increases were also observed for the reported consumption of more fruits, vegetables, and salads (0.1%-29.4%; difference, 30.3%; 95% CI, 28.1%-31.2%; P for trend < .001), changing eating habits (0.3%-20.5%; difference, 20.2%; 95% CI, 19.1%-22.3%; P for trend < .001), and the consumption of less sugar, candy, and sweets (0.2%-20.9%; difference, 21.7%; 95% CI, 19.3%-22.6%; P for trend < .001).

    Conclusions and Relevance  In this cross-sectional study, our data indicated an increasing trend in the proportion of participants who attempted to lose weight and a parallel increasing trend in current measured BMI and weight among adults in the United States.