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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.

    Abstract

    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.

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