In Reply.—We demonstrated that the prevalence of childhood and adolescent obesity increased by over 40% between 1965 and 1980. We defined obesity as a triceps skin-fold thickness equal to or greater than the 85th percentile for children and adolescents of the same age and sex studied during the National Health Examination Surveys Cycles 2 and 3. Dr Kashani, in his letter, and Dr Barness, in his editorial, commented on the validity of our diagnostic criteria for obesity. Furthermore, Dr Barness disparaged our use of the "pejorative term obese... for normal children."
We agree that the definition of obesity is crucial. In contrast to the use of obesity as a pejorative term by the general public, nutritional scientists have always relied on a dichotomous, statistically derived, and somewhat arbitrary definition of obesity.1-3 An individual either is or is not obese, based on whether they are in the fattest 15% of the population,