Table 13. Classification of Overweight/Obesity by Body Mass Index, Waist Circumference, and Associated Disease Risk

Body Mass   Index (kg/m2)     Obesity   Class Disease Risk* Relative to Normal Weight and Waist Circumference Men <102 cm ( <40 in)   Women <88 cm ( <35 in)   Men >102 cm (>40 in)   Women >88 cm (>35 in)    Underweight <18.5 — — —  Normal† 18.5–24.9 — — —  Overweight 25.0–29.9 — Increased High  Obesity 30.0–34.9 35.0–39.9 I II High Very High Very High Very High  Extreme obesity    >40 III Extremely High Extremely High

* Risk for type 2 diabetes, hypertension, and cardiovascular disease.
† Increased waist circumference can also be a marker for increased risk even in persons of normal weight.

National Heart, Lung, and Blood Institute. Obesity Education Initiative Expert Panel. Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: The Evidence Report 1998. NIH Publication 98-4083.

Figure 13. Treatment Algorithm for Overweight and Obese Patients*

*This algorithm applies only to the assessment of overweight and obesity and subsequent decisions based on that assessment. It does not reflect an initial assessment for other cardiovascular risk factors that may be indicated.
^†Drug side effects/contraindications must be evaluated for each patient.
^‡Pharmacotherapy recommendations not included in original algorithm.

Reproduced from the National Heart, Lung, and Blood Institute. Obesity Education Initiative Expert Panel. Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: The Evidence Report 1998. NIH Publication 98-4083.