ArticleBMJ open2023
Temporal trends in obesity defined by the relative fat mass (RFM) index among adults in the United States from 1999 to 2020: a population-based study.
Article in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers.
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Who cites it
26 citing papers in PubMed, 37 citations in OpenAlex.
- Association between relative fat mass and increased prevalence of gallstone disease in American adults: A cross-sectional study.Medicine · 2026Article
- Glucagon-Like Peptide-1 Receptor Agonists (GLP-1RAs) for Obesity and Symptoms in Menopause: A Review.Cureus · 2026Review
- Association of relative fat mass with the incidence of type 2 diabetes: over a decade follow-up from the TLGS.International journal of obesity (2005) · 2025Article
- 2024 Obesity Fact Sheet in Korea: Prevalence of Obesity, Abdominal Obesity, Obesity Defined by Body Fat Percentage, and Underweight in Adults in Korea from 2013 to 2022.Journal of obesity & metabolic syndrome · 2025Article
- Obesity Risk Factors Promote Metabolic Reprogramming and Viral Infection in Airways with Type 1 High Inflammation.Biomolecules · 2025Article
- Bridging the gap in obesity research: A consensus statement from the European Society for Clinical Investigation.European journal of clinical investigation · 2025Review
- Replacing body mass index with relative fat mass to accurately estimate adiposity.Nature reviews. Endocrinology · 2025Article
- Observational
- Relative fat mass and risk of metabolic dysfunction associated steatotic liver disease and severe hepatic steatosis in U.S. adults: analysis of NHANES 2017-2020 data.BMC gastroenterology · 2025Article
- Association between relative fat mass and risk of gallstones in adults.Scientific reports · 2025Article
- Fructose induces inflammatory activation in macrophages and microglia through the nutrient-sensing ghrelin receptor.FASEB journal : official publication of the Federation of American Societies for Experimental Biology · 2025Article
- Body Fat and Obesity Rates, Cardiovascular Fitness, and the Feasibility of a Low-Intensity Non-Weight-Centric Educational Intervention Among Late Adolescents: Quasi-Experimental Study.JMIR pediatrics and parenting · 2025Article
- The association between relative fat mass (RFM) and lumbar bone density in US adults: Insight from 2011-2018 NHANES.PloS one · 2025Article
- Association between relative fat mass and cardiovascular disease: a cross sectional study based on NHANES.Frontiers in cardiovascular medicine · 2025Article
- Cardiovascular and renal comorbidities among saudi patients with type 2 diabetes: A cross-sectional observational study.PloS one · 2025Observational
- Article
- Integrated Insights into Metabolic and Bariatric Surgery: Improving Life Quality and Reducing Mortality in Obesity.Medicina (Kaunas, Lithuania) · 2024Review
- Gestational Diabetes: An Update 60 Years After O'Sullivan and Mahan.The Journal of clinical endocrinology and metabolism · 2024Review
- Dietary Regulation of Lipid Metabolism in Gestational Diabetes Mellitus: Implications for Fetal Macrosomia.International journal of molecular sciences · 2024Article
- Bone Fragility in High Fat Diet-induced Obesity is Partially Independent of Type 2 Diabetes in Mice.Calcified tissue international · 2024Article
Corrections and comments
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Authors and funding
2 authors at 2 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThe body mass index (BMI) largely underestimates excess body fat, suggesting that the prevalence of obesity could be underestimated. Biologically, women are known to have higher body fat than men. This study aimed to compare the temporal trends in general obesity by sex, ethnicity and age among adults in the USA using the relative fat mass (RFM), a validated surrogate for whole-body fat percentage and BMI.
designPopulation-based study.
settingUS National Health and Nutrition Examination Survey, from 1999-2000 to 2017-March 2020.
participantsA representative sample of adults 20-79 years in the USA.
main outcome measuresAge-adjusted prevalence of general obesity. RFM-defined obesity was diagnosed using validated cut-offs to predict all-cause mortality: RFM≥40% for women and ≥30% for men. BMI-defined obesity was diagnosed using a cut-off of 30 kg/m
resultsAnalysis included data from 47 667 adults. Among women, RFM-defined obesity prevalence was 64.7% (95% CI 62.1% to 67.3%) in 2017-2020, a linear increase of 13.9 percentage points (95% CI 9.0% to 18.9%; p<0.001) relative to 1999-2000. In contrast, the prevalence of BMI-defined obesity was 42.2% (95% CI 39.4% to 45.0%) in 2017-2020. Among men, the corresponding RFM-defined obesity prevalence was 45.8% (95% CI 42.0% to 49.7%), a linear increase of 12.0 percentage points (95% CI 6.6% to 17.3%; p<0.001). In contrast, the prevalence of BMI-defined obesity was 42.0 (95% CI 37.8% to 46.3%). The highest prevalence of RFM-defined obesity across years was observed in older adults (60-79 years) and Mexican Americans, in women and men. Conversely, the highest prevalence of BMI-defined obesity across years was observed in middle-age (40-59 years) and older adults, and in African American women.
conclusionsThe use of a surrogate for whole-body fat percentage revealed a much higher prevalence of general obesity in the USA from 1999 to 2020, particularly among women, than that estimated using BMI, and detected a disproportionate higher prevalence of general obesity in older adults and Mexican Americans.
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