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Morbidity burden starts at much lower BMIs

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The setting of these cut points has led many clinicians to assume that a BMI between 20 and 25 is optimum as the mortality risk is minimum. However, it has been known for decades that the risk of diabetes increases progressively from a BMI of about 20, and in the United States is then 5 times higher in women before the BMI of 25 is reached [10]. Furthermore, the incidence of hypertension and increases in blood cholesterol levels, and the risk of both cardiovascular diseases and colon cancer show linear increases as the BMI moves up from a BMI of about 20. So considering a BMI in the range of 20–25 as optimum may result in neglecting all the increasing comorbidities of weight gain within this “acceptable” range. These issues will be considered in greater detail later when we consider the overall hazards of obesity.

Clinical Obesity in Adults and Children

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