Disproportionate increase in BMI of ≥60 kg/m2 in the USA
The obesity epidemic has reached alarming levels, with most attention focusing on obesity in general (BMI >30 kg/m2) and class 3 obesity (BMI ≥40 kg/m2).1–3 However, less is known about the prevalence and trends in extremely severe obesity (BMI ≥60 kg/m2), a threshold associated with substantial clinical burden, impaired mobility, and increased health-care costs.4 Patients in this high BMI category have a 2–3 times greater incidence of major comorbidities, surgical morbidity, and mortality than those in lower BMI classes.
