Background Obesity is a serious disease that is associated with an increased risk of diabetes, hypertension, heart disease, stroke, and cancer, among other diseases. The United States Centers for Disease Control and Prevention (CDC) estimates a 20% obesity rate in the 50 states, with 12 states having rates of over 30%. Currently, the body mass index (BMI) is most commonly used to determine adiposity. However, BMI presents as an inaccurate obesity classification method that underestimates the epidemic and contributes to failed treatment. In this study, we examine the effectiveness of precise biomarkers and duel-energy x-ray absorptiometry (DXA) to help diagnose and treat obesity. Methodology/Principal Findings A cross-sectional study of adults with BMI, DXA, fasting leptin and insulin results were measured from 1998–2009. Of the participants, 63% were females, 37% were males, 75% white, with a mean age = 51.4 (SD = 14.2). Mean BMI was 27.3 (SD = 5.9) and mean percent body fat was 31.3% (SD = 9.3). BMI characterized 26% of the subjects as obese, while DXA indicated that 64% of them were obese. 39% of the subjects were classified as non-obese by BMI, but were found to be obese by DXA. BMI misclassified 25% men and 48% women. Meanwhile, a strong relationship was demonstrated between increased leptin and increased body fat. Conclusions/Significance Our results demonstrate the prevalence of false-negative BMIs, increased misclassifications in women of advancing age, and the reliability of gender-specific revised BMI cutoffs. BMI underestimates obesity prevalence, especially in women with high leptin levels (>30 ng/mL). Clinicians can use leptin-revised levels to enhance the accuracy of BMI estimates of percentage body fat when DXA is unavailable.

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United States , Pakistan , Americans , American , Qamaruddin Nizami , Vemco Meded , Cerner Lifesciences , Glaxosmithkline , University Of South Florida Medical School , National Institute Of Health , Novartis , Robert Wood Johnson Foundation , Pfizer , Bioreference Lab , Astrazeneca , Health Nutrients Inc , York State Department Of Health , United States Centers For Disease , American Academy Of Medicine Fellowship In Anti , American Academy Of Medicine Tarsus Medical Conference , Pinnacle Health Geisinger System , Fiona Druckenmiller Fund , American Health Drug , Life Extension Foundation , World Health Organization , Aga Khan University , American Medical Association , American Society Of Bariatric Physicians , Venebio Group , National Institute For Quality Improvement , American Academy Of Neurology , Nassau University Medical Center , Excellence Media , Johnson , Bellevue Hospital Association , United States Centers , Disease Control , Measuring Adiposity , Body Mass Index , Percent Body Fat , Creative Commons Attribution License , New York State Department , New York , Unified Competing Interest , Partners Healthcare , American Academy , Engage Healthcare , Medical Learning Institute , American Health , Drug Benefits , National Institute , Quality Improvement , Total Health Nutrients , Weill Cornell Medical College , Anti Aging Medicine Fellowship , Functional Medicine , Nutritional Medicine , South Florida Medical School , Anti Aging Medicine Tarsus Medical Conference , Douglas Labs , Life Extension Magazine , American Society , Bariatric Physicians , Review Board , Receiver Operating Curve , Obesity , Adipose Tissue , Leptin , Insulin , Body Weight , Morbid Obesity , Public And Occupational Health ,