Increasing prevalence of overweight and obesity among Spanish adults, 1987 – 1997 JL Gutie ´rrez-Fisac 1 *, JR Banegas Banegas 1 , F Rodrı ´guez Artalejo 2 and E Regidor 3 1 Department of Preventive Medicine and Public Health, Universidad Auto ´noma de Madrid, Madrid, Spain; 2 Department of Preventive Medicine and Public Health, Universidad del Paı ´s Vasco, Spain; and 3 Department of Preventive Medicine and Public Health, Universidad Complutense de Madrid, Madrid, Spain OBJECTIVE: To study the trend in the prevalence of obesity and overweight in Spanish men and women 25 – 64 y of age between 1987 and 1997. DESIGN: Cross-sectional surveys of representative samples of the non-institutionalized population in Spain in 1987, 1995 and 1997. SUBJECTS: 14,676 and 7004 adults aged 25 – 64 who were representative of the Spanish population in 1987 and 1995=1997. MEASURES: Body mass index (BMI) calculated from self-reported weight and height. Overweight is defined as BMI  27 – 29.9 kg=m 2 and obesity as BMI  30 kg=m 2 . RESULTS: Between 1987 and 1995=97, the prevalence of overweight in the Spanish population aged 25 – 64 increased by 2.2% (P < 0.01); the increase was greater in men (3.8%; P < 0.01) than in women (0.6%; P > 0.05). The largest increases in the prevalence of overweight were seen in men (5.2%; P < 0.01) and women (2.3%; P < 0.05) aged 25 – 34. During the same period, the prevalence of obesity increased by 3.9% (P < 0.01), 4.6% in men (P < 0.01) and 3.2% in women (P < 0.01). The largest increases were seen in men aged 45 – 54 (6.5%, P < 0.01) and in women aged 25 – 34 (2.2%, P < 0.05). By educational level, the prevalence of overweight increased significantly in men with fewer than 12 y of education (4.7%, P < 0.01). Obesity increased by 4.6% (P < 0.01) and by 4.9% (P < 0.01) in men and women with fewer than 12 y of education, respectively. CONCLUSIONS: The prevalence of overweight and obesity is increasing in Spain, the same as it is in other developed countries. The increase, which is found in most age and sex groups in the population, especially affects middle-aged men, young women and persons with lower educational level. The causes of the increase in the prevalence of overweight and obesity are likely to be multifactorial. International Journal of Obesity (2000) 24, 1677–1682 Keywords: obesity; overweight; survey; trends Introduction Obesity is not only a well-defined disease entity, but is also one of the most important risk factors for cardio- vascular disease, adult-onset diabetes, some types of cancer and other chronic disorders. 1–4 In addition, there is a high prevalence of obesity in the general population, making it the principal nutritional problem in the developed world today. For a number of years, a major increase in the prevalence of obesity and overweight in the adult population has been observed in most developed countries. In the USA, the prevalence of overweight has risen by about 1% per year in absolute terms since the early eighties, while the prevalence of obesity has risen by 0.5%. 5,6 Similar increases have been observed in several European countries 7 such as the UK, 8 The Netherlands, 9 Sweden, 10,11 Germany 12 and France. 13 In Spain, periodic national health interview surveys have been carried out since 1987 on representative samples of the population. Data from these surveys can be used to monitor obesity in the general popula- tion, study trends over time, and analyse the popula- tion subgroups that are most affected by this health problem. These studies, based on health interview surveys and some other population studies, have shown large variations by age, sex, educational level and many other socio-demographic factors. 14,15 Like- wise, regional differences in body mass index (BMI) and in the prevalence of obesity have been shown in Spain. 16 Some of these variations suggest that there is a potential for the reduction of the magnitude of the problem through public health intervention programs directed both to the general population and to the groups most affected. Much less investigated has been the trend over time in the prevalence of overweight and obesity. Identifi- cation of the groups in which trends in obesity are less *Correspondence: JL Gutie ´ rrez-Fisac, Departamento de Medicina Preventiva Salud Pu ´ blica, Facultad de Medicina, Universidad Auto ´ noma de Madrid, Avda. Arzobispo Morcillo s=n, 28029 Madrid, Spain. Received 9 September 1999; revised 24 May 2000; accepted 7 July 2000 International Journal of Obesity (2000) 24, 1677–1682 ß 2000 Macmillan Publishers Ltd All rights reserved 0307–0565/00 $15.00 www.nature.com/ijo