The prevalence of overweight among children and adolescents and obesity among men increased significantly during the 6-year period from 1999 to 2004; among women, no overall increases in the prevalence of obesity were observed. These estimates were based on a 6-year period and suggest that the increases in body weight are continuing in men and in children and adolescents while they may be leveling off in women.

IMPORTANCE More than one-third of adults and 17% of youth in the United States are obese, although the prevalence remained stable between 2003–2004 and 2009–2010. OBJECTIVE To provide the most recent national estimates of childhood obesity, analyze trends in childhood obesity between 2003 and 2012, and provide detailed obesity trend analyses among adults. DESIGN, SETTING, AND PARTICIPANTS Weight and height or recumbent length were measured in 9120 participants in the 2011–2012 nationally representative National Health and Nutrition Examination Survey. MAIN OUTCOMES AND MEASURES In infants and toddlers from birth to 2 years, high weight for recumbent length was defined as weight for length at or above the 95th percentile of the sex-specific Centers for Disease Control and Prevention (CDC) growth charts. In children and adolescents aged 2 to 19 years, obesity was defined as a body mass index (BMI) at or above the 95th percentile of the sex-specific CDC BMI-for-age growth charts. In adults, obesity was defined as a BMI greater than or equal to 30. Analyses of trends in high weight for recumbent length or obesity prevalence were conducted overall and separately by age across 5 periods (2003–2004, 2005–2006, 2007–2008, 2009–2010, and 2011–2012). RESULTS In 2011–2012, 8.1% (95% CI, 5.8%–11.1%) of infants and toddlers had high weight for recumbent length, and 16.9% (95% CI, 14.9%–19.2%) of 2- to 19-year-olds and 34.9% (95% CI, 32.0%–37.9%) of adults (age-adjusted) aged 20 years or older were obese. Overall, there was no significant change from 2003–2004 through 2011–2012 in high weight for recumbent length among infants and toddlers, obesity in 2- to 19-year-olds, or obesity in adults. Tests for an interaction between survey period and age found an interaction in children (P = .03) and women (P = .02). There was a significant decrease in obesity among 2- to 5-year-old children (from 13.9% to 8.4%; P = .03) and a significant increase in obesity among women aged 60 years and older (from 31.5% to 38.1%; P = .006). CONCLUSIONS AND RELEVANCE Overall, there have been no significant changes in obesity prevalence in youth or adults between 2003–2004 and 2011–2012. Obesity prevalence remains high and thus it is important to continue surveillance.

VERALL TRENDS IN OBESITYin the adult population of the United States can be tracked using national survey data that include measured heights and weights. Based on national survey data, the population prevalence of obesity, defined as a body mass index (BMI) of 30 or greater (calculated as weight in kilograms divided by height in meters squared), showed little change in the

The increases in the prevalences of obesity and overweight previously observed continued in 1999-2000. The potential health benefits from reduction in overweight and obesity are of considerable public health importance.

Context The prevalence of childhood obesity increased in the 1980s and 1990s but there were no significant changes in prevalence between 1999-2000 and 2007-2008 in the United States. Objectives To present the most recent estimates of obesity prevalence in US children and adolescents for 2009-2010 and to investigate trends in obesity prevalence and body mass index (BMI) among children and adolescents between 1999-2000 and 2009-2010. Design, Setting, and Participants Cross-sectional analyses of a representative sample (N=4111) of the US child and adolescent population (birth through 19 years of age) with measured heights and weights from the National Health and Nutrition Examination Survey 2009-2010. Main Outcome Measures Prevalence of high weight-for-recumbent length (Ն95th percentile on the growth charts) among infants and toddlers from birth to 2 years of age and obesity (BMI Ն95th percentile of the BMI-forage growth charts) among children and adolescents aged 2 through 19 years. Analyses of trends in obesity by sex and race/ethnicity, and analyses of trends in BMI within sex-specific age groups for 6

The prevalence of overweight among children in the United States is continuing to increase, especially among Mexican-American and non-Hispanic black adolescents.

No abstract

O bstructive sleep apnea (OSA) is a common disorder that affects sleep and quality of life. Because many people with OSA cannot or will not comply with the standard treatment with a continuous positive airway pressure (CPAP) mask, alternative treatments have been sought. Upper-airway stimulation using unilateral stimulation of the hypoglossal nerve is a possible option. This multicenter, prospective, single-group, cohort trial and a follow-up randomized therapy-withdrawal trial were performed to evaluate the clinical safety and effectiveness of upper-airway stimulation for treating moderate to severe OSA.Patients who had difficulty accepting or adhering to CPAP treatment were included and served as their own controls. After initial screening, including polysomnography, qualified patients underwent surgery to implant the upper-airway stimulation system in which a stimulation electrode was placed on the hypoglossal nerve to recruit tongue-protrusion function. The sensing lead was placed between the internal and external intercostal muscles to detect ventilatory effort, and the neurostimulator was implanted in the right ipsilateral midinfraclavicular region. A month after implantation, patients had a second baseline diagnostic polysomnographic exam before the device was activated. Patients used a controller to initiate and stop therapy each night and then were assessed at 2, 3, 6, 9, and 12 months. The primary outcome was the change in the severity of OSA as determined by the apnea-hypopnea index (AHI; number of apnea or hypopnea events per hour; score ≥15 indicates moderate to severe OSA) and the O 2 desaturation index (ODI; number of times per hour of sleep that the blood O 2 level drops by ≥4 percentage points from baseline). At the 12-month assessment, a response to treatment was defined as an AHI reduction of 50% or greater from baseline and a score of less than 20 events per hour along with an ODI reduction of 25% or greater from baseline. The primary efficacy objectives were response rates of 50% or greater as assessed in the AHI and ODI. Secondary outcomes were the Epworth Sleepiness Scale, the Functional Outcomes of Sleep Questionnaire (FOSQ), and the percentage of sleep time with the O 2 saturation of less than 90%. Consecutive patients with a response were included in a randomized controlled therapywithdrawal trial in which they were assigned in a 1:1 ratio to either the therapy-maintenance or therapy-withdrawal group. The withdrawal group had the device turned off for 7 days; the maintenance group continued using the device. Polysomnography was done to measure the effects of withdrawal compared with continued use of therapy. Serious adverse events were those that led to death, lifethreatening illness, permanent impairment, or new or prolonged hospitalization with serious health impairment.Of the 126 participants, 83% were men; mean age was 54.5 years, and mean body mass index was 28.4 kg/m 2 . The mean AHI score on the initial screening polysomnography was 32.0 events per hour, and the mean ODI score was...