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	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Clinically severe obesity is even more common than noted by Sturm¹ based on telephone data. The Health Appraisal Center at Kaiser Permanente, San Diego, Calif, performs a comprehensive physical examination on more than 36 000 individuals between the ages of 18 and 65 years annually.² Sturm noted 1 in 5 Americans self-reporting a body mass index (BMI; calculated as weight in kilograms divided by the square of height in meters) of 30 or higher, and 1 in 50 self-reported a BMI of 40 or higher in 2000. He also commented that underreporting weight may increase with increasing weight. In 2001, a measured BMI of 30 or higher was noted in fully 30.2% (10 919 of 36 133) and a BMI of 40 or higher was noted in 4.4% (1606 of 36 133) of the patients attending our Health Appraisal Center. This is occurring in a city noted for having a health- and weight-conscious population.

Eric Macy, MD; Eric Blau, MD
San Diego, Calif

1. Sturm R. Increases in clinically severe obesity in the United States, 1986-2000. Arch Intern Med. 2003;163:2146-2148. FREE FULL TEXT 2. Felitti VJ. Automated health appraisal. Group Pract J. 1980;29:11-13. PUBMED

Arch Intern Med. 2004;164:677-678.

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Increases in Clinically Severe Obesity in the United States, 1986-2000
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