The Prevalence of Overweight, Obesity, and Substandard Fitness in a Population-Based Firefighter Cohort

OBJECTIVE: To examine the prevalence of overweight and obesity in firefighters. METHODS: Body mass index (BMI), waist circumference, and body fat percentage (BF%) were assessed in 478 career and 199 volunteer male firefighters from randomly selected departments. RESULTS: High prevalence rates of overweight + obesity (BMI ≥ 25 kg/m) and obesity (BMI ≥ 30 kg/m) were found in career (79.5%; 33.5%) and volunteer firefighters (78.4%; 43.2%). False-positive obesity misclassification based on BMI, compared to waist circumference and BF%, was low (9.8% and 2.9%, respectively). False negatives were much higher: 32.9% and 13.0%. Obese firefighters demonstrated unfavorable cardiovascular disease (CVD) profiles. CONCLUSIONS: The prevalence of overweight and obesity exceeded that of the US general population. Contrary to common wisdom, obesity was even more prevalent when assessed by BF% than by BMI, and misclassifying muscular firefighters as obese by using BMI occurred infrequently.