If half of Americans are "overweight" then basic statistic al evaluations dictate that you must re-evaluate your sample base to get rid of bias.
Americans should be compared to their peers i.e. North Americans or first world samples because 98% of the world is overweight compared to Somalis.
On the other hand, my doctor could do the scene from Airplane where Johnny says "And Leon's getting larger" for my diagnosis rather than the BMI.