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To determine the relation of body mass index (weight/height²) with the risk of clinical non-insulin-dependent diabetes, the authors analyzed data from a cohort of 113,861 US women aged 30–55 years in 1976. During 8 years of follow-up (826,010 person-years), 873 definite cases were identified among women initially free from diagnosed diabetes. Among women of average body mass index, 23–23.9 kg/m² the relative risk was 3.6 times that of women having a body mass index less than 22 kg/m² The risk continued to increase above this level of body mass index. The authors observed a much weaker positive association with weight at age 18, and this association was eliminated after adjustment for current body mass index. Thus, weight gain after age 18 was a major determinant of risk. For an increase of 20–35 kg, the relative risk was 11.3, and for an increase of more than 35 kg, the relative risk was 17.3 …