Obesity in the U.S.
Prevalence and Trends
Pennington Biomedical Research Center
Division of Education
Obesity in the U.S.
Current Trends
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Currently, about 66% of American adults are overweight and about 32% are obese.
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The obesity weight class has increased the most over the past few decades.
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Compared with prevalence rates reported in 1976-80, the rates of obesity seen
today are more than double what they were only thirty years ago.
Overweight is Rising
This overweight classification combines those who are classified as
overweight (BMI 25-29.9) and those who are obese (BMI ≥ 30).
68
65.7
66.3
64.5
66
64
62
Prevalence of overweight and
obesity among U.S. adults 20
years of age and older
60
58
56.0
56
54
52
50
1988-94
1999-2000
2001-02
2003-04
Adapted from: the Centers for Disease Control and Prevention (CDC)
Trends in the United States
Obesity Continues to Rise
Obesity is defined as having a BMI ≥ 30
1996
1991
2004
Prevalence of
obesity by state
No Data
<10%
10%–14%
15%–19%
Source: Behavioral Risk Factor Surveillance System, CDC
20%–24%
≥25%
Obesity
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An estimated 66 million adults in the United States are obese.
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Being either overweight or obese substantially raises one’s
risk of morbidity from:
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Hypertension
Dyslipidemia
Type 2 diabetes
Coronary heart disease
Stroke
Gallbladder disease
Osteoarthritis
Sleep apnea and respiratory problems
Endometrial, breast, prostate, and colon cancers.
Obesity
Introduction
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In addition to the increased risk for several diseases, higher body weights are
also associated with increases in all-cause mortality.
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An estimated 300,000 deaths per year are attributable to obesity.
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As the second leading cause of preventable death in the United States today,
overweight and obesity pose a major public health threat.
Obesity in the U.S.
Race/Ethnic
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The picture is even worse when rates are looked at by gender and ethnic backgrounds:
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77 percent of Black women are overweight, and 50 percent are obese, while
72 percent of Mexican-American women are overweight, and 40 percent of
Mexican American women are obese.
Significant differences in obesity exist among
different racial or ethnic groups
CDC/NCHS; Flegal KM 2002
Obesity in the U.S.
Socioeconomic Status
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A Dutch study found a link between socioeconomic status (SES) and obesity.
 In fact, those in the very low SES had the highest rates of obesity
and consumed the most soft drinks, potatoes, fat, and meat.
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A long term study found that African American women had higher rates of
obesity than Caucasian regardless of SES.
Hulshof KFAM et al. 2003; Zhang and Wang 2004; Johnson-Down et al 1997
Obesity in the U.S.
Socioeconomic Status
Higher socioeconomic group women:
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Diet more often
Have greater access to resources
Have better nutrition knowledge
Are committed to slimness
Avoid high fat foods
Get more physical activity
In Developing Countries
Obesity & SES
Higher socioeconomic group women:
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Have more incidence of obesity
Have less malnutrition
Have less infection
Have a steady source of income and food
In fact, overweight is associated with wealth
Obesity in the U.S.
What is the Cost?
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According to a study of national costs
attributed to both overweight and obesity,
medical expenses accounted for 9.1% of the
total U.S. medical expenditures in 1998.
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Medical expenses for overweight and obesity may
have reached as high as $78.5 billion in 1998.
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In Louisiana alone, approximately $1.4 billion
was spent on overweight and obesity-related
medical expenses.
Obesity
What are the Causes?
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Overweight and obesity are the result of an
energy imbalance over a long period of time.
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While the whole picture is still unclear on how obesity
develops, it is believed to involve the integration of
social, behavioral, cultural, physiological, metabolic,
and genetic factors.
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Behavior and environment appear to play a large role
the development of obesity, and are often the focus
for prevention and treatment actions.
Energy Imbalance
What is it?
Weight Gain
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Energy balance is like a scale where both
sides are of equal weight.
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An energy imbalance arises when the number of
calories consumed is not equal to the number of
calories used by the body.
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Weight gain usually involves the combination of
consuming too many calories and not expending
enough enough through physical activity, although
weight gain could result from one or the other.
Calories Consumed > Calories Used
Weight Loss
Calories Consumed < Calories Used
No Weight Change
Calories Consumed = Calories Used
CDC
Obesity
Diet and Exercise
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Physical activity contributes to weight loss, especially
when combined with a calorie reduction.
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Physical activity is important in preventing overweight and
obesity and in maintaining weight that is lost.
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In addition to weight control, physical activity helps:
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Prevent heart disease
Control cholesterol levels and diabetes
To slow bone loss associated with advancing age
Lower the risk of certain cancers
Reduce anxiety and depression
Body Mass Index
Indicator of Weight Status
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Body mass index (BMI) is a
mathematical ratio taking into
account an individual’s weight, in
kilograms, and height, in meters
squared (kg/m2). This measure can
be used for adults 20 years
of age and older.
With a BMI of:
You are considered:
Below 18.5
Underweight
18.5 - 24.9
Healthy Weight
25.0 - 29.9
Overweight
30 or higher
Obese
BMI determines an individuals
weight category.
You can find tables on the web that that are ready-made for you. http://www.nhlbisupport.com/bmi
Obesity Classes
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Class 1
 BMI of 30-35
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Class 2
 BMI of 35-40
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Class 3, Extreme obesity
 BMI greater than 40
Waist Circumference
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Waist circumference is a predictor of mortality and chronic disease.
It is a prognostic indicator along with BMI.
The presence of excess body fat in the abdomen, when out of
proportion to total body fat, is considered an independent predictor
of risk factors and ailments associated with obesity.
Men = Greater than 40 inches
Women = Greater than 35 inches
Waist Circumference & BMI
And Disease Risk
Disease Risk * Relative to Normal Weight
and Waist Circumference
BMI (kg/m2)
Men ≤ 102 cm (≤ 40 in)
Women ≤ 88 cm (≤ 35 in)
> 102 cm (> 40 in)
> 88 cm (>35 in)
< 18.5
-----
-----
Normal
18.5 – 24.9
-----
-----
Overweight
25.0 – 29.9
Increased
High
Obesity
30.0 – 34.9
35.0 – 39.9
I
II
High
Very High
Very High
Very High
≥ 40
III
Extremely High
Extremely High
Underweight
Extreme Obesity
Obesity Class
* Disease risk for type 2 diabetes, hypertension, and cardiovascular disease
Adapted from:
Clinical guidelines on the identification, evaluation,
and treatment of overweight and obesity in adults
Why is a BMI of 20-25 considered
as a reference weight?
This is because the relationship between morbidity and
mortality and BMI is minimal at that range.
2.5
2
1.5
Risk
1
Increased
risk
0.5
0
19
Body Mass Index
20
25
35
Body Mass Index
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It is important to remember that although BMI
correlates with the amount of body fat a person has,
it does not directly measure body fat.
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However, with the exception of highly trained
athletes, BMI is a good predictor of chronic disease
and mortality in individuals.
In Summary…
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The prevalence of overweight and obesity in the U.S. is higher than ever before.
BMI & waist circumference are correlated with body fat and can predict the risk for disease.
Being overweight or obese substantially raises one’s risk of morbidity from many diseases.
Significant differences exist in obesity among different racial or ethnic groups.
Diet and physical activity are important in the fight against obesity.
Pennington Biomedical Research Center
Division of Education
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Edited: October 2009
Heli J. Roy, PhD, RD, Associate Professor
Shanna Lundy, BS
Beth Kalicki
Division of Education
Phillip Brantley, PhD, Director
Pennington Biomedical Research Center
Claude Bouchard, PhD, Executive
Director
About Our Company
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The Pennington Biomedical Research Center is a world-renowned nutrition research center.
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Mission:
To promote healthier lives through research and education in nutrition and preventive medicine.
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The Pennington Center has several research areas, including:
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Clinical Obesity Research
Experimental Obesity
Functional Foods
Health and Performance Enhancement
Nutrition and Chronic Diseases
Nutrition and the Brain
Dementia, Alzheimer’s and healthy aging
Diet, exercise, weight loss and weight loss maintenance
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The research fostered in these areas can have a profound impact on healthy living and on the prevention of common chronic diseases,
such as heart disease, cancer, diabetes, hypertension and osteoporosis.
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The Division of Education provides education and information to the scientific community and the public about research findings, training
programs and research areas, and coordinates educational events for the public on various health issues.
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We invite people of all ages and backgrounds to participate in the exciting research studies being conducted at the Pennington Center in
Baton Rouge, Louisiana. If you would like to take part, visit the clinical trials web page at www.pbrc.edu or call (225) 763-3000.
Additional Resources:
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MyPyramid: Food Pyramid. Available at: http://www.mypyramid.gov
Overweight and Obesity: Contributing Factors. Available at:
http://www.cdc.gov/nccdphp/dnpa/obesity/contributing_factors.htm
Calculate your daily calorie needs. Available at:
http://www.cancer.org/docroot/PED/content/PED_6_1x_Calorie_Calculator.asp
How many calories will your activity burn? Available at:
http://www.cancer.org/docroot/PED/content/PED_6_1x_Exercise_Counts.asp?
sitearea=&level
References
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Centers for Disease Control and Prevention. Available at: http://www.cdc.gov
Clinical guidelines on the identification, evaluation, and treatment of overweight and
obesity in adults. Available at: http://www.nhlbi.nih.gov/guidelines/obesity/ob_exsum.pdf
Obesity trends among U.S. adults. Available at:
http://www.cdc.gov/nccdphp/dnpa/obesity/trend/maps/obesity_trends_2004.ppt
Johnson-Down L, O'Loughlin L, Koski KG, and Gray-Donald K. High Prevalence of
Obesity in Low Income and Multiethnic Schoolchildren: A Diet and Physical Activity
Assessment. The Journal of Nutrition Vol. 127 No. 12 December 1997, pp. 2310-2315.
References
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Legal KM, Carroll MD, Ogden CL, Johnson CL. Prevalence and trends in obesity
among US adults, 1999-2000 JAMA. 2002;288:1723-1727.
Zhang, Q and Wang Y. Trends in the association between obesity and socioeconomic
status in US Adults: 1971-2000. Obesity Research 12:1622-1632, 2004.
Hulshof KF, Brussaard JH, Kruizinga AG, Telman J, Lowik MR. Socio-economic
status, dietary intake and 10 y trends: the Dutch National Food Consumption Survey.
Eur J Clin Nutr. 2003 Jan;57(1):128-37.