OBESITY IN THE DEEP SOUTH
BY SCOT E. LONG, PH.D., CSCS
OBESITY IN THE UNITED STATES
SOURCE: BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM,
CDC.
PREVALENCE OF SELF-REPORTED OBESITY AMONG
U.S. ADULTS BY STATE AND TERRITORY
DEFINITIONS

OBESITY: BODY MASS INDEX (BMI) OF 30 OR HIGHER.

BODY MASS INDEX (BMI): A MEASURE OF AN ADULT’S
WEIGHT IN RELATION TO HIS OR HER HEIGHT, CALCULATED
BY USING THE ADULT’S WEIGHT IN KILOGRAMS DIVIDED BY
THE SQUARE OF HIS OR HER HEIGHT IN METERS.
PREVALENCE OF SELF-REPORTED OBESITY AMONG
U.S. ADULTS BY STATE AND TERRITORY
SOURCE OF THE DATA

THE DATA WERE COLLECTED THROUGH THE BEHAVIORAL RISK
FACTOR SURVEILLANCE SYSTEM (BRFSS), AN ONGOING, STATEBASED, TELEPHONE INTERVIEW SURVEY CONDUCTED BY STATE
HEALTH DEPARTMENTS WITH ASSISTANCE FROM CDC.

HEIGHT AND WEIGHT DATA USED IN THE BMI CALCULATIONS WERE
SELF-REPORTED.
PREVALENCE OF SELF-REPORTED OBESITY AMONG
U.S. ADULTS BY STATE AND TERRITORY
BRFSS METHODOLOGICAL CHANGES STARTED IN 2011

NEW SAMPLING FRAME THAT INCLUDED BOTH LANDLINE
AND CELL PHONE HOUSEHOLDS.

NEW WEIGHTING METHODOLOGY USED TO PROVIDE A
CLOSER MATCH BETWEEN THE SAMPLE AND THE
POPULATION.
PREVALENCE OF SELF-REPORTED OBESITY AMONG
U.S. ADULTS BY STATE AND TERRITORY
EXCLUSION CRITERIA USED BEGINNING WITH 2011 BRFSS DATA
RECORDS WITH THE FOLLOWING WERE EXCLUDED:

HEIGHT: <3 FEET OR ≥8 FEET

WEIGHT: <50 POUNDS OR ≥650 POUNDS

BMI: <12 KG/M2 OR ≥100 KG/M2

PREGNANT WOMEN
PREVALENCE OF SELF-REPORTED OBESITY AMONG U.S.
ADULTS BY STATE AND TERRITORY, BRFSS, 2014
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Prevalence
33.5
29.7
28.9
35.9
24.7
21.3
26.3
30.7
21.7
26.2
30.5
28.0
22.1
28.9
29.3
32.7
30.9
31.3
31.6
34.9
28.2
29.6
23.3
30.7
27.6
35.5
95% Confidence Interval
(32.1, 35.0)
(27.8, 31.7)
(27.7, 30.2)
(33.8, 38.0)
(23.5, 25.9)
(20.4, 22.2)
(24.9, 27.7)
(28.6, 32.8)
(19.5, 24.0)
(25.0, 27.5)
(28.9, 32.1)
(25.6, 30.5)
(20.7, 23.5)
(27.1, 30.8)
(27.6, 31.1)
(31.6, 34.0)
(29.6, 32.3)
(30.3, 32.2)
(30.2, 33.1)
(33.4, 36.4)
(26.9, 29.5)
(28.1, 31.1)
(22.3, 24.4)
(29.4, 32.0)
(26.8, 28.5)
(33.4, 37.6)
State
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Prevalence
30.2
26.4
30.2
27.7
27.4
26.9
28.4
27.0
29.7
32.2
32.6
33.0
27.9
30.2
28.3
27.0
32.1
29.8
31.2
31.9
25.7
24.8
28.5
27.3
35.7
31.2
29.5
95% Confidence Interval
(28.6, 31.9)
(24.9, 27.9)
(29.2, 31.3)
(25.4, 30.1)
(25.8, 29.1)
(25.7, 28.1)
(27.0, 30.0)
(25.6, 28.5)
(28.4, 31.0)
(30.5, 34.0)
(31.2, 34.1)
(31.7, 34.3)
(26.3, 29.6)
(28.9, 31.4)
(26.8, 29.8)
(25.4, 28.6)
(30.9, 33.3)
(27.9, 31.8)
(29.3, 33.2)
(30.6, 33.3)
(24.9, 26.6)
(23.5, 26.1)
(27.2, 29.7)
(26.0, 28.5)
(34.2, 37.2)
(29.6, 32.8)
(27.5, 31.5)
¶
PREVALENCE ESTIMATES REFLECT BRFSS METHODOLOGICAL CHANGES STARTED IN 2011. THESE ESTIMATES SHOULD NOT BE COMPARED TO PREVALENCE ESTIMATES BEFORE 2011. SOURCE: BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM, CDC.
.
PREVALENCE¶ OF SELF-REPORTED OBESITY AMONG U.S. ADULTS BY STATE
AND TERRITORY, BRFSS, 2014
SUMMARY

NO STATE HAD A PREVALENCE OF OBESITY LESS THAN 20%.

5 STATES AND THE DISTRICT OF COLUMBIA HAD A PREVALENCE OF OBESITY
BETWEEN 20% AND <25%.

23 STATES, PUERTO RICO, AND GUAM HAD A PREVALENCE OF OBESITY
BETWEEN 25% AND <30%.

19 STATES HAD A PREVALENCE OF OBESITY BETWEEN 30% AND <35%.

3 STATES (ARKANSAS, MISSISSIPPI AND WEST VIRGINIA) HAD A PREVALENCE
OF OBESITY OF 35% OR GREATER.
¶ Prevalence
estimates reflect BRFSS methodological changes started in 2011. These estimates should not be compared to prevalence estimates before
2011.
http://www.cdc.gov/obesity/data/prevalence-maps.html
OBESITY
• THE UNITED STATES IS THE ONLY COUNTRY IN THE
HISTORY OF CIVILIZATION IN WHICH POVERTYSTRICKEN PEOPLE SUFFER FROM OBESITY
• THE UNITED STATES IS THE 11TH MOST OBESE
COUNTRY IN THE WORLD AND MISSISSIPPI IS THE
3RD MOST OBESE STATE IN THE NATION
• WHY?
MOST OBESE COUNTRIES
• 1-KUWAIT: 42.8%
• 2-SAUDI ARABIA: 35.2%
• 3-BELIZE: 34.9%
• SOURCE: CDC (2015)
MOST OBESE STATES
• 1-ARKANSAS: 35.9%
• 2-WEST VIRGINIA: 35.7%
• 3-MISSISSIPPI: 35.5%
SOURCE: CDC (2015)
DEFINITIONS
• HEALTH: FREE OF DISEASE
• PHYSICAL ACTIVITY: ACTIVITY OF THE BODY
REQUIRING THE USE OF SKELETAL AND CARDIAC
MUSCLES SUCH AS MOWING THE GRASS, CUTTING
FIREWOOD AND RAKING LEAVES
• EXERCISE: STRUCTURED, REPETITIVE ACTIVITY SUCH AS
WALKING, JOGGING AND STRENGTH TRAINING
WHY WE MUST EXERCISE TODAY
• 1760: THE INDUSTRIAL REVOLUTION (A TRANSITION IN PARTS OF GREAT BRITAIN'S PREVIOUSLY MANUAL LABOR AND
DRAFT-ANIMAL–BASED ECONOMY TOWARDS MACHINE-BASED MANUFACTURING.)
• 1860’S: THE CIVIL WAR & TECHNOLOGY (WEAPONS, TELEGRAPHS, CAMERAS, TIN CANS)
• 1900-1913: HENRY FORD: AUTOMOBILE & ASSEMBLY LINE
• 1920-1940’S: TV & MECHANIZED FARM EQUIPMENT
• 1950’S: TV REMOTE CONTROL (THE FIRST TV REMOTE CONTROL, CALLED "LAZY BONES," WAS DEVELOPED IN 1950 BY
ZENITH ELECTRONICS CORPORATION)
• 1960’S: POWER TOOLS (THE FIRST CORDLESS POWER TOOL WAS UNVEILED BY BLACK & DECKER IN 1961)
• 1970’S: SILICON VALLEY ("SILICON VALLEY USA," BEGAN IN THE WEEKLY TRADE NEWSPAPER ‘ELECTRONIC NEWS’ ISSUE
DATED JANUARY 11, 1971.)
• 1980’S: MTV, COMPUTER GAMES (MTV LAUNCHED ON AUGUST 1, 1981)
• 1990’S: DVD PLAYERS, CELL PHONES, MP3 PLAYERS (THE DVD VIDEO FORMAT WAS FIRST INTRODUCED BY
TOSHIBA IN JAPAN IN NOVEMBER 1996)
• NEW MILLENNIUM: IPOD, IPHONE, WIRELESS INTERNET, ALL THINGS ELECTRONIC
FOOD FOR THOUGHT
• “TV WILL NEVER BE A SERIOUS COMPETITOR FOR RADIO BECAUSE
PEOPLE MUST SIT AND KEEP THEIR EYES GLUED ON A SCREEN; THE
AVERAGE AMERICAN FAMILY HASN'T TIME FOR IT.” ~AUTHOR UNKNOWN,
FROM NEW YORK TIMES, 1939
LOOK AT THE EVOLUTION OF COCA-COLA
• 1960’S: 8 OZ GLASS BOTTLE (96 CALORIES)
• 1970’S: 12 OZ CAN (146 CALORIES)
• 1980’S: 16 PLASTIC BOTTLE (192 CALORIES)
• 1990’S: 20 OZ ‘BIG GULP” (240 CALORIES)
• NEW MILLENNIUM: 40 OZ DRINKS (480 CALORIES)
• NOT TO MENTION: ALL PLACES OFFER FREE REFILLS IN
CONTEMPORARY SOCIETY!
OBESITY FACTS
•
64% OF ADULTS IN THE U.S. ARE EITHER OVERWEIGHT OR OBESE. OBESITY INCREASES THE RISK OF:
DIABETES, HEART DISEASE, HYPERTENSION, CERTAIN FORMS OF CANCER AND OTHER CHRONIC ILLNESSES.
•
THE NUMBER OF CHILDREN AND ADOLESCENTS WHO ARE OVERWEIGHT HAS DOUBLED AND TRIPLED
RESPECTIVELY, IN THE PAST 20 YEARS.
•
OVERWEIGHT OR OBESE CHILDREN RISK PSYCHOLOGICAL & SOCIAL STRESS, INCREASED RISK OF CARDIAC
DISEASE, HYPERTENSION, TYPE 2 DIABETES, AND PULMONARY DISEASES.
•
THE EARLIER A CHILD BECOMES OBESE THE MORE OBESE THAT CHILD WILL BECOME AND MORE LIKELY THEY
WILL GROW INTO OBESE ADULTS.
•
ADULT OBESITY CAUSES INCREASED MORBIDITY AND MORTALITY.
THESE FACTS TAKEN FROM THE AUGUST 2006 (V 28, # 4) EDITION OF THE STRENGTH AND CONDITIONING JOURNAL OF THE NATIONAL
STRENGTH AND CONDITIONING ASSOCIATION.
• APPROXIMATELY 17% (OR 12.7 MILLION) OF CHILDREN AND
ADOLESCENTS AGED 2—19 YEARS ARE OBESE
• THE PREVALENCE OF OBESITY AMONG CHILDREN AGED 2 TO 5 YEARS
DECREASED SIGNIFICANTLY FROM 13.9% IN 2003-2004 TO 8.4% IN
2011-2012.
FAST FOOD
• IN 1972, WE SPENT $3 BILLION A YEAR ON FAST FOOD—TODAY WE
SPEND MORE THAN $110 BILLION
• FRENCH FRIES ARE THE MOST EATEN VEGETABLE IN AMERICA
• EACH DAY, 1 IN 4 AMERICANS EATS AT A FAST FOOD RESTAURANT
• MCDONALD’S FEEDS MORE THAN 46 MILLION PEOPLE A DAY: MORE
THAN THE ENTIRE POPULATION OF SPAIN!
THESE FACTS TAKEN FROM THE WEBSITE OF SUPERSIZE ME A FILM OF EPIC PORTIONS:
WWW.SUPERSIZEME.COM
SUGAR
• SIMPLE SUGAR INTAKE TODAY REPRESENTS MORE THAN THE
YEARLY EQUIVALENT OF 70 POUNDS OF TABLE SUGAR (18
TEASPOONS OF SUCROSE A DAY) AND 50 POUNDS OF CORN
SYRUP.
• 100 YEARS AGO, THE YEARLY INTAKE OF SIMPLE SUGARS
AVERAGED ONLY 4 POUNDS PER PERSON!
SPORTS & EXERCISE NUTRITION, 2ND EDITION: MCARDLE, KATCH & KATCH
WHY MISSISSIPPIANS STRUGGLE WITH OBESITY
• SOUTHERN CULTURE
• LACK OF P.E. IN SCHOOLS (AND VENDING/LUNCH FOODS)
• LOW SOCIOECONOMIC STATUS (POOREST STATE IN THE NATION)
• LACK OF EDUCATION OF CITIZENS (%)
• WEATHER (HEAT, HUMIDITY, DIRECT SUN, COLD, RAIN)
• POOR CITY PLANNING (ROADS, PARKS, SIDEWALKS)
• MINDSET (THINK MIAMI OR SAN DIEGO)
• FAILURE TO FACE REALITY (ENERGY EQUATION)
BEING SEDENTARY IS AS DANGEROUS AS
SMOKING A PACK OF CIGARETTES EVERY DAY!
THE SURGEON GENERAL’S REPORT ON PHYSICAL ACTIVITY AND HEALTH
SITTING IS THE SMOKING OF OUR GENERATION
HARVARD BUSINESS REVIEW—NATALIE MERCHANT
• REGULAR EXERCISE AND BEING PHYSICALLY ACTIVE THROUGHOUT THE DAY
ARE NOT THE SAME THING…
ECONOMIC IMPACT
►U.S. ECONOMIC COMPETITIVENESS IS HURTING AS OUR WORKFORCE BECOMES LESS
HEALTHY AND PRODUCTIVE.
►OBESITY RELATED HEALTH CARE COSTS ARE DRAINING DOLLARS FROM THE BOTTOM
LINE OF BUSINESSES.
►MORE THAN A QUARTER OF U.S. HEALTHCARE COSTS ARE RELATED TO PHYSICAL
INACTIVITY, OVERWEIGHT AND OBESITY.
►IF ONE-TENTH OF AMERICANS BEGAN A REGULAR WALKING PROGRAM, $5.6 BILLION
IN HEART DISEASE COSTS COULD BE SAVED.
►THE ESTIMATED ANNUAL MEDICAL COST OF OBESITY IN THE U.S. WAS $147 BILLION
IN 2008 U.S. DOLLARS; THE MEDICAL COSTS FOR PEOPLE WHO ARE OBESE WERE
$1,429 HIGHER THAN THOSE OF NORMAL WEIGHT.
CALORIC EXPENDITURE
• EVEN A MARATHON ONLY BURNS 2,620-3,390 CALORIES: THE
EQUIVALENT OF MANY FAST FOOD MEALS THAT MAY ONLY TAKE
MINUTES TO CONSUME!
TIME
• YOU CAN NEVER FIND THE TIME TO EXERCISE. YOU MUST
MAKE THE TIME TO EXERCISE—MUCH LIKE BRUSHING YOUR
TEETH, BATHING AND DOING THE LAUNDRY.
• P.S. WE ALL ONLY HAVE 24 HOURS IN A DAY..
• “TIRED OF LYING IN THE SUNSHINE STAYING HOME TO WATCH THE
RAIN, YOU ARE YOUNG AND LIFE IS LONG AND THERE IS TIME TO
KILL TODAY; THEN ONE DAY YOU FIND, 10 YEARS HAVE GOT BEHIND
YOU, NO ONE TOLD YOU WHEN TO RUN, YOU MISSED THE
STARTING GUN.” –PINK FLOYD, TIME
FINALLY…
• WE DON’T JUST EAT TOO MUCH (THE ENERGY EQUATION) IN OUR
CONTEMPORARY SOCIETY: WE ALSO MOVE TOO LITTLE!
• HUMANS ARE SIMPLY MADE TO BE PHYSICALLY ACTIVE AND WHEN
WE AREN’T—HYPOKINETIC PROBLEMS OCCUR!
• I.E., CVD, HYPERTENSION (MS #1 @ 32.7%), NIDDM, CERTAIN CANCERS
(KIDNEY, COLORECTAL, GALL BLADDER, ESOPHAGEAL) STROKE, OBESITY &
OBESITY RELATED PROBLEMS (CVD, ORTHOPEDIC), PSYCHOLOGICAL
(STRESS, ANXIETY, DEPRESSION)