American Obesity Rates
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Obesity Rates Continue to
Climb in the United States

American Obesity Rates


By 2015, 75% of American Adults Will Be Overweight; 41% Will Be Obese

The U.S. obesity prevalence increased from 13 percent to 32 percent between the 1960s and 2004, according to researchers at the Johns Hopkins Bloomberg School of Public Health Center for Human Nutrition. The prevalence of obesity and overweight has increased at an average rate of 0.3–0.8 percentage points across different sociodemographic groups over the past three decades. Some minority and low socioeconomic status groups—such as non-Hispanic black women and children, Mexican-American women and children, low socioeconomic status black men and white women and children, Native Americans and Pacific Islanders—are disproportionately affected. The meta-analysis was published online on May 17, 2007, in advance of the 2007 issue of the journal Epidemiologic Reviews.

“The obesity rate in the United States has increased at an alarming rate over the past three decades. We set out to estimate the average annual increase in prevalence as well as the variation between population groups to predict the future situation regarding obesity and overweight among U.S. adults and children,” said Youfa Wang, MD, PhD, lead author of the study and an assistant professor in the Bloomberg School of Public Health’s Department of International Health. “Obesity is a public health crisis. If the rate of obesity and overweight continues at this pace, by 2015, 75 percent of adults and nearly 24 percent of U.S. children and adolescents will be overweight or obese.”

The study authors included 20 journal papers, reports and online data sets in their meta-analysis. In addition, data from four national surveys—NHANES, BRFSS, Youth Risk Behavior Surveillance System and National Longitudinal Survey of Adolescent Health—were included in order to examine the disparities in obesity. They defined adult overweight and obesity using body mass index cutoffs of 25 and 30, respectively. Children at risk for overweight and overweight were classified as being in the 85th and 95th percentiles of body mass index, respectively.

The key findings include:

  • 66% of U.S. adults were overweight or obese in 2003-2004. By 2008 that number has gone up to 71%.
  • Women 20–34 years old had the fastest increase rate of obesity and overweight.
  • 80% of black women aged 40 years or over are overweight; 50% are obese.
  • Asians have a lower obesity prevalence when compared to other ethnic groups. However, Asians born in the United States are four times more likely to be obese than their foreign-born counterparts.
  • Less educated people have a higher prevalence of obesity than their counterparts.
  • States in the southeast have higher prevalence than states on the West Coast, the Midwest and the Northeast.
  • 16% of children and adolescents are overweight and 34% are at risk of becoming overweight in 2003-2004.
  • White children and adolescents had the lowest prevalence of overweight and being at risk of overweight compared with their black and Mexican counterparts.

    American Obesity Rates

    “Our analysis showed patterns of obesity or overweight for various groups of Americans. All groups consistently increased in obesity or overweight prevalence, but the increase varied by group, making this public health issue complex. More research needs to be completed to look into the underlying causes,” says May A. Beydoun, coauthor of the study and a postdoctoral fellow in the Bloomberg School of Public Health’s Department of International Health. “Obesity is likely to continue to increase, and if nothing is done, it will soon become the leading preventable cause of death in the United States.”

    In a related study, the Johns Hopkins co-authors published a research article in the May 7, 2007, issue of the European Journal of Clinical Nutrition that found people purchase foods based on their income level and perception of a food’s health benefit and cost. Ethnicity, gender and environmental factors also impact people’s food choices.

    NOTE: Unlike definitions for adults, the Centers for Disease Control and Prevention uses “overweight” to refer to the highest body mass index for children and adolescents. Therefore, it is inaccurate to use the term “obese” when referring to elevated body mass index in this age group.

    American Obesity Rates

    Most Obese States

    West Virginia and Alabama remained as the second and third fattest states this year. The four states of Mississippi, West Virginia, Alabama, and Louisiana have obese populations that exceed 30 percent over a three-year average and two-thirds of the citizens of Mississippi and West Virginia were either overweight or obese by CDC standards in 2007.

    Also not faring well this year was Delaware, which rose eight places to tie with North Dakota as the 21st fattest state, from last year’s 29th placing. Delaware’s 3-year obesity rate rose 2.4 percent.

    Leanest States

    Colorado repeats as the slimmest state, despite a slight increase in obesity of 0.8 percent over three years. Last year Governor Bill Ritter of Colorado said “[W]e’re not spared from the national obesity epidemic, and we must remain vigilant in order to guard against it. We’re doing all we can to encourage Coloradans — especially our kids — to take advantage of the natural resources our state offers in order to stay fit, healthy and happy.”

    American Obesity Rates

    Hawaii enters the rankings for the first time in 2008 at number 50, the second slimmest state after Colorado. Hawaii had not conducted annual BMI surveys until 2005, so the required three years of data was not available until this year.

    Last year California was the only state whose obesity rate held steady. This year it eaked up by 0.4 percent, but because of the overall increase in obesity nationwide California’s ranking dropped five places, from 36th fattest state to 41st fattest state.

    The only state to get slimmer this year is not actually a state: the District of Columbia’s three-year obesity rate dropped by 0.1 percent.

    Regional Obesity by State Trends

    In general, states in the West and New England rank lowest in the fattest states rankings, while states in the South and the Rust Belt tend to rank highest.

    The fattest state rankings for this year based on the Behavioral Risk Factor Surveillance System database maintained by the Centers for Disease Control and Prevention. The rankings use a three-year average in order to smooth out statistical fluctuations.

    Because of the overall increase in obesity, this year's color coding shifted one percentage point higher to maintain an approximately equal number of states per color. This means that this year’s map cannot be directly compared to last year’s and or any year prior to that.

    United States of Obesity: Fattest States 2008

    State % Obese
    % Obese or
    % Obesity
    1 1 Mississippi 32.6 68.1 31.6 1.0 0
    2 2 West Virginia 30.3 68.0 30.6 0.9 0
    3 3 Alabama 30.9 66.6 30.1 0.7 0
    4 4 Louisiana 30.7 65.2 29.5 1.3 0
    5 5 South Carolina 29.0 65.3 29.2 1.3 0
    6 6 Tennessee 30.7 67.4 29.0 1.2 0
    7 7 Kentucky 28.7 69.1 28.4 1.0 0
    9 8 Oklahoma 28.8 65.1 28.1 1.3 1
    8 Arkansas 29.3 65.6 28.1 1.1 0
    9 10 Michigan 28.2 64.3 27.7 0.9 -1
    9 11 Indiana 27.4 63.2 27.5 0.6 -2
    14 12 Georgia 28.7 65.0 27.4 1.3 2
    12 Missouri 28.2 63.3 27.4 1.1 0
    16 14 Alaska 28.2 65.1 27.3 1.5 2
    12 15 Texas 28.6 65.8 27.2 0.9 -3
    17 16 North Carolina 28.7 64.6 27.1 1.5 1
    15 17 Ohio 28.1 63.5 26.9 0.9 -2
    18 18 Nebraska 26.5 64.7 26.5 1.1 0
    20 19 Iowa 27.7 64.7 26.3 1.4 1
    20 20 South Dakota 27.2 65.5 26.0 1.1 0
    19 21 North Dakota 27.0 64.9 25.9 0.8 -2
    29 Delaware 28.2 65.0 25.9 2.4 8
    27 23 Kansas 27.7 63.8 25.8 1.5 4
    23 24 Pennsylvania 27.8 62.7 25.7 1.2 -1
    24 25 Virginia 26.3 62.9 25.5 1.1 -1
    22 26 Wisconsin 25.3 62.3 25.4 0.7 -4
    24 27 Illinois 25.6 63.0 25.3 0.9 -3
    24 28 Maryland 26.3 62.7 25.2 0.8 -4
    30 29 Oregon 26.3 62.0 25.0 1.7 1
    28 30 Minnesota 26.0 62.0 24.8 1.1 -2
    32 31 Idaho 25.1 63.1 24.6 1.4 1
    31 32 Washington 25.9 62.1 24.5 1.2 -1
    35 33 Wyoming 24.5 62.2 24.0 1.2 2
    32 34 Maine 25.2 62.9 23.7 0.6 -2
    37 35 Nevada 24.6 63.0 23.6 1.2 2
    37 36 New York 25.5 61.9 23.5 1.1 1
    37 New Hampshire 25.1 61.8 23.5 1.2 1
    34 38 Florida 24.1 62.1 23.3 0.4 -4
    43 Arizona 25.8 62.6 23.3 1.5 5
    42 40 New Mexico 25.1 60.8 23.2 1.2 2
    36 41 California 23.3 59.0 23.1 0.4 -5
    40 42 New Jersey 24.1 62.3 22.9 0.7 -2
    40 43 District of Columbia 22.2 55.3 22.1 -0.1 -3
    44 44 Utah 22.4 58.0 21.8 0.7 0
    45 45 Montana 22.6 61.8 21.7 1.0 0
    46 46 Rhode Island 21.7 60.8 21.4 0.9 0
    48 47 Vermont 21.9 58.8 21.1 1.1 1
    49 48 Massachusetts 21.7 58.9 20.9 1.1 1
    47 49 Connecticut 21.7 59.2 20.8 0.7 -2
    N.A. 50 Hawaii 21.7 56.8 20.7 N.A. N.A.
    50 51 Colorado 19.3 55.7 18.4 0.8 -1
    Obesity is defined as a BMI of 30.0 or over, overweight as a BMI of 25.0 to 29.9.

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    Obesity blamed for doubling rate of diabetes cases

    The nation's obesity epidemic is exacting a heavy toll: The rate of new diabetes cases nearly doubled in the United States in the past 10 years, the government said Thursday. The highest rates were in the South, according to the first state-by-state review of new diagnoses. The worst was in West Virginia, where about 13 in 1,000 adults were diagnosed with the disease in 2005-07. The lowest was in Minnesota, where the rate was 5 in 1,000.

    Nationally, the rate of new cases climbed from about 5 per 1,000 in the mid-1990s to 9 per 1,000 in the middle of this decade.

    Roughly 90 percent of cases are Type 2 diabetes, the form linked to obesity.

    The findings dovetail with trends seen in obesity and lack of exercise — two health measures where Southern states also rank at the bottom.

    "It isn't surprising the problem is heaviest in the South — no pun intended," agreed Matt Petersen, who oversees data and statistics for the American Diabetes Association.

    The study, led by Karen Kirtland of the Centers for Disease Control and Prevention, provides an up-to-date picture of where the disease is exploding. The information should be a big help as the government and health insurance companies decide where to focus prevention campaigns, Petersen said.

    Diabetes was the nation's seventh-leading cause of death in 2006, according to the CDC. More than 23 million Americans have diabetes, and the number is rapidly growing. About 1.6 million new cases were diagnosed among adults last year.

    In Type 2 diabetes, cells do not properly use insulin, a hormone needed to convert sugar into energy, and the pancreas gradually loses its ability to produce it. The illness can cause sugar to build up in the body, leading to complications such as heart disease, blindness, kidney failure and poor circulation that leads to foot amputations.

    The study involved a random-digit-dialed survey of more than 260,000 adults. Participants were asked if they had ever been told by a doctor that they have diabetes, and when the diagnosis was made. The comparisons between 1995-97 and 2005-07 covered only the 33 states for which the CDC had complete data for both time periods.

    The researchers had data for 40 states for the years 2005-07.

    West Virginia, South Carolina, Alabama, Georgia, Texas and Tennessee had the highest rates, all at 11 cases per 1,000 or higher. Puerto Rico was about as high as West Virginia. Minnesota, Hawaii and Wyoming had the lowest rates.

    It is not entirely clear why some states were worse than others. Older people, blacks and Hispanics tend to have higher rates of Type 2 diabetes, and the South has large concentrations of all three groups. However, West Virginia is overwhelmingly white.

    The report asked about diagnosed diabetes only. Because an estimated one in four diabetics have not been diagnosed, the findings probably underestimate the problem, said Angela Liese, a diabetes researcher at the University of South Carolina.

    The underestimates may be particularly bad in the rural South and other areas where patients have trouble getting health care, she noted.


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