Obesity in the United States
is common in the United States and is a major health issue associated with numerous diseases, specifically an increased risk of certain types of cancer, coronary artery disease, type 2 diabetes, stroke, and cardiovascular disease, as well as significant increases in early mortality and economic costs.
Definition of obesity
is defined as a person having excess body fat "Obesity can be measured in different ways, but most common is the Body Mass Index which is calculated based on a person's height and weight."Statistics
The CDC defines an adult with a body mass index of 30 or greater as obese and an adult with a BMI of 25.0 to 29.9 as overweight. Obesity in adults is divided into three categories. Adults with a BMI of 30 to 34.9 have class 1 obesity; adults with a BMI of 35 to 39.9 have class 2 obesity; adults with a BMI of 40 or greater have class 3 obesity, which is also known as extreme or severe obesity. Children with a BMI at or above the 95th percentile of children of the same age and sex are defined as obese, and children with a BMI at or above the 85th percentile but less than the 95th percentile are defined as overweight.Compared to non-obese Americans, between 2001 and 2016, obese Americans incurred an average of $2,505 more in medical expenses annually, and in 2016, the aggregate medical cost due to obesity in the United States of America was $260.6 billion. However, some evidence suggests the lifetime cost of medical treatment for obese individuals is lower than for healthy weight individuals. This is because healthy weight people live longer statistically and tend to develop chronic diseases that need to be continually treated into old age, whereas obese people tend to die from metabolic diseases at younger ages and avoid some of those protracted medical costs. While lifetime medical costs for obese individuals may be lower than for healthy weight individuals, obese individuals cause significant economic productivity loss.
The obesity rate has steadily increased since 1960–1962, where approximately 13% of American adults were obese. By 2014, figures from the CDC found that more than one-third of U.S. adults and 17% of children were obese. By 2014, figures from the National Institute of diabetes shows that 82% of Americans are overweight. National Center for Health Statistics at the CDC showed that 42.4% of U.S. adults were obese as of 2017–2018. The National institute of Diabetes states that 73.1% of Americans were obese or overweight as of 2017-2018.
For the following statistics, "adult" is defined as age 20 and over. The overweight + obese percentages for the overall US population are higher reaching 39.4% in 1997, 44.5% in 2004, 56.6% in 2007, 63.8% and 17% in 2008, in 2010 65.7% of American adults and 17% of American children are overweight or obese, and 63% of teenage girls become overweight by age 11. In 2013 the Organization for Economic Co-operation and Development found that 57.6% of all American citizens were overweight or obese. The organization estimated that 3/4 of the American population would likely be overweight or obese by 2020. According to research done by the Harvard T.H. Chan School of Public Health, it is estimated that around 40% of Americans are considered obese, and 18% are considered severely obese as of 2019. Severe obesity is defined as a BMI over 35 in the study. Their projections say that about half of the US population will be considered obese and nearly 1 in 4 will be considered severely obese by 2030.
New data in 2024, reveals the U.S. adult obesity rate decreased by about 2% from 2020 to 2023, according to data from the U.S. National Health and Nutrition Examination Survey. Researchers attribute this decline in part to the increasing use of weight loss drugs like Wegovy and Ozempic, now used by 6% of Americans. These medications may be helping to reverse the long-standing rise in obesity rates in the country.
Global obesity compared to the United States
A survey in 2007 showed 63% of Americans were overweight or obese, with 26% in the obese category. "By 2014, 37.7% of adults in the United States were obese, 35% of men and 40.4% of women values were 7.7% for men and 9.9% for women." However, according to world statistics, "American Samoans have the highest BMI While Egypt has 43% and Iraq has a BMI of 37.4%." According to the WHO, obesity has tripled since 1975 and research has shown that obesity is linked to health issues, and high cost of medical care. The Pacific Islands dominate the top obese countries and factors contributed to this problem include dietary change, fast foods, and possible genetic predispositions. The least obese countries include Madagascar, Ethiopia, and Japan. Factors involve a more healthy diet, famine and poverty. WHO and GOO research reports that obesity rates vary by country because of lifestyle, diet and also obesity rates depend on its economic status as well. However, the wealthier the country is, the more educated their citizens tend to be. Promoting a healthier lifestyle is encouraged. The United States being one of the wealthiest countries has the 18th highest obesity rate in the world at 42.7% and researchers attribute that to diet, environment and cultural factors.Epidemiology
Obesity is a chronic health problem. It is one of the biggest factors for type II diabetes and cardiovascular disease. It is also associated with cancer, osteoarthritis, liver disease, sleep apnea, depression, and other medical conditions that affect mortality and morbidity.According to NHANES data, African American and Mexican American adolescents between 12 and 19 years old are more likely to be overweight than non-Hispanic White adolescents. The prevalence is 21%, 23% and 14% respectively. Also, in a national survey of American Indian children 5–18 years old, 39 percent were found to be overweight or at risk for being overweight. As per national survey data, these trends indicate that by 2030, 86.3% of adults will be overweight or obese and 51.1% obese.
A 2007 study found that long-term participation in the Supplemental Nutrition Assistance Program was associated with a 50% increased obesity rate among female adults.
Looking at the long-term consequences, overweight adolescents have a 70 percent chance of becoming overweight or obese adults, which increases to 80 percent if one or both parents are overweight or obese. In 2000, the total cost of obesity for children and adults in the United States was estimated to be US$117 billion. Given existing trends, this amount is projected to range from US$860.7–956.9 billion in healthcare costs by 2030.
Food consumption has increased over time. Annual per capita consumption of cheese was in 1909; in 2000; the average person consumed of carbohydrates daily in 1970; in 2000; of fats and oils in 1909; in 2000. In 1977, 18% of an average person's food was consumed outside the home; in 1996, this had risen to 32%.
Obesity is a major public health problem in the United States owing to its rapidly increasing prevalence, substantial mortality and morbidity, and growing healthcare costs. Several studies have inquired about the relationship between community food environment and obesity, which are often inversely related. The large-scale study demonstrated a substantial and inverse relationship between the local food environment and adult obesity in the US using local spatially weighted regression. Approximately 23.5 million American live in food deserts, areas in geolocations with minimal healthy food retailers. More importantly, there were considerable regional differences in the strength and direction of this connection. The findings of the study also show the need for geographically specific public health policies and interventions to address issues with food environments that are specific to particular regions.
Contributing factors
Numerous studies have attempted to identify contributing factors for obesity in the United States. Common factors include an overconsumption of food and an insufficient amount of physical exercise. Only 20% of jobs require physical activity.Related factors that have been attributed to an increase in childhood obesity includes "food deserts." Food deserts are considered urban areas that do not have the stores or access to proper nutritional food required for a sustainably healthy diet. Certain examples of this would include cities, where transportation may be limited, and the only surrounding food available at an affordable price is limited to fast food. Food insecure individuals have turned to food banks, which in turn has led to a rise in obesity and diabetes within the food insecure community. Individuals in lower income areas are dependent on food banks and because of that are not getting foods that are high in nutrients. Food insecure individuals, who live in low-income communities experience higher rates of chronic disease, leading to healthcare costs which create more financial hardships.
Other factors not directly related to caloric intake and activity levels that are believed to contribute to obesity include air conditioning, the ability to delay gratification, and the thickness of the prefrontal cortex of the brain. Genetics are also believed to be a factor, with a 2018 study stating that the presence of the human gene APOA2 could result in a higher BMI in individuals. Additionally, factors contributing to the probability of obesity can occur even before birth, including maternal behaviors during gestation such as smoking or significant weight gain.
The microbiome of a person's gastrointestinal tract can additionally contribute to obesity, and is also modified by it. Lean people and obese people have been shown to have differences in their gut bacteria which affect their metabolism.
Causes of obesity
Dietary
In the United States, many people's diets are excessively high in calories, often due to fast food and sugary beverages. Individuals with obesity may consume more calories before feeling full, experience hunger more quickly, or eat in response to stress or anxiety. Per the USDA's Dietary Guidelines for Americans, 2020-2025, most Americans do not follow a healthy dietary pattern. Few individuals being tested for nutrient levels would be able to meet them without the use of fortification or enrichment. Americans eat an abundance of fast food. 36.6% of adults consume fast food on a given day, which is slightly more than 1 out of every 3 people, and 2 out of 3 people consume fast food at least once a week. While the negative effects of fast food, such as lack of nutritional value and high amounts of calories, are widely known, fast food remains popular for its convenience, specifically because it is time-efficient and cheap.Quantity of food consumption plays an important role as well. A study shows a significant increase in food portion sizes of marketplace products since the 1970s that exceed the federal standards for dietary guidance. Reasons for this increase include the expansion of the food industry since the seventies, marketing strategies, and customer demand. Extreme differences in portion sizes between the same menu items of the same franchises have also been observed. In some instances, American food portion sizes are as much as double the size of their British counterparts.