Obesity in the U.S. Prevalence and Trends

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Obesity in the U.S.Prevalence and Trends

• Pennington Biomedical Research Center
• Division of Education

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Obesity in the U.S.Current Trends

• Currently, about 66 of American adults are
  overweight and about 32 are obese.
• The obesity weight class has increased the most
  over the past few decades.
• 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.

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Overweight is Rising
This overweight classification combines those who
are classified as overweight (BMI 25-29.9) and
those who are obese (BMI 30).
66.3
65.7
64.5
56.0
Adapted from the Centers for Disease Control and
Prevention (CDC)
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Obesity Continues to Rise
Trends in the United States
Obesity is defined as having a BMI 30
1996
2004
Prevalence of obesity by state
No Data lt10 1014
1519 2024 25
Source Behavioral Risk Factor Surveillance
System, CDC
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Obesity

• An estimated 66 million adults in the United
  States are obese.
• Being either overweight or obese substantially
  raises ones risk of morbidity
  from
• Hypertension
• Dyslipidemia
• Type 2 diabetes
• Coronary heart disease
• Stroke
• Gallbladder disease
• Osteoarthritis
• Sleep apnea and respiratory problems
• Endometrial, breast, prostate, and colon cancers.
  

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ObesityIntroduction

• In addition to the increased risk for several
  diseases, higher body weights are also associated
  with increases in all-cause mortality.
• An estimated 300,000 deaths per year are
  attributable to obesity.
• As the second leading cause of preventable death
  in the United States today, overweight and
  obesity pose a major public health threat.

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Obesity in the U.S.Race/Ethnic

• The picture is even worse when rates are looked
  at by gender and ethnic backgrounds
• 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
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Obesity in the U.S.Socioeconomic Status

• 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.
• 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
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Obesity in the U.S.Socioeconomic Status

• Higher socioeconomic group women
• Diet more often
• Have greater access to resources
• Have better nutrition knowledge
• Are committed to slimness
• Avoid high fat foods
• Get more physical activity

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In Developing CountriesObesity SES

• Higher socioeconomic group women
• 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
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Obesity in the U.S.What is the Cost?

• 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.
• Medical expenses for overweight and obesity may
  have reached as high as 78.5 billion in 1998.
• In Louisiana alone, approximately 1.4 billion
  was spent on overweight and
  obesity-related medical expenses.

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ObesityWhat are the Causes?

• Overweight and obesity are the result of an
  energy imbalance over a long period of
  time.
• 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.
• Behavior and environment appear to play a large
  role the development of obesity, and are often
  the focus for prevention and treatment actions.

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Energy ImbalanceWhat is it?

• Energy balance is like a scale where both
  sides are of equal weight.
• An energy imbalance arises when the number of
  calories consumed is not equal to the number of
  calories used by the body.
• 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.

Weight Gain Calories Consumed gt Calories
Used Weight Loss Calories Consumed lt Calories
Used No Weight Change Calories Consumed
Calories Used
CDC
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ObesityDiet and Exercise

• Physical activity contributes to weight loss,
  especially when combined with a calorie
  reduction.
• Physical activity is important in preventing
  overweight and obesity and in maintaining weight
  that is lost.
• In addition to weight control, physical activity
  helps
• 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

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Body Mass IndexIndicator of Weight Status

• Body mass index (BMI) is a mathematical ratio
  taking into account an individuals weight, in
  kilograms, and height, in meters squared (kg/m2).
  This measure can be used for adults 20 years
  of age and older.
• BMI determines an individuals weight category.

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
You can find tables on the web that that are
ready-made for you. http//www.nhlbisupport.com/bm
i
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Obesity Classes

• Class 1
• BMI of 30-35
• Class 2
• BMI of 35-40
• Class 3, Extreme obesity
• BMI greater than 40

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Waist Circumference

• 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
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Waist Circumference BMIAnd Disease Risk
Disease Risk Relative to Normal Weight and
Waist Circumference
BMI (kg/m2) Obesity Class Men 102 cm ( 40 in) Women 88 cm ( 35 in) gt 102 cm (gt 40 in) gt 88 cm (gt35 in)
Underweight lt 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
Extreme Obesity 40 III Extremely High Extremely High
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
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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.

Increased risk
Body Mass Index
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Body Mass Index

• 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.
• However, with the exception of highly trained
  athletes, BMI is a good predictor of chronic
  disease and mortality in individuals.

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In Summary

• 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
  ones 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.

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Pennington Biomedical Research Center

• Division of Education
• Heli J. Roy, PhD, RD, Associate Professor
• Shanna Lundy, BS
• Beth Kalicki
• Division of EducationPhillip Brantley, PhD,
  DirectorPennington Biomedical Research
  CenterClaude Bouchard, PhD, Executive Director

Edited October 2009
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About Our Company

• The Pennington Biomedical Research Center is a
  world-renowned nutrition research center.
•  
• Mission
• To promote healthier lives through research and
  education in nutrition and preventive medicine.
•  
• The Pennington Center has several research areas,
  including
•  
• Clinical Obesity Research
• Experimental Obesity
• Functional Foods
• Health and Performance Enhancement
• Nutrition and Chronic Diseases
• Nutrition and the Brain
• Dementia, Alzheimers and healthy aging
• Diet, exercise, weight loss and weight loss
  maintenance
•  
• 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.
•  
• 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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Additional Resources

• MyPyramid Food Pyramid. Available at
  http//www.mypyramid.gov
• Overweight and Obesity Contributing Factors.
  Available at http//www.cdc.gov/nccdphp/dnpa/obes
  ity/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/co
  ntent/PED_6_1x_Exercise_Counts.asp?sitearealevel

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References

• 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_exs
  um.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.

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References

• Legal KM, Carroll MD, Ogden CL, Johnson CL.
  Prevalence and trends in obesity among US adults,
  1999-2000 JAMA. 20022881723-1727.
• Zhang, Q and Wang Y. Trends in the association
  between obesity and socioeconomic status in US
  Adults 1971-2000. Obesity Research 121622-1632,
  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
  Jan57(1)128-37.