U.S. Obesity Rates Down, But More Deadly Than Thought

INCREASE OF OBESITY RELATED DEATHS WITH EACH GENERATION

There is some good news as well as some bad news in two recent reports related to obesity in America.

OBESITY RATES STABLE OR DOWN IN MOST STATES

According to a report from the Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation (RWJF), obesity rates remained steady in every state except one (Arkansas) in the last year, halting a thirty-year trend of near universal increases.

Data from the report came from the Behavioral Risk Factor Surveillance System, an annual telephone survey of more than 400,000 adults.

Risa Lavizzo-Mourey, MD, president of the RWJF, and Jeffrey Levi, PhD, executive director of the TFAH, authors of the report, F as in Fat: How Obesity Threatens America’s Future 2013, said that slowing the long-standing trend of increases is evidence efforts to reduce obesity rates are working.

However, despite that good news, rates remain very high. Thirteen states still have adult obesity rates above 30%, 41 states top 25%, and every state has a rate above 20 percent.

Obesity is defined as an excessively high amount of body fat or adipose tissue in relation to lean body mass. Overweight refers to increased body weight in relation to height, which is then compared to a standard of acceptable weight. Body mass index, or BMI, is a common measure expressing the relationship (or ratio) of weight to height with a BMI of 25 to 29.9 considered overweight, while individuals with a BMI of 30 or more are considered obese.

Florida’s obesity rate of 25.2 percent, down from 26.6 in 2010, ranked 40th (39 states had higher obesity rates), with Louisiana’s rate of 34.7 percent the highest in the nation. According to County Health Rankings & Roadmaps, the 2013 adult obesity rate in Brevard County is 28 percent.

OVER TWO THIRDS OF AMERICANS ARE OVERWEIGHT OR OBESE

According to the report, in 1980, no state had an obesity rate above 15 perfect, and in 1991, no state was above 20 percent. Today more than two-thirds (68.7 percent) of American adults are either obese or overweight.

Other notable findings from the report include:

• Rates vary by region, with the 20 states having the highest percentages of obesity and overweight all located in the South or Midwest
• Rates vary by age, with obesity rates for Baby Boomers (45-to 64-year olds), having reached 30% in 41 states, but exceeding 30% in one state — Louisiana — for seniors (65 years old or older)
• Obesity rates are now nearly the same for men (35.8 percent) and women (35.5 percent) despite a nearly 6-percentage-point difference a decade ago (men: 27.5percent, women: 33.4 percent)
• Almost a third of adults with incomes less than $25,000 a year were obese compared with a quarter of those who earn less than $50,000 a year
• More than 35 percent of those ages 26 and older who didn’t graduate from high school were obese, compared with 21.3 percent of those who graduated from college or technical school

YOUNGER GENERATIONS AT GREATEST RISK

Drs. Lavisso-Mourey and Levi wrote in a letter to open the report, “If we fail to reverse our nation’s obesity epidemic, the current generation of young people may be the first in American history to live sicker and die younger than their parents’ generation.”

Their sage observation is strongly supported by the second recent research study that reports obesity’s effect on public health has been drastically underestimated.

NEARLY 20 PERCENT OF DEATHS ASSOCIATED WITH OBESITY

In a study recently published in the American Journal of Public Health, researchers warn that nearly 20 percent of premature adult deaths in the United States are associated with being overweight or obese, a percentage that is almost four times higher than current estimates.

Researchers from Columbia University’s Mailman School of Public Health analyzed 19 years of annual U.S. National Health Interview Surveys, which included almost 700,000 Americans ages 40 to 85, and linked the data with mortality records from the National Death Index.

Overall, the study found that being overweight or obese was associated with 18.2 percent of deaths among U.S. adults between 1986 and 2006, obesity-related premature mortality affected more women than men, and that black women were particularly vulnerable.

The study showed that obesity accounted for:

• 27 percent of deaths among black women
• 22 percent of deaths among white women
• 5 percent of deaths among black men
• 16 percent of deaths among white men.

OBESITY RELATED DEATHS GREATER WITH EACH GENERATION

Lead author Ryan Masters said the new data suggest that obesity’s death toll is more than three times higher than previously believed, and he told HealthDay, “Obesity has dramatically worse health consequences than some recent reports have led us to believe.”

According to Masters, earlier estimates erred by overlooking generational differences. So, to better gauge the effect of obesity on deaths for specific age groups, he and his research team broke the population down into “cohorts,” or generations, and observed an increase in obesity-related deaths with each generation.

Like the RWJF/TFAH study, the Columbia University report shows that younger generations have been more exposed to risk factors for obesity, resulting in an even greater risk of becoming overweight or obese and suffering the health problems that accompany excess weight.

“A five-year-old growing up today is living in an environment where obesity is much more the norm than was the case for a five-year-old a generation or two ago. Drink sizes are bigger, clothes are bigger and greater numbers of a child’s peers are obese,” study co-author Bruce Link explained in the HealthDay article, adding that “once someone is obese, it is very difficult to undo. So, it stands to reason that we won’t see the worst of the epidemic until the current generation of children grows old.”

MUST ADDRESS CULTURE AND ENVIRONMENT

Dr. Georges Benjamin, executive director of the American Public Health Association says the study provides new insight on how to tackle the obesity epidemic. “The solutions are not only more exercise and eating better, but a whole range of environmental factors we’re going to have to address,” he told HealthDay, adding that because the current generation is expected to be obese longer, it is imperative that we “change things now if we’re going to make this a healthier generation.”

“Up to now, it’s been a unilateral discussion about how obese you were or how much body fat you had,” Benjamin said. “The solutions are not only more exercise and eating better, but a whole range of environmental factors we’re going to have to address. The generation we have now is expected to be obese longer. That’s a core reason we need to change things now if we’re going to make this a healthier generation.”

The conclusions and recommendations of these two studies are very consistent. The RWJF/TSAH study authors agree, and wrote, “We honestly believe real and lasting progress is being made in the nation’s effort to turn back the obesity epidemic. We know what is working to make that progress. Our success among children has taught our nation how to prevent obesity: changing public policies, community environments, and industry practices in ways that support and promote healthy eating and physical activity. When schools, parents, policymakers and industry leaders get together, they can create a culture of health that improves children’s lives.”

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