In the Journals PlusPerspective

CDC: Nearly 40% of American adults have obesity

Craig Hales
Craig M. Hales

Nearly 40% of adults and 20% of children have obesity in the United States, according to a new report released by the CDC’s National Center for Health Statistics.

The crude prevalence of obesity among U.S. adults and children in 2015-2016 was 39.8% and 18.5%, respectively, and the rate has grown steadily since 1999-2000, according to an analysis of nine 2-year cycles of NHANES data. Researchers found overall obesity prevalence to be higher among adults aged 40 to 59 years (42.8%) vs. those aged 20 to 39 years (35.7%), whereas the prevalence of obesity was higher among children and adolescents aged 12 to 19 years (20.6%) vs. those aged 6 to 11 years (18.4%) or 2 to 5 years (13.9%).

“The prevalence of obesity in the United States remains higher than the Healthy People 2020 goals of 14.5% among youth and 30.5% among adults,” Craig M. Hales, MD, MPH, a medical epidemiologist at the CDC, and colleagues wrote in the NCHS Data Brief.

Hales and colleagues used data from cross-sectional NHANES survey cycles between 1999-2000 and 2015-2016 to estimate obesity trends, defining obesity in adults as a BMI of at least 30 kg/m² and childhood obesity as a BMI greater than or equal to the age- and sex-specific 95th percentile of the 2000 CDC growth charts. Researchers adjusted prevalence estimates for the adult population using the direct method to the 2000 projected U.S. Census population using the age groups of 20 to 39 years, 40 to 59 years and aged at least 60 years. Examination samples weights were incorporated into the estimation process and pregnant women were excluded.

Researchers also observed race and sex differences in obesity trends. Among black, Asian and Hispanic adults, women had a higher prevalence of obesity vs. men, the researchers wrote; however, this trend did not persist among white adults. Obesity prevalence in 2015-2016 was 54.8%, 50.6%, 38% and 14.8% for black, Hispanic, white and Asian women, respectively. For men, obesity prevalence rates were 43.1%, 37.9%, 36.9% and 10.1% for Hispanic, white, black and Asian men, respectively.

Scott Isaacs
Scott Isaacs

There were no between-sex differences in obesity prevalence observed among young, according to the researchers. Overall, black and Hispanic adults and youth had a higher prevalence of obesity (22% and 25.8%, respectively) vs. white and Asian youth (14.1% and 11%, respectively).

“Among youths, the prevalence of obesity hovered around 17% from 2003-2004 to 2013-2014,” Hales told Endocrine Today. “The prevalence in 2015-2016 was 18.5%, but was not statistically significantly different from 2013-2014, so we need to see another 2 to 4 years of data to determine if any new trend emerges among youth.”

‘Discouraging’ numbers

“We’ve been seeing increasing obesity prevalence since the 1970s, but these are the highest numbers I think I’ve ever seen,” Scott Isaacs, MD, FACP, FACE, clinical instructor of medicine at Emory University School of Medicine and a spokesperson for The Obesity Society, told Endocrine Today. “As far as I know, this is the first time we are seeing numbers above that 40% mark, especially in adults over the age of 40 years. That would translate to millions more people who have obesity.”

The steady increase in obesity prevalence is likely due to several factors, Isaacs said, including an increase in highly-palatable unhealthy foods, an increasingly sedentary lifestyle, disrupted sleep patterns and environmental endocrine disrupters, such as BPA.

“As an obesity specialist, it’s a little discouraging to see that we’re working so hard to make a change, only to see that the numbers are still going in the wrong direction,” Isaacs said. “Most people who have obesity don’t see an obesity specialist, and the available treatments are underutilized. Most people who would qualify for anti-obesity medications are not taking the medications and an even smaller number of people eligible for obesity surgery get the surgery, about 1%. A lot of that is still a perception that obesity is a lifestyle choice and not a disease, but also a lack of belief among the public that obesity treatments are safe and effective.”

In a statement addressing the CDC data, Nancy Brown, CEO of the American Heart Association, called the disparities in obesity rates among blacks and Hispanics “shocking.”

“We can and must do better,” Brown said in a press release. “Our nation will continue to be in the midst of this public health crisis until we drive transformative change in every community. We have the tools. We just need to employ them.”

Eduardo Sanchez, MD, MPH, chief medical officer for prevention at the AHA, called for a greater, community-wide effort to combat the obesity epidemic.

“It will take a massive push from the food and beverage industry to increase the supply of affordable, healthy, nutritious food and fewer sugary drinks,” Sanchez said in a statement. “And it takes tremendous effort on the part of consumers to demand healthier products and policies in their communities. We all have to do our part.” – by Regina Schaffer

For more information:

Craig M. Hales, MD, MPH, can be reached at the Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, Centers for Disease Control and Prevention, 3311 Toledo Rd., MS P 08, Hyattsville, MD 20782; email: ewx2@cdc.gov.

Scott Isaacs, MD, FACP, FACE, can be reached at Atlanta Endocrine Associates, 775 Johnson Ferry Rd NE, Atlanta, GA 30342; email: scottisaacs@me.com.

Disclosure: Isaacs reports that he serves on the speaker’s bureau for Novo Nordisk and Orexigen.

Craig Hales
Craig M. Hales

Nearly 40% of adults and 20% of children have obesity in the United States, according to a new report released by the CDC’s National Center for Health Statistics.

The crude prevalence of obesity among U.S. adults and children in 2015-2016 was 39.8% and 18.5%, respectively, and the rate has grown steadily since 1999-2000, according to an analysis of nine 2-year cycles of NHANES data. Researchers found overall obesity prevalence to be higher among adults aged 40 to 59 years (42.8%) vs. those aged 20 to 39 years (35.7%), whereas the prevalence of obesity was higher among children and adolescents aged 12 to 19 years (20.6%) vs. those aged 6 to 11 years (18.4%) or 2 to 5 years (13.9%).

“The prevalence of obesity in the United States remains higher than the Healthy People 2020 goals of 14.5% among youth and 30.5% among adults,” Craig M. Hales, MD, MPH, a medical epidemiologist at the CDC, and colleagues wrote in the NCHS Data Brief.

Hales and colleagues used data from cross-sectional NHANES survey cycles between 1999-2000 and 2015-2016 to estimate obesity trends, defining obesity in adults as a BMI of at least 30 kg/m² and childhood obesity as a BMI greater than or equal to the age- and sex-specific 95th percentile of the 2000 CDC growth charts. Researchers adjusted prevalence estimates for the adult population using the direct method to the 2000 projected U.S. Census population using the age groups of 20 to 39 years, 40 to 59 years and aged at least 60 years. Examination samples weights were incorporated into the estimation process and pregnant women were excluded.

Researchers also observed race and sex differences in obesity trends. Among black, Asian and Hispanic adults, women had a higher prevalence of obesity vs. men, the researchers wrote; however, this trend did not persist among white adults. Obesity prevalence in 2015-2016 was 54.8%, 50.6%, 38% and 14.8% for black, Hispanic, white and Asian women, respectively. For men, obesity prevalence rates were 43.1%, 37.9%, 36.9% and 10.1% for Hispanic, white, black and Asian men, respectively.

Scott Isaacs
Scott Isaacs

There were no between-sex differences in obesity prevalence observed among young, according to the researchers. Overall, black and Hispanic adults and youth had a higher prevalence of obesity (22% and 25.8%, respectively) vs. white and Asian youth (14.1% and 11%, respectively).

“Among youths, the prevalence of obesity hovered around 17% from 2003-2004 to 2013-2014,” Hales told Endocrine Today. “The prevalence in 2015-2016 was 18.5%, but was not statistically significantly different from 2013-2014, so we need to see another 2 to 4 years of data to determine if any new trend emerges among youth.”

‘Discouraging’ numbers

“We’ve been seeing increasing obesity prevalence since the 1970s, but these are the highest numbers I think I’ve ever seen,” Scott Isaacs, MD, FACP, FACE, clinical instructor of medicine at Emory University School of Medicine and a spokesperson for The Obesity Society, told Endocrine Today. “As far as I know, this is the first time we are seeing numbers above that 40% mark, especially in adults over the age of 40 years. That would translate to millions more people who have obesity.”

The steady increase in obesity prevalence is likely due to several factors, Isaacs said, including an increase in highly-palatable unhealthy foods, an increasingly sedentary lifestyle, disrupted sleep patterns and environmental endocrine disrupters, such as BPA.

“As an obesity specialist, it’s a little discouraging to see that we’re working so hard to make a change, only to see that the numbers are still going in the wrong direction,” Isaacs said. “Most people who have obesity don’t see an obesity specialist, and the available treatments are underutilized. Most people who would qualify for anti-obesity medications are not taking the medications and an even smaller number of people eligible for obesity surgery get the surgery, about 1%. A lot of that is still a perception that obesity is a lifestyle choice and not a disease, but also a lack of belief among the public that obesity treatments are safe and effective.”

In a statement addressing the CDC data, Nancy Brown, CEO of the American Heart Association, called the disparities in obesity rates among blacks and Hispanics “shocking.”

“We can and must do better,” Brown said in a press release. “Our nation will continue to be in the midst of this public health crisis until we drive transformative change in every community. We have the tools. We just need to employ them.”

Eduardo Sanchez, MD, MPH, chief medical officer for prevention at the AHA, called for a greater, community-wide effort to combat the obesity epidemic.

“It will take a massive push from the food and beverage industry to increase the supply of affordable, healthy, nutritious food and fewer sugary drinks,” Sanchez said in a statement. “And it takes tremendous effort on the part of consumers to demand healthier products and policies in their communities. We all have to do our part.” – by Regina Schaffer

For more information:

Craig M. Hales, MD, MPH, can be reached at the Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, Centers for Disease Control and Prevention, 3311 Toledo Rd., MS P 08, Hyattsville, MD 20782; email: ewx2@cdc.gov.

Scott Isaacs, MD, FACP, FACE, can be reached at Atlanta Endocrine Associates, 775 Johnson Ferry Rd NE, Atlanta, GA 30342; email: scottisaacs@me.com.

Disclosure: Isaacs reports that he serves on the speaker’s bureau for Novo Nordisk and Orexigen.

    Perspective
    Rocio Salas-Whalen

    Rocío Salas-Whalen

    The CDC recently published a data report regarding increasing obesity rates in our country. The report notes different levels of prevalence correlating to age, sex, race and ethnicity. As health care professionals, this data does not come as a surprise. All of us in the medical field see this on a daily basis. The report tells us that obesity rates are higher among non-Hispanic blacks and the Hispanic population and lower among the non-Hispanic white population. The report also indicates that women have higher rates of obesity than men with no statistical variance based on race. One of the most important — and one can say terrifying — findings relates to the increasing prevalence of obesity in the youth. The prevalence of obesity in children between the ages of 2 and 19 years is 18.9%, a material increase from the 15% rate of 10 years ago. Again, to medical personnel working with adults or children, these statistics only corroborate what we see in our daily practice. One might even consider the report to understate the true prevalence of obesity, as it does not fully take the uninsured and undocumented populations into account. Unfortunately, the obese patient often needs to overcome several obstacles before getting the treatment or attention he or she needs, ranging from personal insecurities to the perceived taboo of getting treatment for the condition. One great development that has occurred in recent years is the availability of weight loss pharmacotherapy. Currently, there are four different medications that are FDA approved for chronic treatment of obesity; however, these are generally underutilized due to many physicians' lack of comfort with prescribing them. Past medications for weight loss were found to produce more harm than benefit. This has changed. We need to be more informed about these drugs and their ability to help the patient achieve a greater weight loss in conjunction with a treatment plan that includes a healthy diet and exercise. The alarming results the CDC study and many others indicate that we need to offer more help to the patient other than recommending a healthy diet and exercise.

    • Rocío Salas-Whalen, MD
    • Medical Offices of Manhattan
      New York

    Disclosures: Salas-Whalen reports no relevant financial disclosures.