Overweight and Obesity Epidemic in America – Part X: The Fat Future of America

Suggested Citation: Garko, M.G. (2011, July). Overweight and obesity epidemic in America – Part X:  The fat future of America. Health and Wellbeing Monthly. Retrieved (insert month, day, year), from www.letstalknutrition.com.

 

Overweight and Obesity Epidemic in America – Part X: The Fat Future of America

 

Michael G. Garko, Ph.D.
Host – Let’s Talk Nutrition

 Introduction

There is a strong possibility that in the not too far distance future nearly all Americans will eventually become either overweight or obese. Admittedly, this sounds a bit hyperbolic. Yet, nevertheless, there is credible evidence to suggest that the United States is on a linear path to becoming a nearly all-inclusive obesegenic society.  

Based on their projection analyses of prevalence data on overweight and obesity, Wang et al. (2008), researchers from the Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, reported recently that “the potential for all adults to become overweight or obese is a reality” (p. 2323) and that, consequently, their “analyses, based on nationally representative data collected over the past three decades and the assumptions of similar future increase rate and health costs as observed in the past, clearly show an alarming picture of the future obesity epidemic and related challenges” (p. 2329).

The July, 2011, issue of Health and Wellbeing Monthly presents some of the important findings stemming from Wang et al.’s (2008) projection analyses of overweight and obesity and future health-care costs attributable to the ever growing overweight and obesity epidemic. Since Wang et al. (2008) used data based on measurements of body mass index (BMI) derived from the National Health and Nutrition Examination Survey (NHANES) collected between the 1970s and 2004, BMI will be defined relative to adults and children. Current prevalence findings on overweight and obesity in the United States for adults and children will also be presented.

Body Mass Index

Body Mass Index (BMI) is used to measure the amount of body fat/adipose tissue based on a person’s (either adult or child) height and weight to determine if that person is overweight or obese. Specifically, BMI is expressed as a person’s weight in kilograms divided by height in meters squared (kg/m2). Individuals with a BMI of 25.0-29.9 are classified as being overweight, while those with a BMI of 30 or more are classified as obese and those with a BMI more than or equal to 40.0 are classified as extremely obese).[1]

Future Projections of Overweight and Obesity

Assuming current trends continue, the linear regression model based projections used by Wang et al. indicate that 80%, 90% and 100% of all American adults will be either overweight or obese (i.e., BMI ≥25 kg/m2) by the year 2022, 2035 and 2048, respectively. Further, the linear regression model based projections used by Wang et al. predict that 80%, 90% and 100% of all American adults will be obese (i.e., BMI ≥30 kg/m2) by the year 2072, 2087 and 2102, respectively. In terms of ethnicity and gender, future projections showed African-American women and Mexican-American men would be the most affected, reaching a combined prevalence for overweight and obesity of 96.9% and 91.1% by the year 2030, respectively. With respect to African-American women, the time course for them to reach 100% prevalence for overweight and obese is less than 30 years (by the year 2034).

For all children in the United States 6-11 years of age, Wang et al. predicted that 80%, 90% and 100% of them will be overweight by the year 2031, 2052 and 2074, respectively. For all adolescents in the United States 12-19 years of age, it was predicted that 80%, 90% and 100% of them will be overweight by the year 2028, 2048 and 2069, respectively.2 Astonishingly, it is projected that fifty percent of all children and adolescents in the United States will be overweight near 2070, with African-American girls and Mexican-American boys reaching this level sooner in the year 2050.

Mexican-American young boys and African-American adolescent girls are projected to have the highest prevalence for overweight (both groups at 41.1% by the year 2030), representing a level of overweight ten percentage points higher than the national average. In addition, the prevalence of overweight for Mexican-American adolescents and African-American teens will rise twofold and 1.8 fold, respectively and represent the largest increases.

Future Projections of Obesity-Related Health-Care Costs

Based on their analyses, Wang et al. (2008) predicted that “total health-care costs attributable to obesity and overweight will be more than doubled every decade” (p. 2329). It is projected that by the year 2030, health-care costs associated with overweight and obesity would range between $860-956 billion. This would represent 15.8%-17.6% of the total health-care costs or otherwise one in every six dollars being spent on health-care in the United States. Wang et al. (2008) commented that because of limitations of available data, their projected estimates are most likely an underestimation of the true financial impact of the overweight and obesity epidemic on the health-care system.

 Conclusion

Currently, an estimated 34.2% of American adults 20 years of age and older are overweight, while 33.8% were obese (Ogden & Carroll, 2010). The overall prevalence estimates for overweight and obesity when combined for adults 20 years of age and older (BMI  25) is a stunning 68.0% (Ogden & Carroll, 2010)Another way to think about the overweight and obesity epidemic is that less than a third of adults (i.e., 31.6%) in the United States are at a healthy weight.

With respect to children and adolescents, 16.9% are obese. From 1976-1980 to 2007-2008 obesity among preschool children aged 2-5 increased from 5.0% to 10.4% and among children aged 6-11 from 6.5% to 19.6%. From 1976-1980 to 2007-2008, obesity among adolescents aged 12-19 increased from 5.0% to 18.1% (Ogden & Carroll, 2010).

Most health experts and laypeople alike find these current statistics to be troubling. More disturbing yet is that it did not take all that much time to reach these epidemic levels, the prevalence of overweight and obesity increasing at a steady rate over the past two to three decades. The overweight and obesity epidemic is like a high speed bullet train racing through an obesegenic society picking up more passengers along the way.

In order to slow the prevalence rate of overweight and obesity, attention must be put on prevention. A new report just issued on June 23rd of this year by the Institute of Medicine (IOM), entitled, “Early
 Childhood Obesity Prevention Policies,” emphasizes that childhood prevention of obesity begins at birth. In the IOM’s report is contained the following comments on the rationale for early prevention
:

 

The first years of life are important to health and well-being throughout the life span. Preventing obesity in infants and young children holds promise for enabling significant gains toward both reversing the epidemic of childhood obesity and reducing obesity in adulthood. According to data from the Centers for Disease Control and Prevention, the obesity epidemic has not spared the nation’s youngest children: about 10 percent of infants and toddlers have high weights for length, and slightly over 20 percent of children aged 2-5 are already overweight or obese. Contrary to the common notion that children will “grow out of it,” childhood obesity tends to persist into later life and can increase the risk for obesity-related disease in adulthood. Environmental factors can profoundly affect children’s development and obesity risk in the first years of life, when patterns of eating, physical activity, and sleep are developing, patterns that continue to influence obesity, health, and well-being throughout life. Accordingly, this report offers policy recommendations designed to prevent obesity in infancy and early childhood by promoting healthy early environments in settings outside the home where young children spend substantial time (Birch et al., 2011, p. S1).

Putting attention on prevention will  involve nearly every sector of society, including a concerted and collaborative effort on the part of government, the private sector, medical and healthcare experts and professionals from a variety of relevant disciplines, food producers, urban planners, transportation experts, educators and parents to create nutritional and lifestyle programs for children, adolescents and adults, along with laws, regulations and policies, to help curb the tide of the overweight and obesity epidemic undermining the health of the nation.

References

Centers for Disease Control and Prevention (2011). About BMI for children and teens. Retrieved June 15, 2011, from http://www.cdc.gov/healthyweight/assessing/bmi/childrens_bmi/about_childrens_bmi.html

Birch, L.L., Parker, L. & Burns, A. (Eds.). Early childhood obesity prevention policies. Institute of Medicine of the National Academies. Washington, D.C: The National Academies Press. Retrieved June 23, 2011, from http://books.nap.edu/openbook.php?record_id=13124

National Heart Lung and Blood Institute (n.d.). Overweight and obesity. Retrieved November 11, 2010, from http://www.nhlbi.nih.gov/health/dci/Diseases/obe/obe_all.html

Ogden, C.L. & Carroll, M.D. (2010).  Prevalence of overweight, obesity, and extreme obesity among adults: United States, trends 1976–1980 through 2007–2008. NCHS Health E-Stat. Hyattsville, MD: National Center for Health Statistics. Retrieved September 25, 2010, from http://www.cdc.gov/nchs/data/hestat/obesity_adult_07_08/obesity_adult_07_08.pdf

Wang, Y, Beydoun, M.A., Liang, L., Caballero, B. & Kumanyika, S.K. (2008). Will all Americans become overweight or obese? Estimating the progression and cost of the US obesity epidemic. Obesity, 16(10), 2323-2330. doi:10.1038/oby.2008.351. Retrieved June 15, 2011, from http://www.nature.com/oby/journal/v16/n10/full/oby2008351a.html

 

Suggested Citation: Garko, M.G. (2011, July). Overweight and obesity epidemic in America – Part X:  The fat future of America. Health and Wellbeing Monthly. Retrieved (insert month, day, year), from www.letstalknutrition.com.


[1] While BMI is calculated the same way for adults, children and adolescents, different criteria are used when interpreting the BMI number for children and adolescents/teens. The following information regarding BMI for children and teens is provided by the Centers for Disease Control and Prevention (CDC):

After BMI is calculated for children and teens, the BMI number is plotted on the CDC BMI-for-age growth charts (for either girls or boys) to obtain a percentile ranking. Percentiles are the most commonly used indicator to assess the size and growth patterns of individual children in the United States. The percentile indicates the relative position of the child’s BMI number among children of the same sex and age. The growth charts show the weight status categories used with children and teens (underweight, healthy weight, overweight, and obese).

BMI-for-age weight status categories and the corresponding percentiles are shown in the following table.

Weight Status Category Percentile Range
Underweight Less than the 5th percentile
Healthy weight 5th percentile to less than the 85th percentile
Overweight 85th to less than the 95th percentile
Obese Equal to or greater than the 95th percentile

                                                

The BMI-for-age percentile is used to interpret the BMI number because BMI is both age-and sex-specific for children and teens. These criteria are different from those used to interpret BMI for adults — which do not take into account age or sex. Age and sex are considered for children and teens for two reasons:

  • The amount of body fat changes with age. (BMI for children and teens is often referred to as BMI-for-age.)
  • The amount of body fat differs between girls and boys (Centers for Disease Control and Prevention, 2011, p. 1).
  •