About 66% of adults and 33% of children in the United States are overweight or obese, according to the last studies performed on the prevalence of this public health problem in the U.S. During the last three decades the progress towards diminishing the burden of obesity, if any, has been minimal.
What can we do to treat this epidemic and decrease the prevalence of obesity and overweight? To formally attack the problem, a good knowledge of its causes or associated factors is warranted.
According to a recent report from the Institute Of Medicine (IOM), there is increasing evidence that the obesity epidemic has its origin in a complex interaction of changing factors in:
- Food and beverage systems
- Media
- Communities
- Workplaces, and
- Schools
The previous approach is evidently giving more importance to environmental issues than to personal decisions – individual choices –, like the exposure to several risk factors. But obesity is not just a consequence of individual choice, but a response to an obesogenic environment that promotes weight gain.
Currently, there is enough base of evidence that there are specific environmental determinants of obesity to be taken into account in the design of an effective set of prevention strategies, trying not to stigmatize obese people even more.
Obesity is a very important risk factor for multiple and serious diseases. Obesity is associated with an increased risk of premature death. This is why the very high obesity rates are potentially catastrophic for the population health of the United States.
Report from Trust for America's Health:
Analysis of Obesity Rates by State
Twelve states currently have an adult obesity rate above 30 percent, according to a new analysis released by the Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation (RWJF). The analysis used the state obesity rates released made available by the U.S. Centers for Disease Control and Prevention (CDC). Mississippi had the highest rate of obesity at 34.9 percent, while Colorado had the lowest rate at 20.7 percent. Twenty-six of the 30 states with the highest obesity rates are in the Midwest and South.
“Obesity has contributed to a stunning rise in chronic disease rates and health care costs. It is one of the biggest health crises the country has ever faced,” said Jeffrey Levi, PhD, TFAH executive director. “The good news is that we have a growing body of evidence and approaches that we know can help reduce obesity, improve nutrition and increase physical activity based on making healthier choices easier for Americans. The bad news is we’re not investing anywhere near what we need to in order to bend the obesity curve and see the returns in terms of health and savings.”
Later this summer, TFAH and RWJF will release the 2012 edition of F as in Fat, the annual report that analyzes state obesity rates and policy efforts to address the epidemic, and provides policy recommendations. For the first time, the 2012 report will include a study that forecasts 2030 obesity rates in each state and the likely resulting rise in obesity-related disease rates and health care costs. The analysis also will examine the potential impact of a 5 percent reduction in body mass index (BMI) levels and the number of Americans who could be spared from type 2 diabetes, heart disease and stroke, hypertension, arthritis and obesity-related cancers if they were able to achieve that reduction. Additionally, the projection will feature the cost savings that could be achieved in each state as a result of a 5 percent BMI reduction. For a six-foot-tall person weighing 200 pounds, a 5 percent reduction in BMI would be the equivalent of losing roughly 10 pounds.
In 2006, obesity-related medical costs totaled $147 billion a year, or nearly 10 percent of total medical spending, according to a 2011 study in Health Affairs. The bulk of the spending is generated from treating obesity-related diseases, such as diabetes.
“Our nation has made important inroads to creating healthier communities,” said Risa Lavizzo-Mourey, MD, MBA, RWJF president and CEO. “Some cities and states that have taken comprehensive action to address the epidemic are beginning to see declines in their obesity rates. But we need to expand and intensify our efforts. Investing in prevention today will mean a healthier tomorrow for our children.”
In recognition of the dramatic health and financial consequences of obesity, the Institute of Medicine (IOM) earlier this year released a comprehensive report that outlined strategies for reversing the epidemic and called on everyone to advance those strategies. The IOM committee, made up of nutritionists, public health experts, and leaders from the public, private and nonprofit sectors, called for a focused commitment to: making physical activity an integral and routine part of life, creating food and beverage environments that ensure that healthy food and beverage options are the routine, easy choice, transforming messages about physical activity and nutrition, expanding the role of health care providers, insurers and employers in obesity prevention, and making schools a national focal point for obesity prevention.
STATE-BY-STATE ADULT OBESITY RATES
According to the newly released CDC data, part of the 2011 Behavioral Risk Factor Surveillance Survey, the obesity rates by state from highest to lowest were:
1. Mississippi (34.9%); 2. Louisiana (33.4%); 3. West Virginia (32.4%); 4. Alabama (32.0%); 5. Michigan (31.3%); 6. Oklahoma (31.1%); 7. Arkansas (30.9%); 8. (tie) Indiana (30.8%); and South Carolina (30.8%); 10. (tie) Kentucky (30.4%); and Texas (30.4%); 12. Missouri (30.3%); 13. (tie) Kansas (29.6%); and Ohio (29.6%); 15. (tie) Tennessee (29.2%); and Virginia (29.2%); 17. North Carolina (29.1%); 18. Iowa (29.0%); 19. Delaware (28.8%); 20. Pennsylvania (28.6%); 21. Nebraska (28.4%); 22. Maryland (28.3%); 23. South Dakota (28.1%); 24. Georgia (28.0%); 25. (tie) Maine (27.8%); and North Dakota (27.8%); 27. Wisconsin (27.7%); 28. Alaska (27.4%): 29. Illinois (27.1%); 30. Idaho (27.0%); 31. Oregon (26.7%); 32. Florida (26.6%); 33. Washington (26.5%); 34. New Mexico (26.3%); 35. New Hampshire (26.2%); 36. Minnesota (25.7%); 37. (tie) Rhode Island (25.4%); and Vermont (25.4%); 39. Wyoming (25.0%); 40. Arizona (24.7%); 41. Montana (24.6%); 42. (tie) Connecticut (24.5%); Nevada (24.5%); and New York (24.5%); 45. Utah (24.4%); 46. California (23.8%); 47. (tie) District of Columbia (23.7%); and New Jersey (23.7%); 49. Massachusetts (22.7%); 50. Hawaii (21.8%); 51. Colorado (20.7%).
Note: 1 = Highest rate of adult obesity, 51 = lowest rate of adult obesity. Individuals with a body mass index (a calculation based on weight and height ratios) of 30 or higher are considered obese.
CDC has modernized the methodology for BRFSS this year, setting a new baseline for comparisons. The updated approach, incorporating cell phones and using an iterative proportional fitting data weighting method, means rates are even more reflective of each states’ population, but that the rates were determined in a different way than in the past, making direct change comparisons difficult. The full data set can be found at: http://www.cdc.gov/brfss/technical_infodata/surveydata/2011.htm.
The 2011 F as in Fat report is available on TFAH’s website at: www.healthyamericans.org and the upcoming 2012 F as in Fat report will be released later this summer.
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Trust for America's Health is a non-profit, non-partisan organization dedicated to saving lives by protecting the health of every community and working to make disease prevention a national priority. For more information, visit www.healthyamericans.org.
The Robert Wood Johnson Foundation focuses on the pressing health and health care issues facing our country. As the nation’s largest philanthropy devoted exclusively to health and health care, the Foundation works with a diverse group of organizations and individuals to identify solutions and achieve comprehensive, measurable, and timely change. For 40 years the Foundation has brought experience, commitment, and a rigorous, balanced approach to the problems that affect the health and health care of those it serves. When it comes to helping Americans lead healthier lives and get the care they need, the Foundation expects to make a difference in your lifetime. For more information, visit www.rwjf.org. Follow the Foundation on Twitter http://www.rwjf.org/twitter or Facebook www.rwjf.org/facebook.
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References:
Barry CL, Gollust SE, Niederdeppe J. Are Americans Ready to Solve the Weight of the Nation? N Engl J Med 2012; 367:389-391.
Editorial. New weight-loss drugs and the US obesity epidemic. The Lancet 2012; Vol. 380, Issue 9839: 308.