A recent report from the Centers for Disease Control and Prevention (CDC) revealed alarming trends regarding the prevalence of obesity and severe obesity among U.S. adults. According to National Health and Nutrition Examination Survey (NHANES) data collected between August 2021 and August 2023, more than 40% of U.S. adults are obese. This percentage varies significantly by age, sex, and education level.
Prevalence by age and sex
Obesity continues to affect a significant portion of the adult population, with 40.3% of adults falling into this category. No significant differences were found between men and women, with prevalence rates of 39.2% and 41.3%, respectively.
Age appears to influence obesity rates: Adults aged 40-59 years had the highest obesity rates at 46.4%, followed by 35.5% for adults aged 20-39 and 38.9% for those aged 60 and over. Data indicates that middle-aged adults are more affected by obesity than younger and older adults.
Obesity and education level
NHANES data further found that the prevalence of obesity was associated with educational level. Adults with a bachelor's degree or higher had a lower prevalence of obesity (31.6%) than those with less education. For example, adults with less than a high school degree had an obesity prevalence of 44.6%. Adults with some college education had an obesity prevalence of 45.0%.
Severe obesity climbing
While overall obesity rates have remained stable since 2013-2014, the prevalence of severe obesity has increased, now standing at 9.4%, up from 7.7% the previous year. Severe obesity is more common in women (12.1%) than men (6.7%). Middle-aged adults (ages 40-59) have the highest prevalence of severe obesity at 12.0%.
Women in particular have higher rates of severe obesity across all age groups, with the difference being most pronounced among young adults (20-39 years).
Implications
Obesity is a chronic disease with serious health risks, including high blood pressure, type 2 diabetes, heart disease, stroke, certain cancers and even dementia. As obesity and severe obesity continue to increase, especially among women and middle-aged adults, it is important that public health efforts focus on prevention and intervention strategies tailored to high-risk groups, the report states.
According to the CDC, obesity led to an estimated $173 billion in health care costs in 2019. The agency also warns that obesity affects the nation's military readiness, noting that only two in five young people meet the weight and fitness requirements for basic training.
Obesity and BMI
Obesity is often measured by the Body Mass Index (BMI), which is calculated by dividing weight in kilograms by height in meters squared. BMI estimates body fat but does not take into account muscle mass, bone density, or fat distribution. A BMI of 30 or higher is considered obese, and 40 or higher is considered severely obese. Despite its limitations, BMI is widely used in public health due to its simplicity and cost-effectiveness.
Regional rates
The CDC report follows the release of updated data from U.S. states and territories earlier this month. For the first time since 2013, 48 states surveyed have obesity rates above 20 percent, and 23 states report that more than one in three adults are obese. West Virginia “tops” the nation with more than 41 percent of adults classified as obese. In contrast, Washington DC reported the lowest rate, at just under 24 percent.
Obesity rates are disproportionately high in the Midwest and South, with many states suffering from obesity affecting more than one-third of the adult population.
Obesity and Race
State data also show wide variations in obesity rates across racial and ethnic groups. Non-Hispanic black adults have the highest obesity rates, with 38 states and territories reporting obesity rates of 35% or higher. Hispanic adults follow, with 34 states and territories exceeding this threshold. Non-Hispanic American Indian or Alaska Native adults also have high obesity rates, reaching 35% in 30 states. Non-Hispanic white adults have relatively low obesity rates, with 16 states reporting obesity rates of 35% or higher. Notably, no states or territories reported obesity rates of 35% or higher for non-Hispanic Asian adults.
Is any body type healthy?
Several factors are likely responsible for the rise in obesity in the United States, including a sedentary lifestyle, the consumption of unhealthy foods, and socioeconomic conditions. Solveig Cunningham, a professor of global health at Emory University who specializes in obesity, said in an interview with The Hill that it is unclear why severe obesity rates are rising, especially among women, but that hormonal factors and the effects of childbirth may play a role. However, this explanation may not fully explain the rise in obesity. Women in previous decades were thinner, even as they were having more children.
A larger cultural shift, heavily influenced by the body positivity movement, especially among young women, likely played a role. The movement has been praised for promoting self-acceptance and fighting stigma, but it has also been criticized for normalizing obesity. Critics argue that by promoting acceptance of all body types, the movement downplays the serious health risks associated with obesity.
For young women, a focus on “self-love” and a rejection of pressure to be thin can obscure the importance of a healthy weight. This shift complicates public health efforts, making it more difficult to balance body acceptance with promoting healthy lifestyle choices.
Will Big Pharma be our saviour?
As the obesity epidemic grows, pharmaceutical companies are aggressively promoting weight-loss drugs such as semaglutide (sold as Ozempic and Wegovy) and tirzepatide (sold as Mounjaro and Zepbound). These drugs have shown promising results in helping patients lose significant weight. However, questions remain about their long-term effectiveness and safety, availability, and the role of lifestyle changes in tandem with the medication.
