[Editor's Note: When viewing the data in this article, please keep in mind that the Trust for America's Health report was compiled through analysis of data from various sources, some of which came from different years. The report states the following: "How is it that only 12 states have adult obesity rates exceeding 35 percent, yet the national obesity rate is 42.4 percent? It’s because state obesity rates are from the BRFSS, which collects self-reported height and weight. Research has demonstrated that people tend to overestimate their height and underestimate their weight. In fact, one study found that, due to this phenomenon, the BRFSS may underestimate obesity rates by nearly 10 percent. NHANES, from which the national obesity rate is derived, calculates its obesity rate based on measurements obtained at respondents’ physical examinations. Accordingly, the higher rates found by NHANES are a more accurate reflection of obesity in the United States." For more details about the numbers, download the report here.]
The U.S. adult obesity rate is now 42.4 percent, passing the 40 percent mark for the first time recorded, according to data from the 2017–2018 National Health and Nutrition Examination Survey (NHANES) as reported in Trust for America's Health (TFAH) analysis, State of Obesity: Better Policies for a Healthier America. The TFAH analysis, released Sept. 17, compiles data from various sources including newly released 2019 data from the Centers for Disease Control and Prevention’s Behavioral Risk Factors Surveillance System (BFRSS) as well as data from the NHANES (2017-2018).
The national adult obesity rate has increased by 26 percent since 2008, according to the NHANES. An adult is considered obese if they have a BMI of 30 or above.
The TFAH analysis of data from various sources provides an annual snapshot of rates of overweight and obesity nationwide including by age, race and state of residence. The significance of the obesity rate is greater today than perhaps ever due to obesity being one factor that can make contraction of COVID-19 more fatal, according to various studies.
Men had an obesity rate of 43 percent while women’s rate was 41.9 percent. Broken down by race, whites have a 42.2 percent obesity rate while Blacks are at 49.6 percent, Latinx are at 44.8 percent and Asians are at 17.4 percent. When broken down by race and gender, Black women had the highest obesity rate at 56.9 percent followed by Latinx women at 43.7 percent, white women at 39.8 percent and Asian women at 17.2 percent. Among men, Latinx men had the highest obesity rate at 45.7 percent followed by white men at 44.7 percent, Black men at 41.1 percent and Asian men at 17.5 percent. Because the size of the Indigenous population is small, many national surveys do not report data on this group, according to the report, but some data from the 2017 National Health Interview Survey found the rate among American Indians and Alaska Natives to be 38.1 percent.
Individuals with less education are more likely to be obese, according to the report. Adults that did not graduate from high school had obesity rate of 35.6 percent, according to the BFRSS. That compares to 22.7 percent for college graduates.
Rural communities have adult obesity rates that are 19 percent higher than in metro areas, and rural areas also had higher levels of chronic disease associated with obesity than in metro areas, according to BFRSS data.
Childhood Obesity On The Rise
Childhood obesity rates are also increasing with the latest data showing that 19.3 percent of people, ages 2 to 19, have obesity. In the mid-1970s, 5.5 percent of children were obese. Being overweight or having obesity as a young person puts children at higher risk for having obesity and its related health risks as an adult. In addition to this increase, children are exhibiting earlier onset of what used to be considered adult conditions, including hypertension and high cholesterol.
Twelve States Above 35 Percent
Obesity rates vary between states and regions of the country. Mississippi has the highest adult obesity rate in the country at 40.8 percent, and Colorado has the lowest at 23.8 percent, according to a 2019 report by the Centers for Disease Control's BFRSS. The twelve states with adult rates above 35 percent at that time were:
- South Carolina
- West Virginia
As recently as 2012, no state had an adult obesity rate above 35 percent. In 2000, no state had an adult obesity rate above 25 percent.
Solving the Obesity Crisis
The report includes recommendations on how best to address the obesity crisis. The recommendations are grounded in the need for a multi-sector, multi-disciplinary approach, and a focus on those population groups that are disproportionately affected by the obesity crisis.
The report’s recommendation include to:
- Continue USDA nutrition policy waivers and expand no-cost school meals to all enrolled students for the entire 2020-2021 school year while the COVID-19 public health emergency continues.
- Increase funding to allow for the expansion of critical CDC obesity-prevention programs including the State Physical Activity and Nutrition Program and the Racial and Ethnic Approaches to Community Health program.
- Expand benefits in the Supplemental Nutrition Assistance Program (SNAP) by raising maximum benefit levels, extending Pandemic-EBT for students and children, doubling investments in SNAP-Ed, and finding innovative, voluntary ways to improve diet quality without harming access or benefit levels.
- Incentivize businesses and public land use to increase access to healthy food options and safe places to be physically active.
- Disincentivize unhealthy food choices by closing tax loopholes and eliminating business-cost deductions related to the advertising of unhealthy food and beverages to children and by enacting sugary drink taxes where tax revenue is allocated to local efforts to reduce health and socioeconomic disparities.
- Encourage Medicaid to cover pediatric weight-management programs for all eligible beneficiaries.