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Overweight in America - A bad situation gets worse

(November 2002)

Overweight is perhaps the most important single health problem in the United States. It is the major risk factor for adult onset diabetes and an important risk factor for heart attacks, strokes, and certain cancers. Beginning in 1960, the Centers for Disease Control and Prevention started conducting national health surveys. In the decade of the 1990s, these surveys showed that the problem of overweight and obesity was getting substantially worse. A new report, published in the Journal of the American Medical Association, October 9, 2002, provides disturbing data for the years 1999 and 2000. The measure used was the Body Mass Index (BMI) - the weight in kilograms divided by the square of the height in meters. A normal BMI is below 25; overweight is a BMI of 25 to 29.9; obesity is a BMI of 30 or over; and extreme obesity is a BMI of 40 and over.

In the period 1988 to 1994, 32 percent of adults ages 20 to 74 were classified as overweight. In 1999-2000, that figure rose a bit to 34.5 percent. In 1988 to 1994, an additional 22.9 percent were considered obese; in 1999-2000, that percentage rose markedly to 30.5 percent. Extreme obesity rose from 2.9 percent in 1988-1994 to 4.7 percent in 1999-2000.

Overall in 1999-2000, 64.5 percent, almost two-thirds of all adult Americans, were classified as overweight or obese. In 1988-1994, the figure was 55.9 percent. That is a huge increase in a short period of time.

In 1962, 13.4 percent of American adults were classified as obese; in 1980, the figure was 15 percent; in 1988 to 1994, 23.3 percent; and in 1999-2000, 30.5 percent. That is astonishing.

The increase in overweight and obesity was found among men and women; all age groups; whites and blacks.

Commentary: Overweight is the major risk factor for adult onset diabetes. There are currently about 14 million diabetics in the United States. There are going to be millions more because of the worsening epidemic of overweight and obesity.

That is the bad news. The good news is that a combination of weight loss and exercise can prevent most of the adult onset diabetes.

Healthful Life recommends regular weight checks (at least monthly, but weekly or even daily is okay). You should start to get concerned and take action when your BMI is 25 to 27.5 (up to 10 percent over ideal weight).

The earlier you react to being a little overweight, the easier it will be to avoid slipping into greater degrees of overweight and also to get your BMI into the normal range (less than 25). Reducing your daily intake of calories by common sense eating and increasing your physical activity should allow you to control your weight.

If you do nothing until you are 15 to 20 percent or more overweight, until your BMI is 30 or over, losing weight with diet and exercise becomes progressively more difficult.

Nobody should suggest weight control is easy, but if you start working on it as soon as you get beyond the normal range, achieving weight control objectives will be a lot easier. If attempts at weight control by regulating your diet and increasing physical activity does not seem to work, consultation with a nutritionist or dietician may help. There are also companies that specialize in behavior change modules (for example, Health Media Inc which is associated with the University of Michigan, ActivHealth which is associated with Duke University).

We must get control of the obesity epidemic and the derivative diabetes epidemic. Reducing overweight and obesity will also lower the occurrence of heart attacks, strokes and cancers of the uterus, breast, kidneys, and gallbladder (and, perhaps, others).

CLICK HERE for charts that allow you to determine your own BMI. It should be noted that the BMI tables do not take into account the influence of big bones and big muscles. For big boned and big muscled people, a BMI of 30 or 32 may not be obese, and a BMI of 27 or 28 may not be overweight. For those over age 60, a BMI of 25 to 27 is probably normal.

Flegal, K.M., et al. Prevalence and trends in obesity among US adults 1999-2000. Journal of the American Medical Association. Vol 288 (October 9) Pgs 1723-1727. 2002.