Back to Menu

Twin American epidemics: Obesity and Diabetes

(July 2001)

The health of the American public has improved dramatically over the last three decades: life span has increased; the occurrence of and deaths from heart disease and stroke have fallen dramatically, cure rates for some cancers have improved markedly. But, with the good news comes some bad news: there are interlocking epidemics that appear to be getting progressively worse: overweight and diabetes.

According to a recent survey, in 1990, 12 percent of adults in the United States were obese (defined as a body mass index over 30; in general, that equates to more than 20 percent above ideal weight). [CLICK HERE FOR BODY MASS INDEX TABLE] By 1998, that 12 percent had increased to 18 percent - a 50 percent increase in seven years. In addition to the 18 percent designated as frankly obese, an additional 33 percent were overweight (body mass index 25 to 30). This striking increase in obesity occurred among men and women and all age groups. So, over 50 percent of American adults are either overweight or obese. In other studies, the percentage either overweight or obese is even greater - 55 to 60 percent.

As the overweight and obesity epidemic has grown, so has adult onset (Type 2) diabetes. That is hardly unexpected; 85 percent of all cases of Type 2 diabetes occur in men and women classified as overweight or obese. Between 1990 and 1999, the frequency of diabetes in the United States increased from almost 5 percent to 6.5 percent, a 30 percent increase. Among adults over age 50, 10 to 15 percent have Type 2 diabetes.

Among those who are overweight, the risk of diabetes increases two to three fold. For those classified as obese, the risk increases by five to eight fold; in general, the more obese the man or woman, the greater the risk of diabetes.

Once you get into the overweight category, for every two-pound increase in weight, the risk of diabetes increases by 4 to 9 percent.

Diabetics are predisposed to heart attacks, stroke, and kidney failure.

In a society that persistently overeats and exercises far too little, the overweight and obesity problem is likely to get worse; and with it, the occurrence of diabetes will inevitably increase.

That makes weight control one of the top health priorities for the United States. It will require a gargantuan effort - a combination of regular weight monitoring, control of caloric intake, exercise, and for those who cannot control weight gain any other way, medications under a physician’s supervision.

One thing is clear -the continuing twin epidemics of obesity and diabetes can threaten the continuing progressive improvement in the health of the American public.