American Obesity Ballooning

Government health officials fret about expanding waistlines, even in kids 

The US government's latest health and nutrition survey is in, and the results are huge. Literally.

More than 30 percent of American adults, or 59 million people, were obese in 2000, far more than the 23 percent who made their scales wince just six years earlier.

Weight problems among the nation's children have also continued to surge, with 15 percent, or nearly 9 million, considered overweight or obese in 1999 and 2000, triple the rate in 1980. Ten percent of pre-schoolers are now overweight, compared with 7 percent in the early 1990s.

The Problem Keeps Getting Worse

"The problem keeps getting worse," Tommy Thompson, secretary of the US Department of Health and Human Services, said in a statement. "We've seen virtually a doubling in the number of obese persons over the past two decades and this has profound health implications. Obesity increases a person's risk for a number of serious conditions, including diabetes, heart disease, stroke, high blood pressure and some types of cancer."

Morgan Downey, executive director of the American Obesity Association, called obesity "the most prevalent public health problem of the 21st century." Heaviness is behind 300,000 to 500,000 deaths a year, says Downey, who criticized the government for not doing enough to help the nation stay fit.

"We think the government needs to do more than just exhort people to live better," Downey says. His group is calling for more research dollars devoted to studying obesity, better insurance coverage of weight-loss treatments, and more attention to physical activity and nutrition in the nation's schools.

The survey results appear in two studies published in the Journal of the American Medical Association (JAMA). Both use data from the National Health and Nutrition Examination Survey (NHANES). They included information on 4,115 men and women over age 20, and 4,722 children from birth through age 19.

Using Body Mass Index (BMI) As Disease Predictor

Since obesity is weight in the context of height, scientists use a term called "body mass index," or BMI, to relate a person's north-south to their east-west. A man who is 6 feet tall, for example, has a body mass index of 30 if he weighs 221 pounds. A woman who is 5-foot-5 has a BMI of 30 if she weighs 180 pounds. A BMI of 25 or more for both sexes is considered overweight, while a BMI in excess of 29 is considered obese.

Between 1988 and 1994, roughly 23 percent of adults surveyed had a BMI of 30 or higher, and 56 percent were overweight but not yet obese. By 1999-2000, however, those numbers had risen to 30.5 percent and 64.5 percent, respectively. One-third of women and 28 percent of men were obese by the end of the last decade.

The number of "extremely obese" Americans—those with a BMI of 40 or more—jumped from 2.9 percent to 4.7 percent in the years between the two surveys. [A third study in the journal found somewhat lower rates of severe obesity. However, that work relied on self-assessments of weight, which are usually not reliable.]

People with extreme obesity have twice the risk of premature death as those with BMIs between 30 and 39—who themselves are at much greater risk of dying early than their thinner peers. The extremely obese are so heavy that they may qualify for stomach-shrinking surgery.

The surveys found that waistlines bulged for both sexes and in every age group. However, the scientists were surprised to see an 11 percent to 12 percent surge in obesity in women and men between the ages of 60 and 74, says Cynthia Ogden, an epidemiologist at the National Center for Health Statistics and a member of the research team.

Although men in the various racial and ethnic groups surveyed had roughly the same rates of overweight and obesity, African-American and Mexican-American women had the most trouble with their waistlines. More than one in two African-American women over age 40 were obese in 2000, and more than eight in 10 were overweight. Extreme obesity was also highest among African-American women, rising from 7.9 percent to just over 15 percent by 2000.

Overweight Teens Become Overweight Adults

For the youth survey, children aged 2 and older were considered overweight if their BMI was in the top 5 percent for their gender.

It found that more than 15 percent of children between the ages of 6 and 19 were overweight in 1999-2000, about 50 percent more than in the previous NHANES review. The problem was slightly better among the very young, 10.4 percent of whom were overweight, compared with 7.2 percent in 1988-1994.

Being overweight was more common among African-American and Mexican-American boys and girls than it was among Caucasians.

Ogden, who also co-wrote the journal article on the youth survey, says being overweight even early in life is linked to high blood pressure, high cholesterol, and the first stages of diabetes. "Overweight teens are more likely to become overweight adults," she adds.

In an unrelated survey released last week, the National Association for Sport and Physical Education found that most Americans greatly overestimate the amount of exercise they get each week. The Centers for Disease Control and Prevention (CDC) advises 30 minutes of physical activity every day.

Always consult your physician for more information.

Online Resources

(Our Organization is not responsible for the content of Internet sites.)

American Association of Diabetes Educators

American Diabetes Association

American Obesity Association

Centers for Disease Control and Prevention (CDC)

Journal of the American Medical Association (JAMA)

National Association for Sport and Physical Education

National Center for Health Statistics

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

US Department of Health and Human Services

November 2002

The Problem Keeps Getting Worse

Using Body Mass Index (BMI) As Disease Predictor

Overweight Teens Become Overweight Adults

Diabetes: The Silent Killer

Online Resources 

Diabetes: The Silent Killer

Millions of Americans have a potentially deadly disease and do not even know it.

The disease: Diabetes, which can cause blindness, kidney failure, heart attacks, and strokes. More than 16 million Americans have diabetes, but more than five million of them are not aware of their condition.

"It is truly a huge national problem," says Dr. Francine Kaufman, president-elect of the American Diabetes Association. "And it is an epidemic in the adolescent population."

Diabetes is increasing at a startling rate. In the last decade, there has been a 33 percent jump in people with type 2 diabetes, often called "lifestyle diabetes."

Type 2 diabetes used to be known as "adult-onset diabetes," because it usually occurred in mature adults. But that term has been dropped as the disease increasingly strikes children in their teens or younger.

At the heart of the problem: Too much food and not enough exercise.

"We're getting heavier. We're not as active," says Dr. Frank Vinicor, head of diabetes programs for the federal Centers for Disease Control and Prevention (CDC). 

"We're not only eating more calories, but maybe not the best foods, either," he adds.

Diabetes is caused by an imbalance of insulin, a substance that helps the body process sugar to produce energy.

Type 1 diabetes, usually first seen in children, is caused by the body's failure to produce insulin. People with type 1 diabetes have to take daily injections of insulin.

But type 1 diabetes accounts for only 5 percent to 10 percent of all diabetes cases. Type 2 diabetes is much more common—and more preventable.

Drastic improvements in your risk for diabetes can be made with only modest changes in behavior.

Recent studies show that a brisk 30-minute walk five times a week and the loss of 10 pounds can cut the risk of type 2 diabetes in half.

"That's hot stuff," says Vinicor. "You can cut the risk in half if you exercise and eat better.

"Those can be tough things to do," he acknowledges. "It's tough to exercise and to push away from the table. Food tastes good."

With more and more children developing diabetes, Vinicor and Kaufman say the schools are a good place to start changing habits.

"It's important that the schools are a healthy environment," says Kaufman. "It has deviated from that. You can eat junk food and sugary sodas whenever you want, and meanwhile, they've taken away physical education."

"That's not a good switch," she says.

Vinicor says school districts need to say "no" to lucrative contracts with soft-drink companies, which often pay schools millions of dollars for exclusive sales rights. Schools also need to reinstate physical-education requirements, he says.

"Somebody's got to step in and say, 'The risks are too great,' " Vinicor says. "We're not only harming the kids today, but also harming them later as adults."

While those with type 1 diabetes have no choice but to inject insulin, an array of newly developed drugs is available to treat type 2 diabetes. Some make the body more sensitive to its own insulin. Others slow down the body's absorption of sugar or reduce the addition of sugar from the liver.

Possible symptoms of type 2 diabetes include excessive thirst, frequent urination, sudden weight loss, fatigue, blurred vision or tingling and numbness in the hands or feet.

Consult your physician if you have any of these symptoms and/or for more information on preventing diabetes, particularly if you are overweight.