Number of states with high rates of obesity more than doubles

The number of states where at least 35 percent of the adult population is obese has more than doubled since 2018, according to a new report from the U.S. Centers for Disease Control and Prevention (CDC). A total of 19 states and two territories has a high prevalence of obesity, the CDC found, noting that many people report being stigmatized due to their weight.

High rates of obesity are concentrated in the South and Midwest, including Alabama, Arkansas, Indiana, Iowa, Kansas, Kentucky, Louisiana, Mississippi, Missouri, Nebraska, North Carolina, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, West Virginia, and Puerto Rico and the U.S. Virgin Islands.

A February 2020 CDC report based on a 2017-2018 survey of more than 5,000 people aged 20 and older found that about 42.4 percent of U.S. adults are obese, and 9.2 percent are severely obese. This latest report suggests the country’s obesity epidemic has not improved and remains a serious public health threat.

Many Americans do not have equal access to preventative measures and treatments for obesity, such as weight management programs, medications, and bariatric surgery, the CDC points out. This is particularly true for people with low incomes and less access to health care, healthy foods, and convenient places to exercise safely.

High rates of obesity in the United States varies greatly across different racial and ethnic groups, the CDC shows. The report found that 36 states and the District of Columbia have an obesity prevalence of at least 35 percent among Black adults. The CDC also found that 31 states have a high prevalence of obesity among American Indian or Alaska Native adults, and 27 states have high rates of obesity among Hispanic adults.

This racial and ethnic disparity has significant health implications as obesity is tied to a higher risk for a slew of chronic conditions, including heart disease, stroke, type 2 diabetes, certain forms of cancer, COVID complications, and worse mental health.

Overall, obesity is less common among people with more education or college degrees than those with less education. Obesity is also more common among middled-aged adults between 45 and 54 years old than younger age groups.

“This report illustrates the urgent need for making obesity prevention and treatment accessible to all Americans in every state and every community,” said CDC acting principal deputy director, Debra Houry, MD, MPH in a September 27 news release. “When we provide stigma-free support to adults living with obesity, we can help save lives and reduce severe outcomes of disease.”

Reasons for the rise

Many issues contribute to the rise in U.S. obesity, but lack of exercise is a primary factor. The government recommends that adults get a minimum of 150 minutes of moderately intense physical activity or 75 minutes of vigorous activity each week. Less than a third of Americans actually hit that goal, according to the CDC.

What’s more, an increasing amount of our time is spent sedentary. A 2019 JAMA Network Open study of about 27,000 U.S. adults found they spent 6.4 hours per day sitting, up from 5.7 hours eight years before.

Another primary contributor? A Western diet filled with cheap, convenient ultra-processed foods that are high in sugar, salt and fat. A 2016 BMJ Open study found that these items account for about 60 percent of U.S. calorie intake—and 90 percent of our added sugars. A separate study, published in JAMA Internal Medicine in 2019, suggested that ultra-processed foods were associated with increased odds of any-cause mortality.

“There are key actions and resources that can help slow and ultimately reverse the obesity epidemic,” said Karen Hacker, MD, MPH, director of CDC’s National Center for Chronic Disease Prevention and Health Promotion. “These include supporting healthy individual lifestyle changes and ensuring that all people have access to healthy foods, evidence-based health care services, obesity treatment programs, and safe places for physical activity.”

Tips for weight control

People who are worried about excess weight should talk to their healthcare provider (HCP) about their concerns. Their HCP can consider their medical history, lifestyle, and other health risks to determine safe and effective weight management strategies.

There are also things people can do at home to help maintain a healthy weight, such as:

• Try to sit less and move more each day. Avoid sitting for long periods of time, break your day up with walks. Taking a brisk 20-minute stroll daily can help you hit the recommended amount of weekly activity. Anyone with a disability, injury, or other mobility issue could work with a physical therapist or other healthcare professional to incorporate more movement into their routine.
• Make small, healthy changes to your diet and repeat them until they become habits. Have nutritious snacks on hand instead of chips or candy, for example, or replace your sugar-sweetened drinks with seltzer or water. Some advance planning each week can help people eat healthier foods while sticking to a budget.
• Keep a food journal. It will give you an idea of your daily calorie intake and help you identify unhealthy eating habits.
• Since your age and health status can affect your weight, it may also help to speak with a healthcare provider (HCP) for advice or treatment recommendations that could help.