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Lifestyle Management of Adult Obesity

Epidemiology

According to the Centers for Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance System (BRFSS), self-reported prevalence of obesity among US adults increased from 12% in 1991 to 18% in 1998. [8] Data from the 1988 to 1994 National Health and Nutrition Examination Survey (NHANES) suggested that 63% of men and 55% of women were overweight. [9] More recent (1999) data from NHANES IV found that obesity rates among adult Americans increased from 15% in 1980 to 27% in 1999. [10]

America regrettably is a world leader in the epidemic of overweight and obesity, but it does not stand alone. Surveys in Europe and the Far East show that over the last 10-20 years, rates of overweight and obesity have increased by 1.5 to 2.0 fold in many countries. [11] Recent reports from Hong Kong and the Republic of China suggest an emerging epidemic of obesity which is directly related to the increasing dietary fat and calories.

The magnitude of the increased prevalence of obesity in the US between 1991 and 1998 varies by region. It ranges from 31.9% in the mid-Atlantic to 67.2% in the south Atlantic regions. [8] The increased prevalence also varies considerably by state ranging from 11.3% in Delaware to 101.8% for Georgia. [8] In another survey, Missouri ranked 2nd in overweight. [11] The magnitude of the increase is greatest in 18 to 29 year olds (7.1% to 12.1%), those with some college education (10.6% to 17.8%), and those of Hispanic ethnicity (11.6% to 20.8%). [8]

Although attempts to lose weight are common in the United States (36.2% of the population in the 1998 BRFSS were trying to lose weight), the prevalence of overweight and obesity continues to increase. [12] An additional 55.6% of respondents in the 1998 BRFSS indicated they were trying to maintain their current bodyweight. One third of the respondents indicated they were consuming fewer calories and fat, and 60% indicated they were using exercise to assist with weight control. However, other studies indicate that most persons attempting to lose weight through exercise and diet are neither doing enough exercise nor are they using sound dietary principles. [13]

The annual economic costs of obesity are estimated to be > 70 billion dollars. [14] In spite of the health and economic burden of obesity, studies show that health professionals do not consistently advise overweight and obese patients that they should lose weight. [12] [15] In fact, the 200 BRFSS revealed that only 14.5% of patients were counseled about weight whether it was to lose, gain, or maintain bodyweight. [15]

Thus, there is clearly a global epidemic of overweight and obesity. It can be estimated that, at the present rate of increasing prevalence of obesity, by the year 2030, 90% of US adults will be obese! We think it's time to seriously address this issue and establish a nationwide campaign to help American adults achieve and maintain healthy body weights.