A special article posted online in The New England Journal of Medicine on Dec. 19 released the results of a study of adult obesity, with highly concerning projections around the levels of obesity nationwide.
The article, entitled “Projected U.S. State-Level Prevalence of Adult Obesity and Severe Obesity,” was written by a team of healthcare policy researchers: Zachary J. Ward, M.P.H., Sara N. Bleich, Ph.D., Angie L. Cradock, Sc.D., Jessica L. Barrett, M.P.H., Catherine M. Giles, M.P.H., Chasmine Flax, M.P.H., Michael W. Long, Sc.D., and Steven L. Gortmaker, Ph.D.
As the researchers note, “The findings from our approach suggest with high predictive accuracy that by 2030 nearly 1 in 2 adults will have obesity (48.9 percent; 95 percent confidence interval [CI], 47.7 to 50.1), and the prevalence will be higher than 50% in 29 states and not below 35 percent in any state. Nearly 1 in 4 adults is projected to have severe obesity by 2030 (24.2 percent; 95 percent CI, 22.9 to 25.5), and the prevalence will be higher than 25 percent in 25 states. We predict that, nationally, severe obesity is likely to become the most common BMI category among women (27.6 percent; 95 percent CI, 26.1 to 29.2), non-Hispanic black adults (31.7 percent; 95 percent CI, 29.9 to 33.4), and low-income adults (31.7 percent; 95 percent CI, 30.2 to 33.2).”
As the authors state, “Although the growing obesity epidemic in the United States has been well documented, less is known about long-term trends and the future of obesity prevalence. Although national projections of obesity have been made previously, state-specific analyses are limited. State-specific projections of the burden of obesity are important for policymakers, given the considerable variation in the prevalence of obesity across states,8 the substantial state-level financial implications, and the opportunity for obesity-prevention interventions to be implemented at a local level.:
The researchers note that “[A] barrier to accurate state-level projections is the paucity of objectively measured body-mass index (BMI) data according to state. The Behavioral Risk Factor Surveillance System (BRFSS), a nationally representative telephone survey of more than 400,000 adults each year, provides participants’ estimates of height and weight according to state. These data have been used to track obesity prevalence and are the basis of maps that have illustrated the growth of the obesity epidemic. Although the BRFSS provides valuable state-level estimates over time, the reliance on subjective body measures reported by participants substantially underestimates the prevalence of obesity owing to the well-documented self-reporting bias. We developed a method of bias correction to adjust the entire distribution of BMI in the BRFSS surveys from 1993 through 2016 and estimated state-level historical trends and projections of the prevalence of BMI categories from 1990 through 2030 according to demographic subgroup.”
Further, they write, “Our projections show that the national prevalence of adult obesity and severe obesity will rise to 48.9 percent (95 percent confidence interval [CI], 47.7 to 50.1) and 24.2 percent (95 percent CI, 22.9 to 25.5), respectively, by 2030, with large variation across states. Maps of state-level prevalence of obesity and severe obesity over time are provided in Figure 1. Based on current trends, our projections show that the prevalence of overall obesity (BMI, ≥30) will rise above 50 percent in 29 states by 2030 and will not be below 35 percent in any state. We also project that the prevalence of severe obesity (BMI, ≥35) will rise above 25 percent in 25 states.”
