8.3: Obesity Epidemic

Obesity in the United States

The number of people with obesity has been increasing for decades. Results from the 2017-2018 National and Nutrition Examination Survey provide estimated percentages across time showing the growing trend. Data from the years 1988-1994 through 2017-2018, show obesity prevalence of adults in the United States increased from 22.9 to 42.4%. During the same time, the prevalence of severe obesity in adults increased from 2.8% to 9.2%. The data shows that children in the United States are also impacted by obesity with the percentage of obese children ages 2 through 19 in the United States increasing from 10% in 1988-1994 to 19.3% in 2017-2018 (refer to Tables 8.3 and 8.4).

Table 8.4.1: Prevalence of Overweight and Obesity Among Adults 20 and Over from 1988 through 2018. Selected data from the 2017-2018 National Health and Nutrition Examination Survey (NHANES)

Years	Percentage Overweight	Percentage Obese	Percentage Severely Obese
1988-1994	33.1	22.9	2.8
1999-2000	34	30.5	4.7
2005-2006	32.6	34.3	5.9
2011-2012	33.6	34.9	6.4
2017-2018	30.7	42.4	9.2

Table 8.4.2: Prevalence of Overweight and Obesity Among Children 2-19 from 1988 through 2018. Selected data from 2017-2018 National Health and Nutrition Examination Survey (NHANES)

Years	Percentage Overweight	Percentage Obese	Percentage Severely Obese
1988-1994	13	10	2.6
1999-2000	14.2	13.9	3.6
2005-2006	14.6	15.4	4.7
2011-2012	14.9	16.9	5.6
2017-2018	16.1	19.3	6.1

We can observe that in both adults and children in the United States that the percentage of individuals that are obese and percentage that are severely obese has increased over the years.

Obesity in the World

The United States is not the only country seeing a rise in obesity. Since 1975, obesity across the world has nearly tripled. Data from 2016 show that more than 1.9 billion (39%) adults around the world were overweight with 650 million (13%) obese. Most of the world’s population live in countries where overweight and obesity kills more people than underweight.

The number of obese children and adolescents (aged 5 to 19 years) worldwide has risen tenfold in the past four decades. Obesity rates in the world’s children and adolescents increased from less than 1% (equivalent to 5 million girls and 6 million boys) in 1975 to nearly 6% in girls (50 million) and nearly 8% in boys (74 million) in 2016. In 2016, there were 50 million girls and 74 million boys with obesity in the world, while the global number of moderately or severely underweight girls and boys was 75 million and 117 million respectively. If current trends continue, more children and adolescents will be obese than moderately or severely underweight by 2022.

Negative Health Implications of Obesity

People who have obesity, compared to those with a normal or healthy weight, are at increased risk for many serious diseases and health conditions, including the following:

• All-causes of death (mortality)
• High blood pressure (hypertension)
• High LDL (bad) cholesterol, low HDL (good) cholesterol, or high levels of triglycerides (dyslipidemia)
• Type 2 diabetes
• Coronary heart disease
• Stroke
• Gallbladder disease
• Osteoarthritis (a breakdown of cartilage and bone within a joint)
• Sleep apnea and breathing problems
• Many types of cancer
• Low quality of life
• Mental illness such as clinical depression, anxiety, and other mental disorders
• Body pain and difficulty with physical functioning

Understanding Diabetes

As we have learned so far in our studies, the body breaks down the food we eat to turn it into energy, this process is called metabolism. The disease that affects how your body turns food into energy is called diabetes. There are three main types of diabetes: Type 1, Type 2, and Gestational diabetes (diabetes while pregnant). More than 122 million Americans are living with diabetes (37.3 million, 11.3% of the United States population) or pre-diabetes (96 million, 38% of the adult United States population).

When discussing diabetes you will often hear people talk about insulin. Most of the food you eat is broken down into sugar (also called glucose) and released into your bloodstream. When your blood sugar goes up, it signals your pancreas to release insulin. Insulin acts like a key to let the blood sugar into your body’s cells for use as energy. Without insulin, blood sugar can’t get into cells causing the blood sugar to build up in the bloodstream. High amounts of blood sugar are damaging to the body and cause many of the symptoms and complications of diabetes.

If you have Type 1 diabetes, your pancreas does not make insulin or makes very little insulin. Approximately 5-10% of the people who have diabetes have Type 1. Type 1 diabetes is usually diagnosed in children, teens, and young adults. Type 1 diabetes is thought to be caused by an autoimmune reaction (the body attacks itself by mistake) that stops your body from making insulin.

If you have Type 2 diabetes, your cells do not respond normally to insulin. About 90-95% of people with diabetes have Type 2. It develops over many years and is usually diagnosed in adults (but more and more in children, teens, and young adults). Type 2 diabetes can be prevented or delayed with healthy lifestyle changes, such as losing weight, eating healthy food, and being active.

You’re at risk for developing Type 2 diabetes if you:

• Have pre-diabetes
• Are overweight
• Are 45 years or older
• Have a parent, brother, or sister with Type 2 diabetes
• Are physically active less than 3 times a week
• Have ever had Gestational diabetes (diabetes during pregnancy) or given birth to a baby who weighed more than 9 pounds
• Are African American, Hispanic/Latino American, American Indian, or Alaska Native (some Pacific Islanders and Asian Americans are also at higher risk)