Obesity and maintaining a healthy BMI is not about fitting into designer clothing, it is about your health, BMI is a measure of fatness based on height and weight as limitation of a predictor of personal health. To put it bluntly, and honestly, in populations where obesity rates are high people tend to be sicker, live shorter lives, and have higher healthcare expenses.
A BMI of 40 or more defines severe obesity, this is predicted to become about as common in 2030 as regular obesity was in the 1990s. To make matters worse where Americans were already obese, the generation following them is expected to become severely obese bringing with it significantly increased risks of joint and back issues, cardiovascular disease, diabetes, certain cancers, and an increase rate of premature death.
This recent report from Harvard and George Washington University was published in the New England Journal of Medicine, their projections were made by applying established weight trends to Americans across lifespan across the nation. To focus on a single state rate existing data was analyzed and corrected to account for the fact that people lie about their weight, and they used state history of weight gain to predict its future.
The new projections indicate a sharp increase from current obesity rate. The last period of reliable figures were presented in 2015-16 from the CDC in which 39.8% of American adults were obese; this translates to 93.3 million people with obesity, and keep in mind that the American Medical Association calls this condition a disease state.
The extra weight in this hefty statistics prediction is not distributed evenly; 21.1% of American men are projected to be severely obese by 2030 and 27.6% of women who will by then make up the largest single weight category for women; severe obesity is projected to affect 23.4% of non-Latino white males, 24.5% of Latino adults, and 31.7% of non-Latino black Americans.
Severe obesity is projected to be spread across but be clustered near the bottom of the economic ladder to affect some 21.6% of adults in homes with incomes above the 2030 equivalent of $50,000 and 31.7% of adults in homes making $20,000 or less annually in America.
States that have long appeared to harbour extra weight such as Hawaii, Colorado, and California are expected to have populations in which more than 1 in 3 adults will be obese. This situation is projected to become more dire in the southern stroke belt states including Mississippi, Oklahoma, Louisiana, Alabama, and Arkansas where close to 6 in 10 adults are expected to be obese by 2030, and the proportion of adults in these states that will be severely obese is projected be more than 30%.
According to the researchers, the rate of obesity has been increasing since the 1980s and hasn’t shown any signs of improving despite decades of warnings, body shaming, finger pointing, and obesity prevention campaigns; not a single state with a steady population has been able to succeed at stabilizing weight let alone tackle obesity anywhere near effectively.
What makes matters worse is the children, continued failure of obesity prevention efforts aimed at children is helping to drive continued increases in adult obesity. Earlier research simulations from this same group projected that 57% of American children alive in 2017 will be obese by the time they are 35, and evidence suggests that for at least several decades after that an adult’s weight continue to increase. Meaning not only has obesity been established earlier driving rates higher, when it is set in early midlife it sets people up to develop severe or even morbid obesity.
According to lead author Zachary J. Ward the increase in weight gain has the unintended effect of decreasing the amount of people predicted to be overweight with a BMI between 25-29.9. But this is not a cheering matter, weight gain has become so rapid that more adults are passing from the healthy BMI of 18.5-24.9 to move alarmingly quickly through the overweight phase to proceed directly to being obese or severely obese.
The disparities in obesity means that no single strategy is going to solve this increasing problem. What is clear is that exhorting people to lose weight is not enough, with obesity throwing it’s dangerous extra weight around and threatening to become the new normal among American adults, public health experts may do well to redefine what counts as being success and redouble their efforts renewed.
Each step up the BMI ladder from a healthy range to being overweight and beyond increases the risks of serious health problems and mortality. Prevention is the best medicine, but according to Ward at this point helping those that are obese to stabilize their weight may be the best way to improve health prospects to avoid going into severe and morbid obesity. Stabilizing weight could even be a starting point before moving to the goal of reduction.
“That could still be a public health victory if we could get people to stop gaining more weight,” explained Ward.
