Almost one in two Americans will be obese by 2030

By Dr. Liji Thomas, MDDec 19 2019

A shocking new study led by Harvard T.H. Chan School of Public Health reveals that by 2030, just a decade away, almost half of all Americans will be suffering from obesity – making this the biggest epidemic ever in history. And that’s not all – half of these obese individuals will be severely obese, or, to put it in simple terms, they will be over their expected weight by more than 100 pounds.

In contrast, today 18% of people are severely obese, while 40% of the population is obese. The study was published on December 19, 2019 in the New England Journal of Medicine.

The prevalence of obesity is not uniform across the US, with more than half of the population in 29 states predicted to be obese. At least 35% (and probably, nearer 40%) of people in every single state of America will have this condition – and many states will have a much higher prevalence, around 60%.

Close to half of US population projected to have obesity by 2030. Image Credit: Prazis Images / Shutterstock

The study

The researchers analyzed data on the body mass index (BMI) reported by over 6 million adults as part of the Behavioral Risk Factor Surveillance System Survey (BRFSS) over the 26 years from 1993 to 2016. The BMI is calculated as the weight of the individual in kilograms divided by the squared height in meters. A BMI between 18 and 25 is generally taken as normal. At and over 30, the BMI signals obesity, while severe obesity is diagnosed by a BMI of 35 and above.

Since the survey data was based on self-reported BMI, the researchers adopted specialized analytical methods to obtain the corrected results, after compensating for the inevitable bias that accompanies self-reporting. The large volume of data allowed them to look for the association between obesity and the geographical state, the economic status and the other subsets of this survey group.

The findings

The researchers found that most states will have more than 35% of obesity, and that the prevalence in a number of states will be 60%. Severe obesity will become the most frequent category by BMI for the following subsets of people: women, non-Hispanic blacks, and people earning less than $50,000 a year.

The reasons

Public health expert Aviva Must says the reasons for obesity have to do with a change in food pricing and consumption patterns. While earlier, people who were poor had little to eat, in today’s America, hunger is not as much a reality as is the lack of purchasing power to buy healthy food. Sugary drinks and highly processed foods are freely available, pushing up the caloric intake but not providing the other nutrients needed to use these calories efficiently.

Secondly, fast food is unhealthy but cheaper than healthy food, and has become a less expensive option over the years. This is one reason why the low-income classes are at greater risk for obesity than the rich. Other factors include less physical activity with the changing patterns of work, and structural racism.

Implications

The researchers point to the troubling implications of this high incidence of obesity, which severely affects health and requires expensive healthcare inputs to prevent and treat further complications such as diabetes and related conditions, cardiovascular disease, hypertension and osteoarthritis, as well as psychological issues related to poor self-esteem. Both chronic medical conditions and spending on health is bound to shoot up with this surge in obesity. On the other hand, the increased risk of acute and chronic ill-health will have a negative impact on life expectancy as well.

The study also brings out the association of obesity with low-income groups. Says researcher Zachary Ward, “The high projected prevalence of severe obesity among low-income adults has substantial implications for future Medicaid costs. In addition, the effect of weight stigma could have far-reaching implications for socioeconomic disparities as severe obesity becomes the most common BMI category among low-income adults in nearly every state.”

Must says, “Given how notoriously difficult obesity is to treat once it's established, you can see that we're in an untenable situation. It will probably take lots of federal, state and local policy interventions and regulations to have a big impact. We can't rely on individual behavior change in an environment that is so obesity promoting.”

The scientists are interested in the impact this study will have upon those who shape state policies. For instance, it is known that imposing heavy taxes on beverages sweetened with sugars, which are typically preferred by children and adults alike, can effectively and inexpensively curb an increase in the rate of obesity. Similar preventive measures include doing away with the tax deduction for advertising unhealthy foods to poor and socially disadvantaged sections of society, while improving the nutritional value of snacks sold at schools.

Another successful program was the Special Supplemental Nutrition Program for Women, Infants and Children which helped reduce obesity rates in children by promoting healthy foods provided through the program to pregnant and post-childbirth mothers and children aged 2-4 years.

Such measures are recommended by the researchers, who say, “Prevention is going to be key to better managing this epidemic.”