Abstract
Introduction: Obesity is increasing globally. Obesity exacerbates risk for diabetes, dyslipidemia, hypertension, and ASCVD. We evaluated the prevalence of overweight and obese adults in the US during 2003-2018. HYPOTHESIS: The percentage of men and women overweight/obese is increasing continuously and may exceed the percentage with ‘normal’ weight. Methods: From 77007 participants in 8 NHANES surveys (between 2003-2004 and 2017-2018), we selected 39952 aged 20-79 years for this analysis. Participants with BMI data (n = 39440, 98.7%) were categorized as being underweight (BMI < 18.5), normal (BMI 18.5 - <25), overweight (BMI 25 - <30), obese (BMI 30 - <40) or morbidly obese (BMI 40+). Results were extrapolated to the entire US population (50 states plus the District of Columbia) using the direct method to the US Census 2000 population. Statistical analyses were performed in the R language. Results: There are statistically significant mean increases in BMI (95% confidence interval and p-value) between successive surveys of 0.18 (0.11, 0.25, p<0.0001) for men and 0.24 (0.14, 0.33, p<0.0001) for women. There are clear trends in morbid obesity (BMI 40+) from 3% in the first survey to 7% among men in the last survey, and from 7% to 12% in women. Obesity/morbid obesity (BMI 30+) increased from 31% to 44% in men and from 34% to 43% in women. About 78% of adult men are either overweight, obese, or morbidly obese (BMI 25+) in the most recent survey, an increase from 71% in the first survey. Among women 70% are either overweight, obese, or morbidly obese, an increase from 63% in the first survey. Very few US adults (1-2%) are underweight (BMI<18.5). About one quarter of US adults have normal weight (BMI 18.5- 25). Conclusion: During the period 2003-2018, there has been a substantial rise among both US adult men and women in BMI who are overweight/obese. This necessitates invigorated public education about the clinical hazards posed and the need for lifestyle/dietary modification to stem this crisis.
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