Abstract
Introduction: There are numerous health disparities impacting African Americans and Hispanics compared to other racial and ethnic groups in the US leading to poorer clinical outcomes. Obesity is an important risk factor predisposing to cardiac and renal diseases and it is important to quantify differences in obesity in greater detail. Hypothesis: African Americans and Hispanics may be disproportionately and adversely impacted by obesity. Methods: From 77007 participants in 8 NHANES surveys (between 2003-2004 and 2017-2018), we included 39952 aged 20-79 years. 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. The R language was used to perform statistical analyses. Results: Morbid obesity is as more common in black women (16%) compared with white or Hispanic women (both 8%). Black women are more overweight, obese, or morbidly obese compared with black men (80% vs 71%). Black men (7%) have a higher prevalence of morbid obesity compared to white (5%), Hispanic (5%), or “other” (race other than Hispanic, black, Asian, or white) racial/ethnic groups (4%). Hispanic men (80%) and African American women (80%) have the highest prevalence of overweight/obesity/morbid obesity. Normal weight is more common among race/ethnicity ‘other’ in both men and women. White women have a higher prevalence of normal weight compared to white men (34% vs 25%). Conclusion: There are important differences in the prevalence of obesity and morbid obesity between racial and ethnic groups in US adults. More emphasis needs to be placed on preventing/treating morbid obesity, particularly in Hispanic men and African American women, to reduce CV risk and correct disparities in health outcomes.
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