Fall 2001 Issue
Obesity: A Growing Epidemic Among Americans
EPIDEMIC - a word once reserved for massive outbreaks of infectious disease is now being used by medical professionals to describe the prevalence and rapid rise of obesity in the United States. With over 60 percent of American adults overweight and 25 percent obese, the numbers alone support the use of the word epidemic.
Obesity, defined as a body mass index (BMI) greater than or equal to 30 (see box, page 2), has increased in both sexes; across all age groups, races, and educational levels; and among smokers and nonsmokers.
It is the leading lifestyle-related cause of disease and death in the United States after smoking. A growing number of Americans are putting themselves at risk: The number of obese adult Americans increased more than 50 percent between 1980 and 1994, according to a 2000 CDC study.
The increase of overweight young people is even more dramatic. Between 1980 and 1994, the number of overweight children and adolescents in the United States doubled. Overall, 10 to 15 percent of children and adolescents are overweight, and of these, 61 percent have at least one or more cardiovascular disease risk factor, such as elevated cholesterol or hypertension. What does this say about the nation’s health?
“Obesity is not a benign disorder,” says William Dietz, M.D., Ph.D., director of CDC’s Division of Nutrition and Physical Activity. “It’s a major public health concern because it is associated with chronic diseases including cardiovascular disease, diabetes, and some types of cancer.” In children, being overweight leads to hypertension, abnormal lipid values, sleep apnea, gallbladder disease, and bone abnormalities - particularly of the legs. Type 2 diabetes, formerly called adult onset diabetes, is now occurring in adolescents.
“A number of lifestyle changes have occurred synchronously that may contribute to obesity,” Dietz says. “People are drinking more sodas, skipping more meals, and eating out more. Restaurants are serving larger portions. Busy people have little time to cook healthy meals for their families, and grocery stores offer hundreds of time-saving prepared foods containing high levels of sugar and fat. Physical activity has declined dramatically.”
Charlene Burgeson, public health advisor in CDC’s Division of Nutrition and Physical Activity, says, “The equation is simple. Whether a person is overweight or not depends on the difference between the amount of calories consumed and the amount expended. To control weight, Americans must engage in both healthy eating and regular physical activity.”
Burgeson points to the change in lifestyles as a major contributing factor to physical inactivity. Exercise, such as walking or bicycling to work or school, is no longer a natural part of a daily routine, largely because communities are not designed to facilitate it, she says. To get where we need to go, we must drive a car. In many communities, there are no sidewalks, only roads, so often it is not even safe to walk.
In addition, Burgeson says many schools are dropping recess and physical activities from their schedules. According to CDC, in 1999, only 29 percent of high school students attended daily physical education classes compared to 42 percent in 1991. Currently, one in three high school students does not participate regularly in vigorous physical activity.
“We have to create safe environments that encourage physical activity, and we need to create an awareness that we aren’t making healthy choices,” says Burgeson. In an effort to promote physical activity and improve eating habits, CDC is implementing a variety of initiatives for adults and children. These programs include:
- ACEs: Active Community Environments - an initiative to promote walking and bicycling, as well as the development of accessible recreation facilities;
- KidsWalk-to-School - a guide that encourages individuals and organizations to work together to identify and create safe walking routes to school;
- 5-A-Day for Better Health - a national effort, in partnership with the National Cancer Institute, to increase the per capita consumption to five or more servings of fruits and vegetables daily.
In addition, CDC and the CDC Foundation recently partnered with MetLife Foundation to develop guides for parents and teachers to promote physical activity.
CDC is continually working to educate Americans that obesity is an epidemic that can no longer be ignored. For more information on these programs, visit these related web sites:
- Rosemarie Perrin