Obesity is high and in the U.S., but the proportion of those with severe obesity 鈥� especially women 鈥� has climbed since a decade ago, according to .
The U.S. obesity rate is about 40%, according to a 2021-2023 survey of about 6,000 people. Nearly 1 in 10 of those surveyed reported severe obesity, the U.S. Centers for Disease Control and Prevention found. Women were nearly twice as likely as men to report severe obesity.
The overall obesity rate appeared to tick down vs. the 2017-2020 survey, but the change wasn鈥檛 considered statistically significant; the numbers are small enough that there鈥檚 mathematical chance they didn鈥檛 truly decline.
That means it鈥檚 too soon to know whether for obesity, including blockbuster weight-loss drugs such as Wegovy and Zepbound, can help ease the epidemic of the chronic disease linked to a host of health problems, according to Dr. Samuel Emmerich, the CDC public health officer who led the latest study.
鈥淲e simply can鈥檛 see down to that detailed level to prescription medication use and compare that to changes in obesity prevalence,鈥� Emmerich said. 鈥淗opefully that is something we can see in the future.鈥�
Most telling though, the results that show that the overall obesity rate in the U.S. has not changed significantly in a decade, even as the rate of severe obesity climbed from nearly 8% in the 2013-2014 survey to nearly 10% in the most recent one. Before that, obesity had increased rapidly in the U.S. since the 1990s, federal surveys showed.
Measures of obesity and severe obesity are determined according to body mass index, a calculation based on height and weight. People with a BMI of 30 are considered to have obesity; those with a BMI of 40 or higher have severe obesity. BMI is regarded as a flawed tool but remains widely used by doctors to screen for obesity.
鈥淪eeing increases in severe obesity is even more alarming because that鈥檚 the level of obesity that鈥檚 most highly associated with some of the highest levels of cardiovascular disease and diabetes and lower quality of life,鈥� said Solveig Cunningham, an Emory University global health professor who specializes in obesity.
Cunningham, who was not involved in the new study, said it鈥檚 not clear why rates of severe obesity are going up, or why they were higher among women. Factors could include the effects of hormones, the impact of childbearing or other causes that require further study, she said.
The new study also found that obesity rates varied by education. Almost 32% of people with a bachelor鈥檚 degree or higher reported having obesity, compared with about 45% of those with some college or a high school diploma or less.
The new report follows the release of data from U.S. states and territories that showed that in 2023, the rate of obesity ranged widely by place, from a high of more than 41% of adults in West Virginia to a low of less than 24% of adults in Washington, D.C. Rates were highest in the Midwest and the South.
All U.S. states and territories posted obesity rates higher than 20%. In 23 states, more than 1 in 3 adults had obesity, the data showed. Before 2013, no state had a rate that high, said Dr. Alyson Goodman, who leads a CDC team focused on population health.
Color-coded U.S. maps tracking the change have gradually shifted from green and yellow, the hues associated with lower obesity rates, to orange and dark red, linked to higher prevalence.
鈥淪ometimes, when you look at all that red, it鈥檚 really discouraging,鈥� Goodman said.
But, she added, recent emphasis on understanding obesity as a metabolic disease and new interventions, such as the new class of weight-loss drugs, gives her hope.
The key is preventing obesity in the first place, starting in early childhood, Cunningham said. Even when people develop obesity, preventing additional weight gain should be the goal.
鈥淚t鈥檚 really hard to get obesity to reverse at the individual level and at the population level,鈥� Cunningham said. 鈥淚 guess it鈥檚 not surprising that we鈥檙e not seeing downward shifts in the prevalence of obesity.鈥�
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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute鈥檚 Science and Educational Media Group. The AP is solely responsible for all content.
Jonel Aleccia, The Associated Press
