1. Obesity in the U.S. Prevalence and Trends
Pennington Biomedical Research Center
Division of Education

2. Obesity in the U.S. Current Trends
Currently, about 66% of American adults are overweight and about 32% are obese.
The obesity weight class has increased the most over the past few decades.
Compared with prevalence rates reported in , the rates of obesity seen today are more than double what they were only thirty years ago.

3. Overweight is Rising
This overweight classification combines those who are classified as overweight (BMI ) and those who are obese (BMI ≥ 30).
66.3
65.7
64.5
56.0
Adapted from: the Centers for Disease Control and Prevention (CDC)

4. Obesity Continues to Rise
Trends in the United States
Obesity is defined as having a BMI ≥ 30
1996
1991
2004
Prevalence of obesity by state
No Data <10% %–14% %–19% %–24% ≥25%
Source: Behavioral Risk Factor Surveillance System, CDC

5. Obesity An estimated 66 million adults in the United States are obese.
Being either overweight or obese substantially raises one’s risk of morbidity from:
Hypertension
Dyslipidemia
Type 2 diabetes
Coronary heart disease
Stroke
Gallbladder disease
Osteoarthritis
Sleep apnea and respiratory problems
Endometrial, breast, prostate, and colon cancers.

6. Obesity Introduction
In addition to the increased risk for several diseases, higher body weights are also associated with increases in all-cause mortality.
An estimated 300,000 deaths per year are attributable to obesity.
As the second leading cause of preventable death in the United States today, overweight and obesity pose a major public health threat.

7. Obesity in the U.S. Race/Ethnic
The picture is even worse when rates are looked at by gender and ethnic backgrounds:
77 percent of Black women are overweight, and 50 percent are obese, while
72 percent of Mexican-American women are overweight, and 40 percent of Mexican American women are obese.
Significant differences in obesity exist among different racial or ethnic groups
CDC/NCHS; Flegal KM 2002

8. Obesity in the U.S. Socioeconomic Status
A Dutch study found a link between socioeconomic status (SES) and obesity.
In fact, those in the very low SES had the highest rates of obesity and consumed the most soft drinks, potatoes, fat, and meat.
A long term study found that African American women had higher rates of obesity than Caucasian regardless of SES.
Hulshof KFAM et al. 2003; Zhang and Wang 2004; Johnson-Down et al 1997

9. Obesity in the U.S. Socioeconomic Status
Higher socioeconomic group women:
Diet more often
Have greater access to resources
Have better nutrition knowledge
Are committed to slimness
Avoid high fat foods
Get more physical activity

10. In Developing Countries Obesity & SES
Higher socioeconomic group women:
Have more incidence of obesity
Have less malnutrition
Have less infection
Have a steady source of income and food
In fact, overweight is associated with wealth

11. Obesity in the U.S. What is the Cost?
According to a study of national costs attributed to both overweight and obesity, medical expenses accounted for 9.1% of the total U.S. medical expenditures in 1998.
Medical expenses for overweight and obesity may have reached as high as $78.5 billion in 1998.
In Louisiana alone, approximately $1.4 billion was spent on overweight and obesity-related medical expenses.

12. Obesity What are the Causes?
Overweight and obesity are the result of an energy imbalance over a long period of time.
While the whole picture is still unclear on how obesity develops, it is believed to involve the integration of social, behavioral, cultural, physiological, metabolic, and genetic factors.
Behavior and environment appear to play a large role the development of obesity, and are often the focus for prevention and treatment actions.

13. Energy Imbalance What is it?
Energy balance is like a scale where both sides are of equal weight.
An energy imbalance arises when the number of calories consumed is not equal to the number of calories used by the body.
Weight gain usually involves the combination of consuming too many calories and not expending enough enough through physical activity, although weight gain could result from one or the other.
Weight Gain
Calories Consumed > Calories Used
Weight Loss
Calories Consumed < Calories Used
No Weight Change
Calories Consumed = Calories Used
CDC

14. Obesity Diet and Exercise
Physical activity contributes to weight loss, especially when combined with a calorie reduction.
Physical activity is important in preventing overweight and obesity and in maintaining weight that is lost.
In addition to weight control, physical activity helps:
Prevent heart disease
Control cholesterol levels and diabetes
To slow bone loss associated with advancing age
Lower the risk of certain cancers
Reduce anxiety and depression

15. Body Mass Index Indicator of Weight Status
Body mass index (BMI) is a mathematical ratio taking into account an individual’s weight, in kilograms, and height, in meters squared (kg/m2). This measure can be used for adults 20 years of age and older.
BMI determines an individuals weight category.
With a BMI of:
You are considered:
Below 18.5
Underweight
Healthy Weight
Overweight
30 or higher
Obese
You can find tables on the web that that are ready-made for you.

16. Obesity Classes Class 1 Class 2 Class 3, Extreme obesity BMI of 30-35
BMI greater than 40

17. Waist Circumference
Waist circumference is a predictor of mortality and chronic disease.
It is a prognostic indicator along with BMI.
The presence of excess body fat in the abdomen, when out of proportion to total body fat, is considered an independent predictor of risk factors and ailments associated with obesity.
Men = Greater than 40 inches
Women = Greater than 35 inches

18. Waist Circumference & BMI And Disease Risk
Disease Risk * Relative to Normal Weight and Waist Circumference
BMI (kg/m2)
Obesity Class
Men ≤ 102 cm (≤ 40 in)
Women ≤ 88 cm (≤ 35 in)
> 102 cm (> 40 in)
> 88 cm (>35 in)
Underweight
< 18.5
-----
Normal
18.5 – 24.9
Overweight
25.0 – 29.9
Increased
High
Obesity
30.0 – 34.9
35.0 – 39.9 I II
Very High
Extreme Obesity
≥ 40
III
Extremely High
* Disease risk for type 2 diabetes, hypertension, and cardiovascular disease
Adapted from: Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults

19. Why is a BMI of 20-25 considered as a reference weight?
This is because the relationship between morbidity and mortality and BMI is minimal at that range.
Increased risk
Body Mass Index

20. Body Mass Index
It is important to remember that although BMI correlates with the amount of body fat a person has, it does not directly measure body fat.
However, with the exception of highly trained athletes, BMI is a good predictor of chronic disease and mortality in individuals.

21. In Summary…
The prevalence of overweight and obesity in the U.S. is higher than ever before.
BMI & waist circumference are correlated with body fat and can predict the risk for disease.
Being overweight or obese substantially raises one’s risk of morbidity from many diseases.
Significant differences exist in obesity among different racial or ethnic groups.
Diet and physical activity are important in the fight against obesity.

22. Pennington Biomedical Research Center
Division of Education
Heli J. Roy, PhD, RD, Associate Professor
Shanna Lundy, BS
Beth Kalicki
Division of Education Phillip Brantley, PhD, Director Pennington Biomedical Research Center Claude Bouchard, PhD, Executive Director
Edited: October 2009

23. About Our Company
The Pennington Biomedical Research Center is a world-renowned nutrition research center.
Mission:
To promote healthier lives through research and education in nutrition and preventive medicine.
The Pennington Center has several research areas, including:
Clinical Obesity Research
Experimental Obesity
Functional Foods
Health and Performance Enhancement
Nutrition and Chronic Diseases
Nutrition and the Brain
Dementia, Alzheimer’s and healthy aging
Diet, exercise, weight loss and weight loss maintenance
The research fostered in these areas can have a profound impact on healthy living and on the prevention of common chronic diseases, such as heart disease, cancer, diabetes, hypertension and osteoporosis.
The Division of Education provides education and information to the scientific community and the public about research findings, training programs and research areas, and coordinates educational events for the public on various health issues.
We invite people of all ages and backgrounds to participate in the exciting research studies being conducted at the Pennington  Center in Baton Rouge, Louisiana. If you would like to take part, visit the clinical trials web page at or call (225)

24. Additional Resources:
MyPyramid: Food Pyramid. Available at:
Overweight and Obesity: Contributing Factors. Available at:
Calculate your daily calorie needs. Available at:
How many calories will your activity burn? Available at:

25. References
Centers for Disease Control and Prevention. Available at:
Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults. Available at:
Obesity trends among U.S. adults. Available at:
Johnson-Down L, O'Loughlin L, Koski KG, and Gray-Donald K. High Prevalence of Obesity in Low Income and Multiethnic Schoolchildren: A Diet and Physical Activity Assessment. The Journal of Nutrition Vol. 127 No. 12 December 1997, pp

26. References
Legal KM, Carroll MD, Ogden CL, Johnson CL. Prevalence and trends in obesity among US adults, JAMA. 2002;288:
Zhang, Q and Wang Y. Trends in the association between obesity and socioeconomic status in US Adults: Obesity Research 12: , 2004.
Hulshof KF, Brussaard JH, Kruizinga AG, Telman J, Lowik MR. Socio-economic status, dietary intake and 10 y trends: the Dutch National Food Consumption Survey. Eur J Clin Nutr Jan;57(1):