Seven authors assembled a seven-page study on the future of the obesity epidemic – and according to the study, it is clear the problem is an actual epidemic. The results were published on May 7 in the American Journal of Preventative Medicine predicting the obesity level in the U.S. to hit 42% and severe obesity to hit 11%.
The authors ended the study in 2008 showing the obesity rate at 33.8%, which represented a 100% increase from 1976 to 1980 and a 50% increase from 1988 to 1994. The study reported that severe obesity was nearly non-existent in the early 1970s, but has increased at a faster pace than obesity and doesn’t show signs of slowing.
The next 20 years don’t appear to be any less gloomy than the previous 20. Over the next two decades, obesity is projected to increase 33% and severe obesity increase by 130% in prevalence.
These are a lot of numbers and percentages. Predictions and scientific assumptions based upon the Body Mass Index (BMI) calculations. The BMI calculates a person’s health based upon their weight to height ratio. It is the same system the Center for Disease Control and Prevention (CDC) uses to gauge overweight and obesity in the U.S. The CDC says its uses the BMI because it is an inexpensive and easy way for clinicians to track the general public.
Although the BMI is widely used, it’s accuracy is commonly questioned and at times criticized. Several physicians and institutions prefer other forms of tracking obesity like the waist-to-hip ratio (which divides the circumference of the waist by the hips), caliper measurements (measuring the percentage of body fat from four locations on the body with calipers), BodPod, and underwater weighing. Despite the various ways to calculate body fat, each have their shortcomings.
When it comes to gauging the obesity rate, the BMI has cornered the market for being used by government agencies and, as proven by the recent study, by most medical institutions.
“For the average American, it is a reasonable score to help compare populations,” said Dr. Scott Rand, Primary Care Sports Medicine Fellowship Director and physician for the Methodist Center for Orthopedic Surgery and Sports Medicine at Willowbrook in Houston.
Personal BMI Use
To see what all the fuss was about, I checked my own BMI. At 6-foot tall and 169 pounds, my BMI is 22.9. Normal BMI for me is between 18.5 and 24.9, putting me close the middle. Of course, it was nice to see where I stood for health reasons. Oddly enough, for my height, the normal weight could be anywhere from 136 to 184 pounds. People already consider me pretty thin. I don’t believe I could safely drop 30 pounds.
What is concerning is the oversimplification of obesity. The BMI testing is inexpensive and easy, but it also leaves a lot to be desired – like pertinent information including gender or how active the person is. Dropping 30 pounds, which would still keep me in my “normal” weight range, doesn’t seem healthy; the same could be said for a 6-foot woman weighing in at 184 pounds.
The BMI doesn’t apply to athletes or to people with increased muscularity rather than body fatness. If athletes weren’t exempt then the organized sports industry would be trouble with high cholesterol and potential type 2 diabetes. The NFL’s Detroit Lions had 71 players on its 2011 roster. According to accepted BMI calculations, only five players were at a normal weight, while 30 were overweight and 36 were considered obese.
So maybe the BMI isn’t completely accurate, but when it comes to gauging the masses, what system is ever completely accurate? The authors admit that one of the limitations of the study was the reliance on self-reported height and weight. Even if the percentages have room for error, obesity seems to be just as big as what the authors report.
“The biggest health problem we have in the U.S. is the obesity epidemic,” Rand said. “Obesity itself is not a disease, but a condition that increases risk for many other diseases. Increasing BMI tracks as an independent risk factor for diabetes, heart disease, osteoarthritis and being restricted from flying Southwest Airlines.”
Follow the Money
One can’t dismiss obesity just because every calculation for the condition isn’t 100% accurate. Perhaps one way to gauge obesity in America is financially. The costs of obesity could be as high as $147 billion per year, according to the study. In 2008, the average medical cost for obese individuals was $1,429 higher than those of normal weight. The combined savings on medical expenditures over the next 20 years, if obesity levels remained at its 2010 levels, would total $549.5 billion.
As the medical expenditures for obesity continue to climb, the costs behind the problem haven’t changed much. The amount of restaurants per 10,000 people increased to 22.9 in 2008 from 12.1 in 2000. Fast-food prices have remained flat over the past 20 years, ranging from $5.95 in 1990 to $5.77 in 2008. The price index for groceries have actually decreased from 0.53 in 1990 to 0.34 in 2008.
Rand said obesity has become an epidemic due to the easy availability of food, fast-food, increased screen time (television and Internet), and lifestyles that make exercise something people have to add to their day rather than something that is required to get through the day.
The study included individual variables of gender, age, race, education, marital status, and annual household income. The state-level variables included annual unemployment rates; prices for alcohol, gas, and fast-food; prices of groceries relative to non-grocery items; prices of healthier foods relative to less-healthy foods; access to the Internet; and the number of fast-food and full-service restaurants per 10,000 people.
According to the CDC, no states have an obesity rate of less than 20%, with the lowest being Colorado at 21%. Only 14 states have a rate of less than 25%. There are 12 states that have an obesity rate of at least 30% with Mississippi at 34% being the highest. In 2000, there were no states with an obesity level of 30%.
Too Much to Combat
Obesity is increasing at 0.6% annually. Fast-food restaurants continue to pop up across the country at an alarming rate – McDonald’s franchises have increased by 20% since 2001. Combined, there are currently less than 100,000 fitness facilities, heath food stores, and weight loss service businesses, which is only one option per approximately 3,000 people – compared to one fast-food restaurant per approximately 400 people.
For many, fast-food or cheap, processed groceries are the only affordable source of food. The U.S. Department of Agriculture reported nearly 50 million people live in food-insecure households in 2010.
Another contributor for obesity, according to the study, is the access to the Internet which has increased from 1% in 1990 to 68.8% in 2008.
There are a lot of contributors for the current obesity crisis any way you try to scale it – BMI, Bod Pod, calipers. Will the obesity rate hit 42% by 2030? If it does, we’ll at least know how we got there no matter how much we try to blame the inaccuracy of the various calculators.
Follow Dustin Bass on Twitter @dbass_cmn