Defining Overweight and Obesity

Overweight and obesity are both labels for ranges of weight that are greater than what is generally considered healthy for a given height. The terms also identify ranges of weight that have been shown to increase the likelihood of certain diseases and other health problems.

Definitions for Adults

For adults, overweight and obesity ranges are determined by using weight and height to calculate a number called the "body mass index" (BMI). BMI is used because, for most people, it correlates with their amount of body fat.

An adult who has a BMI between 25 and 29.9 is considered overweight. An adult who has a BMI of 30 or higher is considered obese.

See the following table for an example.

Height Weight Range 124 lbs or less 5' 9"

BMI

Considered

Below 18.5 Underweight Overweight Obese

125 lbs to 168 lbs 18.5 to 24.9 Healthy weight 169 lbs to 202 lbs 25.0 to 29.9 203 lbs or more 30 or higher

It is important to remember that although BMI correlates with the amount of body fat, BMI does not directly measure body fat. As a result, some people, such as athletes, may have a BMI that identifies them as overweight even though they do not have excess body fat. For more information about BMI, visit Body Mass Index. Other methods of estimating body fat and body fat distribution include measurements of skinfold thickness and waist circumference, calculation of waist-to-hip circumference ratios, and techniques such as ultrasound, computed tomography, and magnetic resonance imaging (MRI).

Definitions for Children and Teens

For children and teens, BMI ranges above a normal weight have different labels (overweight and obese). Additionally, BMI ranges for children and teens are defined so that they take into account normal differences in body fat between boys and girls and differences in body fat at various ages. For more information about BMI for children and teens (also called BMI-for-age), visit BMI for Children and Teens. For more, see Defining Childhood Overweight and Obesity.

Assessing Health Risks Associated with Overweight and Obesity

BMI is just one indicator of potential health risks associated with being overweight or obese. For assessing someone's likelihood of developing overweight- or obesity-related diseases, the National Heart, Lung, and Blood Institute guidelines recommend looking at two other predictors:

The individual's waist circumference (because abdominal fat is a predictor of risk for obesityrelated diseases). Other risk factors the individual has for diseases and conditions associated with obesity (for example, high blood pressure or physical inactivity).

For more information about the assessment of health risk for developing overweight- and obesityrelated diseases, visit the following Web pages from the National Heart, Lung, and Blood Institute:

Assessing Your Risk Body Mass Index Table Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults

Causes and Consequences

Is there a quick answer to the question, "what contributes to overweight and obesity?" Overall there are a variety of factors that play a role in obesity. This makes it a complex health issue to address. This section will address how behavior, environment, and genetic factors may have an effect in causing people to be overweight and obese.

The Caloric Balance Equation

Overweight and obesity result from an energy imbalance. This involves eating too many calories and not getting enough physical activity. Body weight is the result of genes, metabolism, behavior, environment, culture, and socioeconomic status. Behavior and environment play a large role causing people to be overweight and obese. These are the greatest areas for prevention and treatment actions. Adapted from U.S. Surgeon General's Call to Action to Prevent and Decrease Overweight and Obesity, 2001 When it comes to maintaining a healthy weight for a lifetime, the bottom line is calories count! Weight management is all about balance balancing the number of calories you consume with the number of calories your body uses or "burns off."

A calorie is defined as a unit of energy supplied by food. A calorie is a calorie regardless of its source. Whether you're eating carbohydrates, fats, sugars, or proteins, all of them contain calories. Caloric balance is like a scale. To remain in balance and maintain your body weight, the calories consumed (from foods) must be balanced by the calories used (in normal body functions, daily activities, and exercise).

If you are

Your caloric balance status is .

Maintaining your "in balance." You are eating roughly the same number of calories that your body is weight using. Your weight will remain stable. Gaining weight "in caloric excess." You are eating more calories than your body is using. You will store these extra calories as fat and you'll gain weight. "in caloric deficit." You are eating fewer calories than you are using. Your body is pulling from its fat storage cells for energy, so your weight is decreasing.

Losing weight

Genetics and the environment may increase the risk of personal weight gain. However, the choices a person makes in eating and physical activity also contributes to overweight and obesity. For more, see Healthy Weight Balancing Calories.

Environment

People may make decisions based on their environment or community. For example, a person may choose not to walk to the store or to work because of a lack of sidewalks. Communities, homes, and workplaces can all influence people's health decisions. Because of this influence, it is important to create environments in these locations that make it easier to engage in physical activity and to eat a healthy diet. The Surgeon General's Call to Action to Prevent and Decrease Overweight and Obesity 2001 identified action steps for several locations that may help prevent and decrease obesity and overweight. The following table provides some examples of these steps.

Location Home

Steps to Help Prevent and Decrease Overweight and Obesity Reduce time spent watching television and in other sedentary behaviors Build physical activity into regular routines Ensure that the school breakfast and lunch programs meet nutrition standards Provide food options that are low in fat, calories, and added sugars

Schools

Provide all children, from prekindergarten through grade 12, with quality daily physical education Create more opportunities for physical activity at work sites Promote healthier choices including at least 5 servings of fruits and vegetables a day, and reasonable portion sizes Encourage the food industry to provide reasonable food and beverage portion sizes Encourage food outlets to increase the availability of low-calorie, nutritious food items Create opportunities for physical activity in communities

Work Community

Genetics
The Population
"Despite obesity having strong genetic determinants, the genetic composition of the population does not change rapidly. Therefore, the large increase in . . . [obesity] must reflect major changes in nongenetic factors." Hill, James O., and Trowbridge, Frederick L. Childhood obesity: future directions and research priorities. Pediatrics. 1998; Supplement: 571. How do genes affect obesity? Science shows that genetics plays a role in obesity. Genes can directly cause obesity in disorders such as Bardet-Biedl syndrome and Prader-Willi syndrome. However genes do not always predict future health. Genes and behavior may both be needed for a person to be overweight. In some cases multiple genes may increase one's susceptibility for obesity and require outside factors; such as abundant food supply or little physical activity. For more information on the genetics and obesity visit Obesity and Genetics: A Public Health Perspective.

Other Factors
Diseases and Drugs Some illnesses may lead to obesity or weight gain. These may include Cushing's disease, and polycystic ovary syndrome. Drugs such as steroids and some antidepressants may also cause weight gain. A doctor is the best source to tell you whether illnesses, medications, or psychological factors are contributing to weight gain or making weight loss hard.

State-Based Programs
NEW! Communities Putting Prevention to Work: States and Territories Initiative The U.S. Department of Health and Human Services (HHS) awarded more than $119 million to states and U.S. territories to support public health efforts to reduce obesity, increase physical activity, improve nutrition, and decrease smoking. This initiative is funded under the American Recovery and Reinvestment Act of 2009.

CDC's State-Based Nutrition and Physical Activity Program to Prevent Obesity and Other Chronic Diseases
Created in 1999, CDC's Division of Nutrition, Physical Activity, and Obesity (DNPAO) currently funds 25 states to address the problems of obesity and other chronic diseases through statewide efforts coordinated with multiple partners. The program's primary focus is to create policy and environmental changes that will improve the health of places where Americans live, work, learn, and play, working to build lasting and comprehensive efforts to address obesity and other chronic diseases through a variety of nutrition and physical activity strategies. To read about specific nutrition and physical activity interventions that our funded states are developing or implementing go toFunded States.

Goal
The program goal is to prevent and control obesity and other chronic diseases through healthful eating and physical activity. The goal will be achieved through strategic public health efforts aimed at the following program objectives: Outcome objectives:

Decrease prevalence of obesity. Increase physical activity. Improve dietary behaviors related to population burden of obesity and chronic diseases.

Impact objectives:

Increase the number, reach, and quality of policies and standards set in place to support healthful eating and physical activity in various settings. Increase access and use of environments to support healthful eating and physical activity in various settings. Increase the number, reach and quality of social and behavioral approaches that complement policy and environmental strategies to promote healthful eating and physical activity.

The state program will develop strategies to leverage resources and coordinate statewide efforts with multiple partners to address all of the following DNPAO principal target areas:

Increase physical activity. Increase the consumption of fruits and vegetables. Decrease the consumption of sugar sweetened beverages. Increase breastfeeding initiation, duration and exclusivity. Reduce the consumption of high energy dense foods. Decrease television viewing.

For these behavior targets, as well as health outcomes of obesity and other chronic diseases, the program emphasizes reducing health disparities including but not limited to those related to race/ethnicity, socioeconomic status, geography, sex, age, and disability.

dult Obesity
Obesity is common, serious and costly. More than one-third of U.S. adults (35.7%) are obese. [Read data brief] No state has met the nation's Healthy People 2010 goal to lower obesity prevalence to 15%. The number of states with an obesity prevalence of 30% or more has increased to 12 states in 2010. In 2009, nine states had obesity rates of 30% or more. [See maps ] In 2000, no state had an obesity prevalence of 30% or more. [Read article] Obesity-related conditions include heart disease, stroke, type 2 diabetes and certain types of cancer, some of the leading causes of death. [Read guidelines ] In 2008, medical costs associated with obesity were estimated at $147 billion; the medical costs paid by third-party payors for people who are obese were $1,429 higher than those of normal weight. [Read summary ] Obesity prevalence varies across states and regions [See maps]

By state, obesity prevalence, on the basis of self-report, ranged from 21% in Colorado to 34% in Mississippi in 2010. Twelve states had a prevalence of 30% or more. The South has the highest obesity prevalence (29.4%) followed by the Midwest (28.7%), Northeast (24.9%) and the West (24.1%).

Obesity affects some groups more than others. Non-Hispanic blacks have the highest rates of obesity (44.1%) compared with Mexican Americans (39.3%), all Hispanics (37.9%) and non-Hispanic whites (32.6%). [Read article ] Obesity and socioeconomic status. [Read data brief (PDF-1.07Mb)]

Among non-Hispanic black and Mexican-American men, those with higher incomes are more likely to be obese than those with low income. Higher income women are less likely to be obese than low-income women. There is no significant relationship between obesity and education among men. Among women, however, there is a trendthose with college degrees are less likely to be obese compared with less educated women. Between 19881994 and 20072008 the prevalence of obesity increased in adults at all income and education levels

Data and Statistics

Obesity rates among all children in the United States
(Data from the National Health and Nutrition Examination Survey) [Read article]

Approximately 17% (or 12.5 million) of children and adolescents aged 219 years are obese. Since 1980, obesity prevalence among children and adolescents has almost tripled. There are significant racial and ethnic disparities in obesity prevalence among U.S. children and adolescents. In 20072008, Hispanic boys, aged 2 to 19 years,were significantly more likely to be obese than non-Hispanic white boys, and non-Hispanic black girls were significantly more likely to be obese than non-Hispanic white girls.

Obesity rates among low-income preschool children

(Data from the Pediatric Nutrition Surveillance System)

1 of 7 low-income, preschool-aged children is obese. [Check out this Fact Sheet to learn more(PDF-1.5Mb)] County obesity rates are variable within states. Even states with the lowest prevalence of obesity have counties where many low-income children are obese and at risk for chronic disease.

2009 State Prevalence Among Low-Income Children Aged 2 to 4 Years

20072009 County Obesity Prevalence Among Low-Income Children Aged 2 to 4 Years

U.S. Obesity Trends

National Obesity Trends
More than one-third of U.S. adults (35.7%) are obese. Approximately 17% (or 12.5 million) of children and adolescents aged 219 years are obese. [Data from the National Health and Nutrition Examination Survey (NHANES)]

Trends by State 19852010

During the past 20 years, there has been a dramatic increase in obesity in the United States and rates remain high. In 2010, no state had a prevalence of obesity less than 20%. Thirty-six states had a prevalence of 25% or more; 12 of these states (Alabama, Arkansas, Kentucky, Louisiana, Michigan,

Mississippi, Missouri, Oklahoma, South Carolina, Tennessee, Texas, and West Virginia) had a prevalence of 30% or more. The animated map below shows the United States obesity prevalence from 1985 through 2010.

Percent of Obese (BMI > 30) in U.S. Adults <previous next> play stop

2010 State Obesity Rates State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho % State 32.2 Illinois 24.5 Indiana 24.3 Iowa 30.1 Kansas 24.0 Kentucky 21.0 Louisiana 22.5 Maine % State 28.2 Montana 29.6 Nebraska 28.4 Nevada 31.3 New Jersey 31.0 New Mexico 26.8 New York % State 23.0 Rhode Island % 25.5

26.9 South Carolina 31.5 22.4 South Dakota 27.3 30.8 31.0 22.5 23.2 26.0 25.5 26.3 25.1 23.8 Texas 25.1 Utah 23.9 Vermont

29.4 New Hampshire 25.0 Tennessee

28.0 Maryland 27.1 North Carolina 27.8 Virginia District of Columbia 22.2 Massachusetts 23.0 North Dakota 27.2 Washington 26.6 Michigan 29.6 Minnesota 22.7 Mississippi 26.5 Missouri 30.9 Ohio 24.8 Oklahoma 34.0 Oregon 30.5 Pennsylvania 30.4 Wisconsin 26.8 Wyoming 28.6

29.2 West Virginia 32.5

The data shown in these maps were collected through the CDC's Behavioral Risk Factor Surveillance System (BRFSS), on the basis of self-reported weight and height. Each year, state health departments use standard procedures to collect data through a series of monthly telephone interviews with U.S. adults. Prevalence estimates generated for the maps may vary slightly from those generated for the states by the BRFSS as slightly different analytic methods are used.

County-Specific Obesity, Diabetes, and Physical Inactivity Prevalence

Combining county-level estimates for obesity, diagnosed diabetes, and leisure time physical inactivity for 2008 show that counties with high levels of all three conditions are primarily concentrated in the South and Appalachia, while counties with low levels of all three conditions are primarily concentrated in the Northeast and West.

Strategies and Solutions

There is no single or simple solution to the childhood obesity epidemic, but learn what states, communities, and parents can do to help make the healthy choice the easy choice for children, adolescents, and their families.

States and communities can

Assess their retail food environment to better understand the current landscape and differences in accessibility to healthier foods. See Healthier Food Retail: Beginning the Assessment Process in Your State or Community (PDF522k). Provide incentives to existing supermarkets and farmers' markets to establish their businesses in low-income areas or to sell healthier foods. See Improving Access to Healthy Food PolicyLink and The Food Trust . Expand programs that bring local fruits and vegetables to schools. See National Farm to School Network . Put salad bars in schools. See Let's Move Salad Bars to Schools .

Adopt standards for child care licensing that reduce the availability of less healthy foods and sugar drinks, and limit screen time. See Preventing Childhood Obesity in Early Care and Education Programs (PDF-6.4Mb). Enroll elementary, middle, and high schools in USDA's Team Nutrition program and apply for certification through the HealthierUS School Challenge. See USDA Team Nutrition and HealthierUS School Challenge. Increase access to free drinking water and limit the sale of sugar drinks in schools by establishing school wellness and nutrition policies. See Nutrition Standards for Foods in Schools and Water in Schools . Support breastfeeding in hospitals and the workplace. See Breastfeeding Promotion & Support to find out how Health Care and Employment can support breastfeeding. Create and maintain safe neighborhoods for physical activity and improve access to parks and playgrounds. See National Center for Safe Routes to School and National Recreation and Parks Association .

Parents can

Support quality daily physical education in schools and daily physical activity in child care facilities. See Working with Schools to Increase Physical Activity Among Children and Adolescents in Physical Education Classes andSPARK (Sports, Play and Active Recreation for Kids) .

Follow the advice of the American Academy of Pediatrics and limit media time for kids to no more than 1 to 2 hours of quality programming per day whether at home, school or child care. See AAP Recommendation on Television Time for Children and Adolescents . Visit the child care centers to see if they serve healthier foods and drinks, and limit TV and video time. See National Association of Child Care Resource & Referral Agencies .

Work with schools to limit foods and drinks with added sugar, fat and salt that can be purchased outside the school lunch program. See Recommended Nutrition Standards for Foods Outside of School Meal Programs(PDF-1.5Mb).

Provide plenty of fruits and vegetables, limit foods high in fat and sugar, and prepare healthier foods at family meals. See 2010 Dietary Guidelines for Americans andHealthy Recipes. Serve your family water instead of sugar drinks. See Rethink Your Drink. Make sure your child gets physical activity each day. See How much physical activity do children need?

Basics About Childhood Obesity

Child and Teen BMI Calculator

How is childhood overweight and obesity measured?

Body mass index (BMI) is a measure used to determine childhood overweight and obesity. It is calculated using a child's weight and height. BMI does not measure body fat directly, but it is a reasonable indicator of body fatness for most children and teens. A child's weight status is determined using an age- and sex-specific percentile for BMI rather than the BMI categories used for adults because children's body composition varies as they age and varies between boys and girls.

CDC Growth Charts are used to determine the corresponding BMI-for-age and sex percentile. For children and adolescents (aged 219 years): Overweight is defined as a BMI at or above the 85th percentile and lower than the 95th percentile for children of the same age and sex.1 Obesity is defined as a BMI at or above the 95th percentile for children of the same age and sex.1

What are the consequences of childhood obesity?

Health risks now
o o o o o o

Childhood obesity can have a harmful effect on the body in a variety of ways. Obese children are more likely to have High blood pressure and high cholesterol, which are risk factors for cardiovascular disease (CVD). In one study, 70% of obese children had at least one CVD risk factor, and 39% had two or more.2 Increased risk of impaired glucose tolerance, insulin resistance and type 2 diabetes.3 Breathing problems, such as sleep apnea, and asthma.4,5 Joint problems and musculoskeletal discomfort.4,6 Fatty liver disease, gallstones, and gastro-esophageal reflux (i.e., heartburn).3,4 Obese children and adolescents have a greater risk of social and psychological problems, such as discrimination and poor self-esteem, which can continue into adulthood.3,7,8

Health risks later

Obese children are more likely to become obese adults.9, 10, 11 Adult obesity is associated with a number of serious health conditions including heart disease, diabetes, and some cancers.12 If children are overweight, obesity in adulthood is likely to be more severe.13

References 1. Barlow SE and the Expert Committee. Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report. Pediatrics 2007;120 Supplement December 2007:S164S192. 2. Freedman DS, Mei Z, Srinivasan SR, Berenson GS, Dietz WH. Cardiovascular risk factors and excess adiposity among overweight children and adolescents: the Bogalusa Heart Study. J Pediatr. 2007;150(1):1217.e2. 3. Whitlock EP, Williams SB, Gold R, Smith PR, Shipman SA. Screening and interventions for childhood overweight: a summary of evidence for the US Preventive Services Task Force.Pediatrics. 2005;116(1):e125144. 4. Han JC, Lawlor DA, Kimm SY. Childhood obesity. Lancet. May 15 2010;375(9727):17371748. 5. Sutherland ER. Obesity and asthma. Immunol Allergy Clin North Am. 2008;28(3):589602, ix. 6. Taylor ED, Theim KR, Mirch MC, et al. Orthopedic complications of overweight in children and adolescents. Pediatrics. Jun 2006;117(6):21672174. 7. Dietz W. Health consequences of obesity in youth: Childhood predictors of adult disease.Pediatrics 1998;101:518525. 8. Swartz MB and Puhl R. Childhood obesity: a societal problem to solve. Obesity Reviews 2003; 4(1):5771. 9. Biro FM, Wien M. Childhood obesity and adult morbidities. Am J Clin Nutr. May 2010;91(5):1499S1505S. 10. Whitaker RC, Wright JA, Pepe MS, Seidel KD, Dietz WH. Predicting obesity in young adulthood from childhood and parental obesity. N Engl J Med 1997;37(13):869873. 11. Serdula MK, Ivery D, Coates RJ, Freedman DS. Williamson DF. Byers T. Do obese children become obese adults? A review of the literature. Prev Med 1993;22:167177. 12. National Institutes of Health. Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: the Evidence Report. Bethesda, MD: National Institutes of Health, U.S. Department of Health and Human Services; 1998.

13. Freedman DS, Khan LK, Dietz WH, Srinivasan SR, Berenson GS. Relationship of childhood overweight to coronary heart disease risk factors in adulthood: The Bogalusa Heart Study.Pediatrics 2001;108:712718.

A Growing Problem
What causes childhood obesity?
Childhood obesity is the result of eating too many calories and not getting enough physical activity.

Why focus on food and physical activity environments?

There are a variety of environmental factors that determine whether or not the healthy choice is the easy choice for children and their parents. American society has become characterized by environments that promote increased consumption of less healthy food and physical inactivity. It can be difficult for children to make healthy food choices and get enough physical activity when they are exposed to environments in their home, child care center, school, or community that are influenced by

Sugar drinks and less healthy foods on school campuses. About 55 million school-aged children are enrolled in schools across the United States,1 and many eat and drink meals and snacks there. Yet, more than half of U.S. middle and high schools still offer sugar drinks and less healthy foods for purchase.2 Students have access to sugar drinks and less healthy foods at school throughout the day from vending machines and school canteens and at fundraising events, school parties, and sporting events. Advertising of less healthy foods. Nearly half of U.S. middle and high schools allow advertising of less healthy foods,2 which impacts students' ability to make healthy food choices. In addition, foods high in total calories, sugars, salt, and fat, and low in nutrients are highly advertised and marketed through media targeted to children and adolescents,3 while advertising for healthier foods is almost nonexistent in comparison. Variation in licensure regulations among child care centers. More than 12 million children regularly spend time in child care arrangements outside the home.4 However, not all states use licensing regulations to ensure that child care facilities encourage more healthful eating and physical activity.5

Lack of daily, quality physical activity in all schools. Most adolescents fall short of the 2008 Physical Activity Guidelines for Americansrecommendation of at least 60 minutes of aerobic physical activity each day, as only 18% of students in grades 912 met this recommendation in 2007.6Daily, quality physical education in school can help students meet the Guidelines. However, in 2009 only 33% attended daily physical education classes.7 No safe and appealing place, in many communities, to play or be active. Many communities are built in ways that make it difficult or unsafe to be physically active. For some families, getting to parks and recreation centers may be difficult, and public transportation may not be available. For many children, safe routes for walking or biking to school or play may not exist. Half of the children in the United States do not have a park, community center, and sidewalk in their neighborhood. Only 27 states have policies directing community-scale design.8

Limited access to healthy affordable foods. Some people have less access to stores and supermarkets that sell healthy, affordable food such as fruits and vegetables, especially in rural, minority, and lower-income neighborhoods.9 Supermarket access is associated with a reduced risk for obesity.9 Choosing healthy foods is difficult for parents who live in areas with an overabundance of food retailers that tend to sell less healthy food, such as convenience stores and fast food restaurants. Greater availability of high-energy-dense foods and sugar drinks. High-energy-dense foods are ones that have a lot of calories in each bite. A recent study among children showed that a high-energy-dense diet is associated with a higher risk for excess body fat during childhood.10,11 Sugar drinks are the largest source of added sugar and an important contributor of calories in the diets of children in the United States.12 High consumption of sugar drinks, which have few, if any, nutrients, has been associated with obesity.13 On a typical day, 80% of youth drink sugar drinks.14 Increasing portion sizes. Portion sizes of less healthy foods and beverages have increased over time in restaurants, grocery stores, and vending machines. Research shows that children eat more without realizing it if they are served larger portions.15,16 This can mean they are consuming a lot of extra calories, especially when eating high-calorie foods. Lack of breastfeeding support. Breastfeeding protects against childhood overweight and obesity.17,18 However, in the United States, while 75% of mothers start out breastfeeding, only 13% of babies are exclusively breastfed at the end of 6 months. The success rate among mothers who want to breastfeed can be improved through active support from their families, friends, communities, clinicians, health care leaders, employers, and policymakers.

Television and media. Children 818 years of age spend an average of 7.5 hours a day using entertainment media, including TV, computers, video games, cell phones, and movies. Of those 7.5 hours, about 4.5 hours is dedicated to viewing TV.19 Eighty-three percent of children from 6 months to less than 6 years of age view TV or videos about 1 hour and 57 minutes a day.20 TV viewing is a contributing factor to childhood obesity because it may take away from the time children spend in physical activities; lead to increased energy intake through snacking and eating meals in front of the TV; and, influence children to make unhealthy food choices through exposure to food advertisements.21,22

Obesity Prevention and Control

Overweight and obesity have been shown to increase the likelihood of certain diseases and other health problems, and are important concerns for adults, children, and adolescents in the United States. An estimated 26.7 percent of adults in the United States reported being obese in 2009, up 1.1 percentage points since 2007 (Behavioral Risk Factor Surveillance System) . Approximately 300,000 deaths per year may be attributable to obesity (Office of the Surgeon General) . In 2008, the annual healthcare cost of obesity in the US was estimated to be as high as 147 billion dollars a year (Finkelstein 2009).

Obesity
Halting the Epidemic by Making Health Easier At A Glance 2011

On this Page

At A Glance Related Materials

The Obesity Epidemic

More than one-third of U.S. adults (over 72 million people) and 17% of U.S. children are obese. During 19802008, obesity rates doubled for adults and tripled for children. During the past several decades, obesity rates for all population groupsregardless of age, sex, race, ethnicity, socioeconomic status, education level, or geographic regionhave increased markedly.

Obesity and Health Disparities

Recent reports show that substantial differences exist in obesity prevalence by race/ethnicity, and these differences vary by sex and age. For example, according to 20052008 data from the National Health and Nutrition Examination Survey, 51% of non-Hispanic black women aged 20 years or older were obese, compared with 43% of Mexican Americans and 33% of whites. Among females aged 219 years, 24% of non-Hispanic blacks, 19% of Mexican Americans, and 14% of whites were obese. Efforts are being made to reduce these disparities by focusing interventions on subgroups with high prevalence of obesity.

Health Consequences of Obesity

Obesity increases the risk of many health conditions, including the following:

Coronary heart disease, stroke, and high blood pressure.

Type 2 diabetes. Cancers, such as endometrial, breast, and colon cancer. High total cholesterol or high levels of triglycerides. Liver and gallbladder disease. Sleep apnea and respiratory problems. Degeneration of cartilage and underlying bone within a joint (osteoarthritis). Reproductive health complications such as infertility. Mental health conditions.

Obesity Is Costly
In 2008, overall medical care costs related to obesity for U.S. adults were estimated to be as high as $147 billion. People who were obese had medical costs that were $1,429 higher than the cost for people of normal body weight. Obesity also has been linked with reduced worker productivity and chronic absence from work.

Policy and Environmental Approaches Needed

The causes of obesity in the United States are complex and numerous, and they occur at social, economic, environmental, and individual levels. American society has become characterized by environments that promote physical inactivity and increased consumption of less healthy food. Public health approaches that can reach large numbers of people in multiple settingssuch as in child care facilities, workplaces, schools, communities, and health care facilitiesare needed to help people make healthier choices. Policy and environmental approaches that make healthy choices available, affordable, and easy can be used to extend the reach of strategies designed to raise awareness and support people who would like to make healthy lifestyle changes.

[A text description of this map is also available.]

CDCs Response
CDC's Division of Nutrition, Physical Activity, and Obesity (DNPAO) is working to improve nutrition and physical activity and reduce obesity through state programs, technical assistance and training, surveillance and applied research, program implementation and evaluation, translation and dissemination, and partnership development.

Supporting State Programs

CDC's State-Based Nutrition and Physical Activity Program to Prevent Obesity and Other Chronic Diseases (NPAO) currently funds 25 states to work with partners across multiple settings such as child care facilities, workplaces (including hospitals), schools, and communitiesto implement policy, system, and environmental strategies that have been proven to work. These strategies address the five target areas identified by CDC for preventing and reducing obesity, which are to

Increase consumption of fruits and vegetables. Increase physical activity. Increase breastfeeding initiation, duration, and exclusivity. Decrease consumption of sugar drinks.

Decrease consumption of high-energy-dense foods, which are high in calories.

The NPAO Program emphasizes the need to reduce health disparities among different population groups, such as racial and ethnic minorities, and requires that states implement a comprehensive state plan. CDC provides technical assistance to help states develop comprehensive plans, implement interventions, and build the leadership needed to improve nutrition and physical activity environments and reduce obesity rates. State program highlights are available athttp://www.cdc.gov/obesity/stateprograms/statestories.html. CDC's Communities Putting Prevention to Work (CPPW) State and Territory Initiative is a 2-year cooperative agreement (20102012) that is focused on helping states promote health and prevent chronic disease through sustained policy, system, and environmental strategies. DNPAO provides program and evaluation assistance to 50 states and 8 U.S. territories to help them implement changes to the social and physical environments that make it easier for people to make healthy choices. DNPAO also provides technical assistance to the CPPW Communities Initiative, which gives direct funding support to selected communities.

Conducting Surveillance and Research

CDC tracks obesity trends among children and adults, as well as policy, environmental, and behavioral factors related to obesity and overweight. For example, in 2010, CDC's new Vital Signs program used 2009 data from the Behavioral Risk Factor Surveillance System to describe the prevalence of obesity at the state level. The data showed that no state had met the national goal of reducing the adult obesity rate to less than 15% and that, in 9 states, at least 30% of adults were obese. CDC also publishes state-level reports on policy, environmental, and behavioral indicators associated with nutrition (e.g., fruit and vegetable consumption, breastfeeding) and physical activity. States can use these state indicator reports, which include action guides and train-the-trainer materials, to identify priority actions for state coalitions, monitor their progress over time, and celebrate successes. CDC also identifies, evaluates, translates, and disseminates effective or promising interventions for obesity prevention and control. For example, CDC provides funding and technical support for theNutrition and Obesity Policy Research and Evaluation Network (NOPREN), whose members include Prevention Research Centers (PRCs) across the country. Network members work to identify effective policies, the factors needed to support them, and the barriers that can prevent their adoption. They also assess whether policy changes can improve people's access to healthy foods and beverages (including water), determine if food labels give people the information they need to make healthy choices, and improve eating behaviors and health outcomes. The Harvard University PRC coordinates the network, and five additional PRCs are funded as collaborating centers.

Working with Partners

following:

CDC is making progress in stopping the obesity epidemic through innovative partnerships such as the

The Healthy Eating Active Living Convergence Partnership fosters policy and environmental change by working with partners in fields not traditionally involved in public health. The group is currently focused on changing transportation and food systems to develop active living environments and improve access to healthy foods. Partners include the California Endowment, Kaiser Permanente, Nemours, Robert Wood Johnson Foundation, and W.K. Kellogg Foundation. CDC provides technical assistance, PolicyLink (a national research and action institute) provides program direction, and the national, nonprofit Prevention Institute provides policy research, analysis, and strategic support. The National Collaborative on Childhood Obesity Research (NCCOR) brings together research funders in a public-private collaboration to accelerate progress on reversing the epidemic of overweight and obesity among U.S. youth. NCCOR's focus is on identifying and evaluating effective interventions (particularly policy and environmental interventions) at individual, community, and population levels. The NCCOR Web site provides a database of diet and physical activity measures used in childhood obesity research and a catalog of relevant surveillance systems. (http://www.nccor.org ) NCCOR members build on each other's strengths through complementary and joint projects. Partners include the Robert Wood Johnson Foundation, National Institutes of Health, CDC, and U.S. Department of Agriculture.