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American Obesity Ballooning

Government health officials fret about expanding waistlines, even in kids

TUESDAY, Oct. 8, 2002 (HealthDayNews) -- The U.S. government's latest health and nutrition survey is in, and the results are huge. Literally.

More than 30 percent of American adults, or 59 million people, were obese in 2000, far more than the 23 percent who made their scales wince just six years earlier.

Weight problems among the nation's children have also continued to surge, with 15 percent, or nearly 9 million, considered overweight or obese in 1999 and 2000, triple the rate in 1980. Ten percent of pre-schoolers are now overweight, compared with 7 percent in the early 1990s.

"The problem keeps getting worse," Tommy Thompson, secretary of the U.S. Department of Health and Human Services, said in a statement. "We've seen virtually a doubling in the number of obese persons over the past two decades and this has profound health implications. Obesity increases a person's risk for a number of serious conditions, including diabetes, heart disease, stroke, high blood pressure and some types of cancer."

Morgan Downey, executive director of the American Obesity Association, called obesity "the most prevalent public health problem of the 21st century." Heaviness is behind 300,000 to 500,000 deaths a year, says Downey, who criticized the government for not doing enough to help the nation stay fit.

"We think the government needs to do more than just exhort people to live better," Downey says. His group is calling for more research dollars devoted to studying obesity, better insurance coverage of weight-loss treatments, and more attention to physical activity and nutrition in the nation's schools.

The survey results appear in two studies published in tomorrow's Journal of the American Medical Association. Both use data from the National Health and Nutrition Examination Survey (NHANES). They included information on 4,115 men and women over age 20, and 4,722 children from birth through age 19.

Since obesity is weight in the context of height, scientists use a term called "body mass index," or BMI, to relate a person's north-south to their east-west. A man who is 6 feet tall, for example, has a body mass index of 30 if he weighs 221 pounds. A woman who is 5-foot-5 has a BMI of 30 if she weighs 180 pounds. A BMI of 25 or more for both sexes is considered overweight, while a BMI in excess of 29 is considered obese.

Between 1988 and 1994, roughly 23 percent of adults surveyed had a BMI of 30 or higher, and 56 percent were overweight but not yet obese. By 1999-2000, however, those numbers had risen to 30.5 percent and 64.5 percent, respectively. One-third of women and 28 percent of men were obese by the end of the last decade.

The number of "extremely obese" Americans -- those with a BMI of 40 or more -- jumped from 2.9 percent to 4.7 percent in the years between the two surveys. [A third study in the journal found somewhat lower rates of severe obesity. However, that work relied on self-assessments of weight, which are usually not reliable.]

People with extreme obesity have twice the risk of premature death as those with BMIs between 30 and 39 -- who themselves are at much greater risk of dying early than their thinner peers. The extremely obese are so heavy that they qualify for stomach-shrinking surgery.

The surveys found that waistlines bulged for both sexes and in every age group. However, the scientists were surprised to see an 11 percent to 12 percent surge in obesity in women and men between the ages of 60 and 74, says Cynthia Ogden, an epidemiologist at the National Center for Health Statistics and a member of the research team.

Although men in the various racial and ethnic groups surveyed had roughly the same rates of overweight and obesity, black and Mexican-American women had the most trouble with their waistlines. More than one in two black women over age 40 were obese in 2000, and more than eight in 10 were overweight. Extreme obesity was also highest among black women, rising from 7.9 percent to just over 15 percent by 2000.

For the youth survey, children aged 2 and older were considered overweight if their BMI was in the top 5 percent for their gender.

It found that more than 15 percent of children between the ages of 6 and 19 were overweight in 1999-2000, about 50 percent more than in the previous NHANES review. The problem was slightly better among the very young, 10.4 percent of whom were overweight, compared with 7.2 percent in 1988-1994.

Being overweight was more common among black and Mexican-American boys and girls than it was among whites.

Ogden, who also co-wrote the journal article on the youth survey, says being overweight even early in life is linked to high blood pressure, high cholesterol and the first stages of diabetes. "Overweight teens are more likely to become overweight adults," she adds.

In an unrelated survey released last week, the National Association for Sport and Physical Education found that most Americans greatly overestimate the amount of exercise they get each week. The U.S. Centers for Disease Control and Prevention advises 30 minutes of physical activity every day.

What To Do

To find out more about obesity in the United States, try the U.S. Centers for Disease Control and Prevention or the American Obesity Association. To determine your BMI, visit the Partnership for Healthy Weight Management.

SOURCES: Cynthia Ogden, Ph.D., epidemiologist, National Center for Health Statistics, Hyattsville, Md.; Morgan Downey, executive director, American Obesity Association, Washington, D.C.; Oct. 9, 2002, Journal of the American Medical Association
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