WASHINGTON, DC—No state has achieved the US government’s goal for 2010 of having an obesity prevalence of 15% or less, CDC Director Thomas Frieden said last month. In addition, the number of states reporting an obesity prevalence of 30% or more has tripled since 2007, from three states to nine states. “Less than a decade ago, in 2000, not a single state had an obesity prevalence of 30% or higher.” The data comes from the Behavioral Risk Factors Surveillance System (BRFSS), a telephone survey, and was published in the August 3 CDC Vital Signs Report.

Only three states in 2007 had an increased prevalence of obesity above 30%. Those states were Tennessee, Alabama, and Mississippi. The 2009 BRFSS reported the states that exceeded the 30% mark were Missouri, Kentucky, West Virginia, Arkansas, Oklahoma, Louisiana and, again, Tennessee, Mississippi, and Alabama.

The 2009 BRFSS data show a 1.1% increase, equating to about 2.4 million additional people self-reporting obesity between 2007 and 2009 among adults aged 18 and over. Frieden said that over the past several decades “obesity has increased faster than anyone could have imagined it would.”

Medical costs associated with obesity were estimated at $147 billion in 2008 dollars. “That translates into medical costs for obese people as $1,429 higher per person each year compared to normal-weight individuals.”

Assessing Obesity Prevalence

To assess obesity prevalence through the BRFSS survey, approximately 400,000 phone survey respondents were asked to provide their height and weight, which was used to calculate their body mass index (BMI).

Overall, the BRFSS found that the prevalence of obesity was 26.7%, which was seven percentage points less than the 33.9% reported in CDC’s National Health and Nutrition Examination Survey, in which participants are weighed and measured, according to William Dietz, MD, PhD, director of CDC’s Division of Nutrition, Physical Activity and Obesity. BRFSS data are believed to be underestimates of obesity prevalence since people may say they weigh less in telephone surveys. “The BRFSS obesity estimates are always lower than the overall obesity prevalence estimates from the national health and nutrition examination survey,” he said.

The BRFSS report found that the number of obese people varied by state. For example, 18.6% of Colorado residents reported being obese while 34.4% of Mississippi residents reported being obese. Only Colorado and the District of Columbia (19.7%) had prevalences of less than 20%.

Frieden said that overall, it is “too hard to say” what the obesity trends are over recent years. While the NHANES data suggests there may be a leveling off of an obesity increase, the BRFSS data suggests that the problem is increasing. “The exact trends are hard to definitively pinpoint, but what we can say is that this is a large problem, it’s widespread throughout the US, and the number of people self-reporting height and weight that puts them in the obese category has continued to increase between 2007 and 2009.”

Frieden said that six things can reduce or prevent obesity. He cited physical activity, increasing the uptake and continuation of breast feeding, increasing fruit and vegetable intake, reducing screen time, reducing high-calorie food consumption, and reducing the consumption of sugary drinks.

Healthcare providers can help their adult patients address obesity by following recommendations of the US Preventive Services Task Force to screen for obesity and provide intensive counseling to those in need of weight loss.

Officials also pointed to efforts by the federal government to reduce and prevent obesity such as Michelle Obama’s Let’s Move! campaign to address childhood obesity and the Communities Putting Prevention to Work program. The CPPW program provides guidance and funding to states and communities to change state and local environments and policies related to diet and physical activity. “We need intensive and ongoing efforts to address obesity or more people will get sick and die from the complications of obesity, such as heart disease, stroke, diabetes and cancer,” said Frieden.

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