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Journal of American Medical Association, 1999;282:1519-1522.
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The spread of the obesity epidemic
in the United States, 1991 - 1998.
Ali H. Mokdad, Mary K. Serdula, William H. Dietz, Barbara A. Bowman, James
S. Marks, Jeffrey P. Koplan.
Center for Disease Control and Prevention, Atlanta, Georgia.
Abstract; Context: The increasing prevalence of obesity is a major public
health concern, since obesity is associated with several chronic diseases.
Objective: To monitor trends in state-specific data and to examine changes
in the prevalence of obesity among adults.
Design: Cross-sectional random-digit telephone survey (Behavioral Risk
Factor Surveillance System) of noninstitutionalized adults aged 18 years or
older conducted by the Centers for Disease Control and Prevention and state
health departments from 1991 to 1998.
Setting: States that participated in the Behavioral Risk Factor
Surveillance System.
Main Outcome Measures: Body mass index calculated form self-reported weight
and height.
Results: The prevalence of obesity (defined as a body mass index ≥ 30
kg/m^2) increased from 12.0% in 1991 to 17.9% in 1998. A steady increase was
observed in all states; in both sexes; across age groups, races, educational
levels; and occurred regardless of smoking status. The greatest magnitude
of increase was found in the following groups: 18 to 29-year-olds (7.1% to
12.1%), those with some college education (10.6% to 17.8%), and those of
Hispanic ethnicity (11.6% to 20.8%). The magnitude of the increased
prevalence varied by region (ranging from 31.9% for mid-Atlantic to 67.2%
for South Atlantic, the area with the greatest increases) and by state
(ranging from 11.3% for Delaware to 101.8% for Georgia, the state with the
greatest increases).
Conclusions: Obesity continues to increase rapidly in the United States.
To alter this trend, strategies and programs for weight maintenance as well
as weight reduction must become a higher public health priority.
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