Trends in body mass index, overweight and obesity among adults in the USA, the NHANES from 2003 to 2018: a repeat cross-sectional survey
Mingxi Li, Weijun Gong, Shidong Wang, Zhe Li
Abstract
OBJECTIVES: To analyse detailed trends in adult obesity from 2003 to 2018 in the USA, and provide the latest national estimates of adult obesity in 2017-2018. DESIGN, SETTING AND PARTICIPANTS: Analysis of data, including measured height and weight, obtained from 42 266 adults aged ≥20 years from the National Health and Nutrition Examination Survey, a cross-sectional, nationally representative sample of the US population. EXPOSURE: Survey period. PRIMARY OUTCOME MEASURES: The mean body mass index (BMI) and prevalence of overweight and obesity. RESULTS: ) was 73.8% (95% CI 71.1% to 76.4%) and 42.8% (95% CI 39.5% to 46.1%), respectively. From 2003 to 2018, a significant increase in the prevalence of overweight (including obesity, overall adjusted OR for 2017-2018 vs 2003-2004, 1.08 (95% CI 1.04 to 1.13) and obesity (overall adjusted OR for 2017-2018 vs 2003-2004, 1.15 (95% CI 1.10 to 1.21) was found among American adults. However, annual changes in mean BMI and the prevalence of overweight and obesity did not differ significantly before and after 2009-2010. The prevalence of overweight and obesity varied significantly by age, sex, race, education, daily total energy intake, economic conditions and physical activity status (all p<0.05). CONCLUSIONS: Although the prevalence of adult obesity continues to rise, there have been no significant changes in the annual growth of adult obesity prevalence between 2003-2004 and 2017-2018. In 2017-2018, the prevalence of obesity was 42.8%, which equates to 76 million American adults at risk for serious and costly chronic conditions. The prevalence of obesity was higher among older adults (aged 60-69 years), females, non-Hispanic blacks, and those who did not graduate college, were physically inactive, reported lower daily total energy intake and had poor economic status.