How many Americans are obese and how has this become such a problem in the last 50 years?

Question

Dr. John E. Lewis · Answer

The question is, "How many Americans are obese and how has this become such a problem in the last 50 years?" Well, let's first define what we normally refer to when we talk about body composition, and that is a quick and dirty measure called body mass index. Body mass index is your weight or your mass relative to your height. It's usually expressed in meters per kilogram squared. So it's not a perfect measure of body composition because if you are muscular or very fit, you might possibly be considered overweight or obese according to this metric. But if you look at someone who's very fit and very muscular, then you obviously know that person's not overweight. They're just very muscular. But nonetheless, it's defined as 30 and above, according to BMI. And from the early 1960s when the average American male was about 10% obese and the average American woman was about 12% or 15% obese, now, today, the latest figures are somewhere around 43% of men and 41%, 42% of women. This is just ridiculous, how this has occurred over the last 50 or so years. So why has this happened? Well, this perfectly correlates with the rise in fast food, number one, the change in the way we produce our food, the agricultural shift away from an agrarian economy over 100 years ago to now. Less than 1% of the population is involved in agriculture in any way. So we changed the way we produce our food. We have much more synthetic inputs. We have genetic modification of our plants and species, and all these other chemicals and contaminants. So these are certainly two of the biggest problems. You have all these endocrine-disrupting, hormone modulators or mimickers in our food supply today, in our water, in our soil, in our air. There are a whole host of reasons why we are now so obese, but to me the biggest one is that we are simply overeating and undernourished. We're eating too many macronutrients, not enough micronutrients, and this is the problem in the context of obesity today. This is the major problem. And to a lesser extent, we're much more sedentary, but you cannot exercise your way to weight loss. So that's much less part of the problem than the nutritional piece.

Dr. Kristian Olson, MD · Answer

So how many Americans are obese and how has this become such a problem in the last 50 years? And I think all of us are recognizing just how frequent it is. But there's a national survey in the National Health and Nutrition Examination Survey that has been administered over time. And just 30 years ago, 1988 to '94, the percent that were objectively obese with a BMI greater than 30 was almost 23%, 23.9%, and it had been increasing over time. Now in 2017 to 2018, the last time the survey was completed, the rate of obesity had almost doubled and was 42.4%. So the numbers are astronomical. And really the reasons get down to two simple reasons with complex underpinnings. But it's really our intake and too much poor quality food, which I'll talk about, as well as too little mobility and activity. If you look back, historically, since the 1950s, our caloric intake per person per year has increased 20%, our fat intake has increased by 2/3, and the amount of fast food in our diet has increased, and processed foods even from large manufacturers that have been determined to be unhealthy for us has increased. So there's more ready access to poor quality processed foods-- certainly is a huge component of this epidemic. The other component is we're moving less as Americans and North Americans. Whereas 50% of jobs in the 1950s had at least moderate exercise component of work itself, now only 20% of jobs have even moderate degree of exercise. And we're moving much less even outside of work. We drive places, we get entertainment in our home, and we move less. So you can think about ways to combat these in your own life with regular exercise and better food.

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"How many Americans are obese and how has this become such a problem in the last 50 years?"