Obesity in the US and World
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March 4 World Obesity Day Infographics
Obesity is on the rise in the United States. According to figures released by the Centers for Disease Control and Prevention, four in ten American adults now have a body mass index at 30 or higher, classifying them as obese. This has climbed since the turn of the century, when it was approximately three in ten.
Obesity rates around the World
In most OECD countries that collect self-reported weight data, more than half of adults were overweight or obese and nearly one in five were obese in 2021 (latest available data).
Obesity prevalence was particularly high in the United States, with just over a third of respondents saying that they are obese. In Chile and the United Kingdom rates were just above one in four, while Korea had the lowest share of people with obesity of the countries studied at just 4.3 percent.
BMI was created in the 1800s.It did not gain popularity until a study published in the Journal of Chronic Diseases in July 1972. This study concluded that BMI is the best proxy for body fat percentage among ratios of weight and height.2 Major health organizations agree with this finding.
A large body of research suggests that people with higher BMIs are more prone to health-related complications.5
All of the BMI studies cited above were done across large populations.
Using that data and applying it to an individual without looking at the person’s overall health is a bad idea.
Someone can have a normal BMI but still have a high visceral fat percentage and be at increased risk for diabetes & heart disease. On the other hand, a sumo wrestler with a high BMI but little visceral fat will be metabolically healthy.10
Additionally, as most people know, essentially all NFL running backs, most of whom sport 6-packs and sub-10% body fat, would be classified as obese under this system. Even a recreational athlete with slightly above-average muscle mass could be considered overweight.
Should we stop giving so much "weight" to BMI?
Maybe. Research suggests that BMI alone frequently misclassifies metabolic health, which is linked to how much fat a person has and how it is distributed. And, BMI may be particularly unreliable during pregnancy, for athletes, and the elderly.
And there's another problem: current BMI definitions of overweight or obesity were based largely on white populations. Yet body composition, including percent body fat or amount of muscle mass, can vary by race and ethnic group. So, BMI may help predict health status among people who are white, but may be less accurate for people in other racial and ethnic groups For example, defining obesity by standard measures of BMI tends to overestimate risk in Black individuals and underestimate it for those of Asian descent.
Weight | BMI | Classify | Low | High |
142 | 22.9 | Normal | 18.5 | 24.9 |
147 | 23.7 | Normal | 18.5 | 24.9 |
158 | 25.5 | Overweight | 25.0 | 29.9 |
162 | 25.1 | Overweight | 25.0 | 29.9 |
165 | 26.6 | Overweight | 25.0 | 29.9 |
174 | 28.1 | Overweight | 25.0 | 29.9 |
178 | 26.7 | Overweight | 25.0 | 29.9 |
185 | 29.9 | Overweight | 25.0 | 29.9 |
In 1997, the New York Times carried a full-page obituary [1] of one Dr. Stanley Schachter, Professor Emeritus of Psychology, Columbia University. The obituary emphasizes that Schachter’s influence was profound and highlights his unique ability to gain important scientific insights from everyday experiences and place those experiences under the microscope of his science. In fact, the American Psychological Association named him as the 7th most influential psychologist of the 20th century [2].
In his classic paper published in Science in 1968 [5], Schachter reviews the current state of the literature and reports three key tests of whether internal and external cues differentially affect eating behavior in normal weight and obese subjects. Taken together, his findings suggest that when compared to non-obese subjects, the eating behavior of obese subjects is more affected by environmental cues (e.g., external time cues, presence of food) than physiological (e.g., hunger, emotional arousal, internal time cues).
Many of his students including, for example, Peter Herman, Judith Rodin, Richard Nisbett, Lee Ross, and Neil Grunberg, went on to become major contributors to the obesity literature and some of the highest regarded investigators in the field [10]. Through the work of his students, who, perhaps to Schachter’s credit, had the intellectual acumen and scientific courage to disagree with their mentor, Schachter’s theory has since been challenged [11, 12] and further extended into restraint theory [13, 14]. Dr. Rodin went on to become the first permanent female president of an Ivy League Institution and is current president of The Rockefeller Foundation, and Dr. Herman’s dietary restraint offered one of the first testable theories of eating disorder etiology, and his scale remains a regular tool for measurement [15]