The Continuing Epidemics of Obesity and Diabetes in the United States

Ali H. Mokdad, PhD; Barbara A. Bowman, PhD; Earl S. Ford, MD, MPH; Frank Vinicor, MD, MPH; James S. Marks, MD, MPH; Jeffrey P. Koplan, MD, MPH

Obesity and diabetes are major causes of morbidity and mortality in the United States. Evidence from several studies indicates that obesity and weight gain are associated with an increased risk of diabetes. Each year, an estimated 300 000 US adults die of causes related to obesity. Obesity also substantially increases morbidity and impairs quality of life.6-8 Overall, the direct costs of obesity and physical inactivity account for approximately 9.4% of US health care expenditures.

The direct and indirect costs of health care associated with diabetes [ ... ]

Full text (300kb, PDF file) - with very interesting graphs

Context Recent reports show that obesity and diabetes have increased in the United States in the past decade.

Objective To estimate the prevalence of obesity, diabetes, and use of weight control strategies among US adults in 2000.

Design, Setting, and Participants The Behavioral Risk Factor Surveillance System, a random-digit telephone survey conducted in all states in 2000, with 184 450 adults aged 18 years or older.

Main Outcome Measures Body mass index (BMI), calculated from self-reported weight and height; self-reported diabetes; prevalence of weight loss or maintenance attempts; and weight control strategies used.

Results In 2000, the prevalence of obesity (BMI $30 kg/m2) was 19.8%, the prevalence of diabetes was 7.3%, and the prevalence of both combined was 2.9%. Mississippi had the highest rates of obesity (24.3%) and of diabetes (8.8%); Colorado had the lowest rate of obesity (13.8%); and Alaska had the lowest rate of diabetes (4.4%). Twenty-seven percent of US adults did not engage in any physical activity, and another 28.2% were not regularly active. Only 24.4% of US adults consumed fruits and vegetables 5 or more times daily. Among obese participants who had had a routine checkup during the past year, 42.8% had been advised by a health care professional to lose weight. Among participants trying to lose or maintain weight, 17.5% were following recommendations to eat fewer calories and increase physical activity to more than 150 min/wk.

Conclusions The prevalence of obesity and diabetes continues to increase among US adults. Interventions are needed to improve physical activity and diet in communities nationwide.

JAMA. 2001;286:1195-1200