America weighs in - growing numbers of overweight people in the US - includes related article about Mode magazine - Cover Story

American Demographics, June, 1997 by Shannon Dortch

Americans enjoy the most abundant and varied diet in the world. Food is cheap, plentiful, and tasty. All those readily available nutrients should make us a strong, healthy people. But for an increasing share of U.S. adults, life in the land of plenty is making them plenty fat. The percent of adults aged 20 to 74 who are obese based on their body mass index increased from 24 percent in the 1960s to 33 percent in 1988-91. By 1994, the share of all adults aged 20 and older who are overweight climbed further, to 35 percent. Applying that rate to the adult population yields a total of 65 million U.S. adults aged 20 or older who were overweight in 1988-94. We don't get to blame the aging population, either. Overweight has become more prevalent among all age groups, not just the elderly.

Children and adolescents are following the example of their elders. The share of children aged 6 to 11 who are overweight increased from 11 percent in the late 1970s to 14 percent in 1994. For children aged 12 to 17, the share doubled to 12 percent in 1994.

Overweight people create markets for large-sized clothing and weight-loss products and services. But Americans seem to be losing interest in weight-loss diets. One market that is certain to benefit from this trend is health care. The National Center for Health Statistics (NCHS) says that overweight and obese adults are at increased risk for numerous acute and chronic conditions, ranging from high blood pressure to diabetes to arthritis.

Most doctors believe that a wide range of chronic ailments can be prevented or mitigated by maintaining a reasonable body weight. Former Surgeon General C. Everett Koop recently said that if he had stayed in office longer, "I would have launched the same assault on obesity that I did on smoking." Plump, Overweight, or Obese

There are several different ways to measure the prevalence of overweight in the population. The NCHS uses body mass index (BMI) to determine if a person is overweight. BMI is a ratio of height to weight. "Overweight" means about 124 percent of desirable weight for men and 120 percent for women, after adjustments for clothing and shoes. Since obesity is defined as having a body weight at least 20 percent greater than desirable, BMI captures only obese children and adults.

People who could stand to lose a pound or 2, and even some who should probably shed 10 or 20, are not counted as overweight using this measure. The standard height/weight tables produced by the Metropolitan Life Insurance Company aren't so forgiving. When you ask U.S. adults their height and weight, and determine their overweight status based on the tables, the share who exceed their desirable body weight jumps to almost seven in ten in 1995. This is how Prevention magazine measured overweight for the 13 years it conducted the Prevention Index survey of Americans' health. Prevention said that the share of adults who are overweight by its definition increased from 58 percent in 1983 to 68 percent in 1995.

Many researchers believe BMI is the best way to determine overweight precisely because it captures the population most at risk of overweight-related health problems. In addition, the way BMI is determined by the NCHS makes it more reliable than self-reported data on weight. The temptation to understate your weight by a pound or ten is natural, and the tendency to underreport one's weight increases with extra pounds.

Participants in the NCHS's National Health and Nutrition Examination Survey (NHANES) didn't have that luxury. They were weighed in the presence of researchers while wearing a standardized gown and slippers. But even with the fudge factor eliminated, overweight rates based on BMI are still lower than those based on MetLife tables, because BMI captures only the more seriously overweight.

Other surveys corroborate the findings of NHANES and the Prevention Index, which has obesity experts agreeing the trend is genuine. Overweight rates have increased across most age and race groups. Young adults aged 20 to 29, who presumably are among the most educated and physically active Americans, have seen their overweight rates increase steadily for women between 1960-62 and 1988-91, and remain stable for men.

Older adults may have assumed for years that old age was a license for weight gain. But some middle-aged and elderly groups have shown declines in prevalence of overweight over the 30-year period. Between the 1976-80 and 1988-91 NHANES surveys, rates declined for black women aged 50 to 59. They were virtually stable for black women aged 60 to 74. There was a marked decline in the percent of black men aged 40 to 49 who are overweight, but rates for white men and women either rose or were stable for all age groups. Researchers at the NCHS aren't patting Americans on the back for these decreases, however. Among middle-aged and older adults, drops in the share who are overweight probably relate to natural aging-related decreases in lean body mass. In addition, older overweight adults may simply be dying prematurely, which reduces their numbers in specific population groups.