Obesity Rates Continue to Rise Among Adults in the US

New U.S. Centers for Disease Control and Prevention (CDC) data shows that in 23 states, 35% of adults are living with obesity. These findings starkly contrast previous CDC data, which showed that before 2013, no state had an obesity prevalence at or above 35%.

Obesity, or having a body mass index (BMI) of 30 or higher, can impact an individual's physical health in several ways. It can lead to heart disease, type 2 diabetes, and certain types of cancer and increase the risk of experiencing poor outcomes from diseases like COVID-19.

Having a high BMI can also affect mental health and wellbeing due to social stigma and negative feelings about body image.

Despite the potential harms, the number of adults with obesity continues to rise in the United States, marking a growing nationwide health concern.

For example, population data from 2022 showed that 22 states had an adult obesity prevalence at or above 35%, compared to 19 states in 2021.

Now, new 2023 CDC surveillance data released on September 12 shows that in 23 states, more than one in three adults (35%) has obesity. Moreover, at least one in five adults (20%) in each state across the nation is living with a BMI of 30 or higher.

This contrasts previous data, which showed no state had adult obesity rates at or above 35% before 2013.

States with the highest obesity rates

The CDC used the Behavioral Risk Factor Surveillance System (BRFSS) to compile self-reported height and weight, race, and ethnicity data among the population in each state.

The results showed that the following states have obesity rates at 35% or higher:

• Alabama
• Alaska
• Arkansas
• Delaware
• Georgia
• Illinois
• Indiana
• Iowa
• Kansas
• Louisiana
• Michigan
• Mississippi
• Missouri
• Nebraska
• New Mexico
• North Dakota
• Ohio
• Oklahoma
• South Carolina
• South Dakota
• Tennessee
• West Virginia
• Wisconsin

Guam and Puerto Rico also had an obesity rate of at least 35%. In contrast, Washington D.C. and Colorado had the lowest prevalence of obesity at 20 to 25%.

The CDC found that obesity rates differed by race and ethnicity. For example, the data showed that Asian adults do not have an obesity prevalence at or above 35% in any state.

However, white adults in 16 states, American Indian or Alaska Native adults in 30 states, Hispanic adults in 34 states, and Black adults in 38 states have an obesity prevalence at or above 35%.

"Obesity is a complex disease. There's a common misconception that obesity is a result of lack of willpower and individual failings to eat well and exercise," said Ruth Petersen, M.D., director of the CDC's Division of Nutrition, Physical Activity, and Obesity, in a news release. "Many factors contribute to obesity, like genes, certain medications, poor sleep, gut microbiome, stress, access to affordable food, safe places to be active, and access to health care. Understanding these factors helps us identify potential prevention and treatment strategies."

New weight loss treatments offer more options

Typically, treatment for obesity involves lifestyle changes such as adopting a reduced-calorie diet and engaging in regular exercise.

However, in addition to diet and exercise, new treatments, including glucagon-like peptide 1 agonists (GLP-1s) like Ozempic and Wegovy (semaglutide), have proven to be an effective weight loss option. The rising popularity of this medication spurred other pharmaceutical companies to create similar weight loss drugs such as Mounjaro and Zepbound (tirzepatide).

Moreover, new GLP-1 options are currently under investigation, including a tri-receptor agonist called retatrutide developed by Eli Lilly and an implantable device created by the Celanese Corporation that delivers GLP-1 medications over time.

Research has shown that weight loss medications like semaglutide can potentially reduce heart disease risks, lower the risk of specific types of cancer, and extend the lifespan. This is likely due to the drug's positive impact on cardiometabolic factors such as blood sugar levels, waist-to-hip ratio, and BMI.

Still, side effects associated with currently available GLP-1s, including suicidal thoughts, hair loss, aspiration of food into the airway, and blocked intestines, may deter some people from using the medications. The drugs' cost, which can run close to $1000 per month without insurance, may also limit access.

In addition, despite the dramatic weight loss observed with these medications, a 2022 study found that one year after discontinuing the GLP-1 semaglutide, participants regained two-thirds of the weight they lost while on the drug.

Therefore, people with obesity who choose to use GLP-1s still need to adopt a healthy reduced-calorie diet and exercise strategy to ensure a well-rounded and sustainable approach to long-term weight management.