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Fat in the USA: Obesity Is Rising

Adult obesity rose in 23 states last year, a new study finds; almost one-third of kids are overweight as well

Americans are getting fatter, portending massive costs for the health-care system in general and Medicare in particular. Adult obesity rates increased in 23 U.S. states last year and did not fall in a single state, an annual survey released on July 1 found. Adult obesity rates now exceed 25% in 31 states, up from 28 states last year and 19 the year before that.

The problem appears destined to continue worsening, too, the report indicates. Among children 10-17, about 30% are overweight or obese in 30 states, says the survey, which also examined youth this time around. Study after study has found that overweight children are more likely to become obese as adults, and obese children are almost certain to remain that way. "There is a huge wave of obese adults coming that will bankrupt us as a nation unless we get this under control now," said Dr. James S. Marks, senior vice-president of the Robert Wood Johnson Foundation.

The survey, titled F as in Fat: How Obesity Problems Are Failing in America, was conducted by the nonprofit organizations Trust for America's Health and the Robert Wood Johnson Foundation. It depicts a disconcerting increase in a condition that, when combined with attendant risks such as diabetes and heart disease, make up the most expensive burdens on the nation's health-care system.

The researchers noted that overweight people tend to live as long as the thin, but with far more chronic diseases that are costly to treat. "How are we going to compete with the rest of the world if our economy and workforce are weighed down by bad health," said Jeff Levi, executive director of Trust for America's Health.

In 49 States, 1 in 5 Is Obese

The researches did see a slim sign of hope, in that only 23 states showed an increase in obesity rates this year, compared with 37 with higher rates in last year's survey. Still, the report found that two-thirds of U.S. adults are now considered overweight or obese, as determined by their body-mass index, a measure of weight in relation to a person's height. The survey also found that four states have obesity rates above 30%: Mississippi (32.5%), West Virginia (31.2%), Alabama (31.1%), and Tennessee (30.2%).

Adult obesity rates now exceed 20% in 49 states plus the District of Columbia. Only Colorado, where 18.9% of the population is obese, falls below the 20% mark. Still, in 1991, no state had an obesity rate above 20%.

Adult obesity rates increased in 19 states in the past year, to the point where more than 10% of the population in seven states now has type 2 diabetes. More than 20 million adult Americans now have diabetes, and prevalence of the disease has doubled over the past 10 years, from 4.8 people per 1,000 to 9.1 per 1,000. A further 57 million Americans are pre-diabetic, which means they are at high risk and likely to develop the disease in 5 to 10 years.

The survey was done by combining three years of data, 2006-08, from the U.S. Centers for Disease Control & Prevention's behavioral Risk Factor Surveillance System. Childhood obesity and overweight rates are based on the National Survey of Children's Health.

Boomers' Weight Problem

The researchers noted that the current recession could exacerbate the obesity crisis, because prices for fruits, vegetables, and other healthier foods are rising at the same time incomes are falling. They also pointed out that the Baby Boom generation, now beginning to retire, is the fattest cohort yet, which could significantly burden Medicare. In every state, the 55-to-64 age group has a higher rate of obesity than people over 65, an ominous sign for Medicare. The researchers calculate that the number of obese Medicare patients could increase by anywhere from 5.2% in New York to 16.3% in Alabama.

Eight of the 10 most obese states are in the South, with Michigan and Ohio rounding out the list. The survey found that adult obesity rates rose for a second straight year in 16 states and a third consecutive year in 11 states. Mississippi has consistently held the top spot for the past three years, while Colorado has been at the bottom of the list.

Mississippi also has the highest percentage of children who are overweight or obese, at 44.4%, while Minnesota and Utah were tied for the lowest, at 23.1%. The full report, with all state rankings, can be found at

Arnst is a senior writer for Business Week based in New York.

Arnst is a senior writer for BusinessWeek based in New York.

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