I’m Back

For those of you who have followed my many blogs in the past, I am sure the fact that I have not had a new blog in almost 15 months has not escaped your attention. For that, I apologize. I do have a good excuse. I had been busy caring for an ailing family member, and that was more of a priority for me than putting my medical thoughts down on paper. But, I am now ready to restart regular entries. I will try to do a new entry every 1-2 weeks. I want to start by discussing a totally frightening article that was published in the NEJM on December 19, 2019. The article was entitled “Projected U.S. State-Level Prevalence of Adult Obesity and Severe Obesity,” and written by Z.J. Ward and colleagues.

The article summarized U.S. state-by state body-mass index (BMI) data collected between 1993 and 2016 on more than 6 million people who have been participating in the Behavioral Risk Factor Surveillance System Survey. The results show with a high degree of predictive accuracy that by 2030 nearly 50% of adults in the U.S, will have obesity. In 29 states, the prevalence will be greater than 50%. In addition, severe obesity (defined by BMI of 35 or greater) will be the most common BMI category among women (27.6%), non-hispanic black adults (31.7%), and low-income adults (31.7%). What is particularly interesting is that there have been and will continue to be very large disparities across states and demographic subgroups. I found it particularly interesting that regardless of income, sex, and race, the highest prevalence of obesity and severe obesity is concentrated in the south-central region of the country. Two states stand out as having far less obesity at present and in the future- Colorado and California. Why is that?

In my opinion the most important consideration is as follows: what can we do to mitigate the disturbing trends? For sure, we should copy the Europeans and stress health and physical education in the schools, not cut back on them which is the current trend in the U.S. We also need to improve our education of all health professionals, so they can better advise their patients on the health hazards of obesity and what to do about it.

It is time to stop just talking about obesity, but to actually do something about it. It won’t be easy, since we will be fighting genetics and opportunity (the alarming trend in modern society to require far less physical activity than in the foggy past). You may want to check out some of my earlier blogs that address these issues.

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