Obesity, Clinical Implications and Prevention:
In the United States, obesity continues to be a serious public health concern; approximately 1 in 5 children and 2 in 5 adults are affected. The CDC's Division of Nutrition, Physical Activity, and Obesity (DNPAO) supports national, state, and local efforts to make healthy living more accessible through public health strategies.
Children with obesity are at greater risk for various health issues, such as high blood pressure and type 2 diabetes, and are more likely to become adults with obesity. In adulthood, obesity significantly increases the risk of conditions like heart disease, type 2 diabetes, and certain types of cancer. In terms of economic evaluation, obesity places a substantial financial burden on the U.S. healthcare system, costing nearly $173 billion annually.
Previous Outcomes:
The rate of obesity among toddlers (ages 2–4) enrolled in WIC—the Special Supplemental Nutrition Program for Women, Infants, and Children—dropped from nearly 16% in 2010 to about 14% in 2020. In addition, the percentage of U.S. adults meeting full physical activity guidelines during leisure time rose from 14% in 1998 to 24% in 2018. Furthermore, from 2014 to 2022, 47 states strengthened their early care and education (ECE) center licensing regulations by adding more high-impact obesity prevention standards.
Why is it still a concern?
Obesity is still a concern because less than 10% of children and adults consume the recommended daily servings of vegetables, fewer than 25% of young people get adequate aerobic exercise, and only 1 in 4 adults meet the full physical activity guidelines. The primary cause of obesity is the imbalance between calories consumed and calories burned. However, many of the factors that contribute to overweight and obesity can be prevented. In addition, while several factors contribute to obesity, in the last few decades, general eating habits have shifted towards energy-dense foods that are high in fat and added sugars. At the same time, levels of physical activity have declined, which could be due to changes in the workplace, greater reliance on transportation, and growing urbanization.
Clinical Implications:
Overweight and obesity are significant risk factors for many chronic diseases. Cardiovascular conditions such as heart disease and stroke—currently the leading causes of death worldwide—are strongly associated with excess weight. Obesity also increases the risk of type 2 diabetes and its complications, which can include blindness, kidney failure requiring dialysis, and even limb amputations. Since 1980, global rates of diabetes have quadrupled. Carrying extra weight also contributes to musculoskeletal problems like osteoarthritis, and it is associated with several types of cancer, including cancers of the endometrium, breast, ovary, prostate, liver, gallbladder, kidney, and colon. Importantly, these risks begin to rise even with modest weight gain and become more serious as body mass index (BMI) increases.
Childhood obesity comes with additional challenges. It is related to numerous serious health complications and raises the likelihood of early onset of related diseases. Research shows that, without intervention, children and adolescents with obesity are highly likely to remain obese as adults.
Prevention:
Reducing the risk of overweight and obesity involves adopting healthier lifestyle choices. This includes limiting calorie intake from fats and sugars, increasing the consumption of fruits, vegetables, legumes, whole grains, and nuts, and engaging in regular physical activity—around 60 minutes daily for children and 150 minutes weekly for adults. Research also shows that exclusive breastfeeding during the first six months of life can lower the likelihood of infants becoming overweight or obese.
Intervention by the CDC
CDC collaborates with state and local groups to prevent obesity and support individuals with obesity through the following programs:
High Obesity Program (HOP)
State Physical Activity and Nutrition (SPAN)
References
[1] Defining adult obesity. Centers for Disease Control and Prevention. Updated June 7, 2021. Accessed January 29, 2021. www.cdc.gov/obesity/adult-obesity-facts/ External link
[2] Fryar CD, Carroll MD, Afful J. Prevalence of overweight, obesity, and severe obesity among adults aged 20 and over: United States, 1960–1962 through 2017–2018. NCHS Health E-Stats, Centers for Disease Control and Prevention. 2020. Updated February 8, 2021. Accessed January 29, 2021. www.cdc.gov/nchs/data/hestat/obesity-adult-17-18/obesity-adult.htm External link
[3] What causes obesity and overweight? National Institute of Child Health and Human Development, National Institutes of Health. Updated July 28, 2021. Accessed January 29, 2021. www.nichd.nih.gov/health/topics/obesity/conditioninfo/cause NIH external link
Dr. Emmanuel Opada is an epidemiologist at the Victoria County Public Health Department, where he coordinates disease surveillance activities for the County of Victoria and its environs. He holds a Master of Public Health degree from Saint Louis University, Missouri.
