MEPS Brief: Obesity in America

Obesity is a serious condition that is associated with numerous comorbid conditions, including heart disease, bone and joint problems, diabetes, and elevated cholesterol levels. The 2009 Medical Expenditure Panel Survey (MEPS) includes data on the prevalence of obesity in the adult (≥20 years of age) population in the United States. The MEPS is conducted by the US Department of Health and Human Services Agency for Healthcare Research and Quality.

According to Statistical Brief #364 (Obesity in America: Estimates for the US Civilian Noninstitutionalized Population Age 20 and Older, 2009), obesity (calculated using an individual’s height and weight) is not evenly distributed across all subgroups of adults. The brief identifies variation in the percentage of healthy weight, overweight, and obese adults by various socioeconomic and demographic characteristics of the population and by selected comorbidities.

Healthy weight was defined as a body mass index ≥18 and <25; overweight as a BMI ≥25 and <30, obese as a BMI ≥30 and <40, and extremely obese as a BMI ≥40.

In 2009, 33.2% of all US adults had a healthy weight, 35.8% were overweight, 25.1% were obese, and 4.5% were extremely obese. There were significant differences by sex, race, age, and geographic area of residence. Men were less likely to have a healthy weight compared with women (27.4% vs 38.6%, respectively), non-Hispanic African Americans were more likely than other race/ethnic groups to be obese or extremely obese (31.0% and 8.0% vs 24.8% and 4.1% for all other races combined).

Those 20 to 24 years of age were less likely to be overweight or obese compared with those 25 to 44 years of age, 45 to 64 years of age, and ≥ 65 years of age (overweight: 26.1%, 35.1%, 37.6%, and 39.0%, respectively; obese, 15.3%, 24.6%, 28.5%, and 24.4%, respectively). Those living in the Northeast and West were more likely to be a healthy weight compared with those living in the Midwest and South (36.0% and 35.6% vs 32.2% and 30.8%, respectively).

Differences in health insurance status were also associated with differences in obesity rates. Compared with those with private insurance, people with public insurance were more likely to be obese or extremely obese (25.1% vs 29.8% and 4.0% vs 10.4%, respectively). There were also differences between those with public insurance and those who were uninsured.

Comorbidities were more common among those who were obese or extremely obese. Heart conditions were reported for 41.5% of the obese and 50.0% of the extremely obese compared with 18.2% of those with healthy weight and 29.8% of those classified as overweight. High cholesterol was reported for 41.9% of the obese and 39.5% of the extremely obese, compared with 21.6% of those with healthy weight and 35.1% of those who were overweight.

Diabetes was reported for 15.0% of the obese and 22.8% of the extremely obese, compared with 4.0% of those with healthy weight and 7.1% of those who were classified as overweight. Joint pain was reported by 58.4% of the obese and 68.8% of the extremely obese, compared with 39.5% of those with healthy weight and 49.1% of those who were overweight.

Among those with healthy weight, 66.8% reported exercising 3 times a week, compared with 61.7% of those who were overweight, 50.0% of those who were obese, and 30.9% of those who were extremely obese. The analysis also found that those people identified as obese or extremely obese were more likely to have been advised by a physician or other healthcare professional to restrict their intake of foods high in fat content compared with those who were overweight or a healthy weight (51.3% and 61.1% vs 36.6% and 20.2%, respectively).