by Marion Nestle
Jan 22 2012

Good news: obesity rates leveling off. But how come?

The latest obesity statistics from the Centers for Disease Control and Prevention show no change over the last several years in either adults or children.  No change is good news.

For adults in 2009-2010 the prevalence of obesity was 35.5% among men and 35.8% among women.  Obesity, in these surveys is defined as a Body Mass Index (BMI) at or greater than 30.

This represents no significant overall change compared to rates in 2003-2008.  

Going back to 1999, however, obesity rates increased significantly among men in general, and among black (non-Hispanic) and Mexican-American women in particular.  In more recent years, the rates among these groups leveled off.

 For children and adolescents in 2009-2010 the prevalence of obesity was 16.9%.  For this group, obesity is defined as a BMI at or greater than the 95th percentile of weight for height.

This represents no significant change compared to rates in 2007-2008, but with one exception: the rate of obesity among adolescent males aged 12 through 19 increased.

For decades, rates of overweight and obesity in the United States stayed about the same. But in the early 1980s, rates increased sharply and continued to increase through the 1990s.

The increases correlated closely with deregulatory policies that encouraged greater farm production and loosened restrictions on food marketing.  These led to an increase in the number of calories available in the food supply, pressures on food companies to sell those calories, a proliferation of fast food places, and marketing strategies that made it normal to drink sodas all day long, and to eat everywhere, at all times of day, and in larger portions.

Why are obesity rates leveling off now except among boys?  Nobody seems to know.

I can make up several reasons, all speculative (and I have my doubts about most of them).

  • People have gained all the weight they can and are in equilibrium
  • People are more careful about what they are eating
  • The poor economy is encouraging people to eat less
  • Junk food marketing is targeted more to boys
  • Girls are more careful about their weight
  • Boys are particularly susceptible to “eat more” marketing pressures
  • Boys are under greater psychological tension and eat to relieve it

Anyone have any better ideas?  It would be good to figure out the reason(s) as a basis for more sensible public policy.

  • http://www.eatrealbewell.net Kerri

    I have no grounding for this but I’m wondering about sexual development, high testosterone levels at this age and its interaction with the chemicals found in the ‘foods’?

  • Erin

    Boys play more video games leading to more sedentary time?

  • http://www.njnutritioncenter.com Alexander J. Rinehart, MS, DC, CCN

    Considering that some 70% of adult Americans are overweight and obese and the generation of Americans born after the year 2000 are the first EVER not expected to outlive their parents (because of problems associated with obesity), I would say that we may have finally maxed out with the forces of “good” finally starting to catch up.

    Grocery stores are changing, the “energy in, energy out” them of nutrition is finally evolving, and Americans are realizing that we do not want the same health outcomes as our aging baby-boomers

    As for economics, the 3 main indicators of food choice is taste, cost and convenience. The last century was defined by cheap, good tasting, highly convenient food that just happened to be highly correlated with progression of chronic diseases like obesity. When we make healthy food, cheap, convenient, and rediscover natural sugars and taste combinations, we will move this trend in the opposite direction.

  • http://www.njnutritioncenter.com Alexander J. Rinehart, MS, DC, CCN

    Considering that some 70% of adult Americans are overweight and obese and the generation of Americans born after the year 2000 are the first EVER not expected to outlive their parents (because of problems associated with obesity), I would say that we may have finally maxed out with the forces of “good” finally starting to catch up.

    Grocery stores are changing, the “energy in, energy out” theme of nutrition is finally evolving, and Americans are realizing that we do not want the same health outcomes as our aging baby-boomers

    As for economics, the 3 main indicators of food choice is taste, cost and convenience. The last century was defined by cheap, good tasting, highly convenient food that just happened to be highly correlated with progression of chronic diseases like obesity. When we make healthy food, cheap, convenient, and rediscover natural sugars and taste combinations, we will move this trend in the opposite direction.

  • http://www.muchmorethanfood.com Bonnie Modugno, MS, RD

    My guess is trans fats. I’m wondering if the labeling of trans fats, removal/reduction of trans fats in so many breads, grain based desserts, snack foods and other processed foods is having more impact than anyone expected.

  • justthefacts

    Perhaps some of it is the recession. People are going out to eat less and perhaps buying a bit less of some calorie dense food–such as meat. Young men, however, perhaps are more likely to maintain larger appetites for really big burgers with extra cheese and bacon?

    Most of your guesses could be true in some ways, all adding up to the result you report.

    Increased awareness may also be a partial factor. I really think it’s probably the sum total of many little things.

  • http://mediterraneandiet.tv/ edSanDiego

    It’s you Marion! And the army of good food folk online.

    The internet has given a voice to rationality. And there are many rational people trying to make a difference.

    Nutritional advice was once channeled through specific mediums. You had to be in need of help to get help.

    Now, good nutritional advice can be delivered to a wider group for no extra cost or effort. All you need is an ethical head, a computer and any number of social media tools to stay in the minds of people that just need a daily nudge or reminder.

    In the internet age, Big Food is not as big as the internet with an army of coordinated public health advocates.

    If you add up all the people that follow Marion and any number of other health professionals via social media, it all ads up to many hundreds of thousands of people, that each have one or two people they talk to about healthy eating and what they have herd from trusted sources.

    Go forth and give good advice, its working. You always advise people to ‘take small steps’, so keep connecting with one more person via social media.

    Well, that’s my theory at any rate.

    @mediterraneandi

  • Jill

    I have taught nutrition at the community college level since 1984. I have seen many hundreds of three day food records. I am going to vote for Marion’s second supposition. “People are more careful about what they eat.”

    Many students of mine bring to class a better understanding of some of the important concepts of healthful eating than they did a decade ago. Many understand the risks of being overweight and are actively making choices to try to avoid or remedy this problem for themselves and their families. (As an aside, they bring a host of misunderstandings too. These can often be traced to advertising for commercially available products.) Many are trying to make good choices in an environment that is rife with poor nutrition options.

    I would hazard a guess that the rising obesity rate of adolescent males is directly related to their lack of knowledge about healthful eating. Some male students are well informed but the vast majority are surprised to discover that their food choices may put them at risk of poor health.

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  • http://kitchnsink.wordpress.com Elizabeth

    I don’t think this is cause for celebration. Just because the prevalence of obesity didn’t increase, doesn’t mean that the obese didn’t continue to gain weight. Aren’t we still seeing escalating rates of severe obesity?

  • Casey

    I think it’s a good sign the obesity rates didn’t go up the past few years despite an increase in poverty. I’m inclined to agree the internet has helped stop the rates from rising. Instead of individuals fighting this on their own in isolated pockets, we have the ability to connect and share what is working. We can also find out what’s not working (dieting) and shift the focus to prevention. When my children’s teachers use food as a reward, I can back up my opinion that it’s not in our kids’ best interest with information from all the major medical organizations.

  • http://www.orgasmicchef.com Maureen

    I think more people are cooking at home and that means less fast food filled with salt, sugar and fat. Could be the economy but it could also be that so many of us are learning more and deciding the best meals for our families.

  • Margeretrc

    I don’t imagine there is one single reason–I’m sure there are a lot of things at play. Perhaps, as has been said, people are eating less processed foods, eating out less, cooking more with real ingredients, eating real food. Perhaps they are drinking less sugary beverages. Who knows? All of the above are good things.
    @justthefacts, check your facts. It’s not meat or cheese that makes anyone fat–it’s the sugar and starches that come with them. Young men are likely eating extra large fries and drinking boatloads of soft drinks with their “really big burgers with extra cheese and bacon”, which could explain the lack of decline in obesity among them–not the burger itself or the cheese or the bacon. People have been reducing consumption of meat and sat fat for decades–why would that suddenly level the rate of obesity off now, in the last few years? On the other hand, it could be the opposite of what you said–people are eating more meat and fat and concomitantly reducing their consumption of sugar and starch. Now that would explain the leveling off of obesity numbers. One can only hope it’s true.

  • http://www.primegourmetmeats.com Nancy Siyad

    Boys, please try to avoid the unhealthy eating habits and control your weight, it will makes you more energetic.

  • Michael

    Surprisingly, soda consumption — at least on a raw per capita basis — has apparently been going down for the last decade or so:
    http://cspinet.org/new/201004141.html

    This might be contributing to the leveling off; we might still be undergoing a catchup period from higher levels of consumption in earlier years, leading to cohort effects; also, people may be substituting sodas and energy drinks, specific groups almost certainly will vary in their secular trends, etc.

  • Michael

    Example of differential consumption: “The [NYC] citywide average [soda consumption] is 32 percent, down 12 percent between 2007 and 2009.” But there are much lower rates in upper-income neighborhoods in NYC, and higher rates in poorer ones:
    http://www.nypost.com/p/news/local/straw_poll_income_divides_soda_drinkers_b0nhA4gYebA90skuybfKvI

    Other associations reported in previous NYC data:
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2329746/

  • http://facebook.com/trillstreasures Tricia

    I think the amount of calories available in the food supply is now saturated. We have had 1000’s of calories available to us day and night, and you can’t go up from there.

    I think that adolescent boys who were overweight used to play a lot of sports. These days there are a lot of competing activities available, computers, video games, ect. I also think that sports programs have been cut somewhat, with the remaining sports programs more competitive. The average “fat kid” might have been encouraged to participate in sports 10-20 years ago, and might not even make the team these days.

  • Cathy Richards

    My theory is that some reports just look at “obesity” with a BMI of over 30, and don’t get into the finer categories of 35-40 or greater than 40. Similarly with kids they look at BMI for Age above the 97th percentile, but don’t fine tune how many standards of deviation they are from the norm/50th percentile. Some kids BMI for Age is way off the charts.

    Anyway, as we know BMI is a very poor measure of fatness and of fitness, let alone health (stress, social, etc). I wish there was a “waist for height” growth chart :)

    Oh well, BMI is what we’ve got.

    Hopefully this study — when they looked at kids — corrected for whatever growth charts were used, and whether self-reported or measured data was used. Mark Tremblay in Canada has shown how skewed stats on BMI can be if they compare apples to oranges (or should I say apples to pears?).

  • Joe

    If the BMI scale is not giving an accurate picture of overweight and obesity (let alone health) then why is it the measure of record.

    This is part of the insanity that is the health establishment/public health/government health. They can move the goal post at will, set the rules at will, change the rules at will then deride us for breaking their rules. It is a weapon of mass distortion!

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  • http://drjohnlapuma.com Dr John La Puma (@johnlapuma)

    Actually, obesity rates increased significantly among men in general, not just boys, from 1999 until 2010.

    Men are half the population, though not the half for whom diet books, plans and programs are written.

    Obesity went up in men from 27.5% in 1999 to 35.5% in 2009-10.

    I wonder if men are more affected by environmental endocrine disruptors than women, and boys than girls. I know men handle food differently and need a different approach behaviorally and in diet.

  • Laura

    Echoing others, I think men are less likely to be aware, or admit, the connection between food and health for themselves. And the relationship between foodies and hipsters that’s exploded in recent years includes many young men who are now eating artisanal doughnuts, single-origin lattes, handmade chocolate bars, heirloom cheeses, and organic bacon wrapped around everything. I think there’s a perception that if it’s artisanal or organic, it’s not as bad for you. (Wish that were true!)

  • NYVegan

    Three additional (and highly speculative) thoughts:
    The population of boys in the 12-19 year age range is heavily weighted (no pun intended) toward public school age. The USDA’s influence (i.e., subsidized foods, guidelines, etc.) on school lunch composition may have changed, but you will know about this better than anyone.
    Regarding the rest of the population, red meat consumption has actually declined (yea!), whether because of health concerns or financial difficulties.
    All Americans, and perhaps young boys in particular, are more sedentary. Riding the subway, I was amazed at how many people were experiencing their own reality, talking on their cell phones, playing video games, or working on their computers. Young boys are possibly most susceptible to this trend, at the expense of exercise.