Diabetes Rates Soar

November 28th, 2012 No comments »

The Center for Disease Control and Prevention (CDC) has reported that the prevalence of diagnosed diabetes has increased in all US states, the District of Columbia and Puerto Rico between 1995 and 2010. The prevalence increased by 50% or more in 42 states and by 100% or more in 18 states. The states with the largest increases were Oklahoma, Kentucky, Georgia, Alabama and Washington. According to the CDC press release, in 1995 only 3 states had diagnosed diabetes prevalence of 6% or more; by 2010, all 50 states had a prevalence over 6%.

The press release, (rather amazingly to my point of view) states, “Type 2 diabetes, which may be prevented through lifestyle changes, accounts for 90 percent to 95 percent of all diabetes cases in the United States. CDC and its partners are working on a variety of initiatives to prevent type 2 diabetes and to reduce complications in those already diagnosed. CDC leads the National Diabetes Prevention Program, a public-private partnership that brings evidence-based programs for preventing type 2 diabetes to communities. The program is helping to establish a network of lifestyle-change classes for overweight or obese people at high risk of developing type 2 diabetes.” Of course the evidence-based program they refer to are the Diabetes Prevention Program, which found lifestyle prevention was only effective in young retirees and the Look AHEAD trial, which was terminated prematurely because the lifestyle group had no better outcomes than the control group. Why does the CDC continue to hype bang-the- lifestyle-drum when they know it doesn’t work?

 

Gallup: Obesity Increases In All Age Groups

October 24th, 2012 No comments »

The Gallup survey has reported that obesity has increased in every age group in the United States from 2008 to 2012. The Gallup-Healthways Well-Being Index tracts health indicators. This survey showed significant increases in obesity among the elderly. It points to a steady pattern of weight gain through adulthood with decreases only in the 70s. “Most Americans who are over the age of 35 are now significantly more likely to be obese than those who were that same age four years ago, “ according to the report. GallupPoll: Obesity Increases in Every Age Group

One Third of Elderly Are Obese

October 3rd, 2012 No comments »

The National Center for Health Statistics has updated its prevalence figures for obesity among older Americans.  It finds that more than one-third of older Americans over age 65 were obese in 2007-2010, representing 8 million adults aged 65-74 and 5 million age 75 and older.  There was a strong linear increase among older men but not women. The report somewhat understates the baby-boomers hitting retirement age, noting, “As Americans live longer and the age distribution shifts so that there are more older adults, the number of obese adults could grow, even without an increase in obesity prevalence.”  CDC/NCHS_Prevalence of obesity Among Older Adults

 

Morbid Obesity Continues to Increase

October 3rd, 2012 No comments »

Severe or morbid obesity (BMI >40) continues to grow. A new analysis estimates, after adjusting for self-report biases, that, in 2010,  15.5 million adult Americans or 6.6% of the population had an actual BMI >40 kg m−2. The prevalence of clinically severe obesity continues to be increasing, although less rapidly in more recent years than prior to 2005.   PubMed: Morbid Obesity Continues to Rise in the US. To put this number in perspective, 15.5 million is the in-between the population of the 4th and 5th largest states by population, Florida and Illinois. Or, it is roughly equal to the populations of Nebraska, Idaho, Hawaii, Maine, New Hampshire, Rhode Island, Montana, Delaware, South Dakota, Alaska, North Dakota, Vermont, Washington, DC, and Wyoming, combined. It is also about equal to the total US population that use Twitter and the total Asian-American population.

Eric Finkelstein et al have projected that morbid obesity will increase 130% over the next 2 decades. PubMed: Obesity and Severe Obesity Forecasts through 2030

What is significant, to my mind, is that unlike any other chronic disease I can think of, we have an effective treatment for the most severe cases…bariatric surgery. We could (and should) employ a strategy to bring this intervention to this population which we know can benefit from it. This is the same population which has the highest mortality, morbidity and health care costs and health care utilization. What am I missing?

 

Updated Adult Obesity Prevalence Figures

September 18th, 2012 No comments »

The National Center for Health Statistics (NCHS)  has issued one of its periodic reports, “Prevalence of overweight, obesity and extreme obesity among adults: United States Trends 1960-1962 Through 2009-2010.” The results of the 2009-2010 NHANES show that 33% of US adults are overweight, 35.7% are obese and 6.3% are extremely obese (defined as a BMI of 40 or more.)  In 1988-1994, the prevalence of adult obesity was 23%. The prevalence of obesity among adults 20-74 more than doubled between 1976-1980 and 2009-2010 while the prevalence of overweight was basically stable.

Extreme obesity has increased among adults age 20-74 from 0.9% in 1960-1962 to 6.6% in 2009-2010. Among men, the prevalence has changed from 0.3% to 4.6%; among women from 1.4% to 8.5%.

Source: http://www.cdc.gov/nchs/data/hestat/obesity_adult_09_10/obesity_adult_09_10.html

 

Updated obesity prevalence figures for children and adolescents

September 18th, 2012 No comments »

NCHS has also updated the prevalence figures for children and adolescents, from 1963-1965 to 2009-2010. Overall, data from NHANES indicate 16.9% of children and adolescents aged 2-19 are obese. Among preschool children aged 2-5,  obesity increased from 5% to 12% between 1976-1980 and 2009-2010. Among children aged 6-11, the prevalence rate increased from 6.5% to 18% and among adolescents aged 12-19 from 5% to 18.4%.

Source: http://www.cdc.gov/nchs/data/hestat/obesity_child_09_10/obesity_child_09_10.html

 

The Picture of Underweight in America

September 18th, 2012 No comments »

Regarding adults, they report a significant decrease in underweight from an estimated 4% in the early 1960s to 1.7% in 2007-2010. The decrease was significant among all age groups. While the prevalence of underweight is greater among women than men, a significant decline was observed in both genders. Women age 20-39 saw a decrease in prevalence of underweight went from 3% in 1988-1994 to 1.9% in 2007-2008.

Source: http://www.cdc.gov/nchs/data/hestat/underweight_adult_07_10/underweight_adult_07_10.htm

Regarding children and adolescents aged 2-19, an estimated 3.5% are underweight, down from 5.1% in 1971-1974. Among children aged 2.5, prevalence dropped from 5.8% to 3.4% from 1971-1974 to 2007-2010; among children 6-11, the rate dropped from 5.3% to 3.6%. No significant change was observed among adolescents aged 12-19.

Source: http://www.cdc.gov/nchs/data/hestat/underweight_child_07_10/underweight_child_07_10.htm

An interesting observation on underweight has come from a study by Koh and colleagues. They looked at demographic, BMI and related data from the Boston Health Care for the Homeless Program and compared the data on the homeless to the NHANES data. They found that only 1.6% of the homeless adults were underweight. They found that the homeless population weight distribution was basically the same as the general population. They state, “Although underweight has been traditionally associated with homelessness, this study suggests that obesity may be the new malnutrition of the homeless in the United States. PubMed: Koh: The Hunger_Obesity Paradox: Obesity in the Homeless

 

Older Americans Showing Greater Obesity

August 17th, 2012 No comments »

It had been generally assumed that older Americans were not experiencing the higher rates of obesity seen in children, adolescents and younger adults. Not so, according to a new federal report. The report, covering many demographic features of older Americans, finds that in 2009-10, 38% of people age 65 and over were obese, compared with 22% in 1988-1994. In 2009-2010, 44% of people age 65-74 were obese, as were nearly 30% of those 75 and over. The report is available at http://www.agingstats.gov/agingstatsdotnet/main_site/default.aspx.

This report would indicate that Medicare should do more to address obesity in the over 65 population. Bariatric surgery is already covered as is intensive behavioral counseling. What is excluded are drugs to treat obesity under Part D. This report would indicate it is time to re-examine this exclusion.