State-Specific Prevalence of Obesity Among Adults - United States, 2005

Obesity, one of the 10 leading U.S. health indicators, is associated with increased risk for hypertension, dyslipidemia, type 2 diabetes, coronary heart disease, stroke, and certain cancers. A Healthy People 2010 objective is to reduce to 15% the prevalence of obesity among adults in the United States (objective 19-2). Both national-level data from the National Health and Nutrition Examination Survey (NHANES) and state-level data from the Behavioral Risk Factor Surveillance System (BRFSS) indicate that the prevalence of obesity among adults continued to increase during the past decade.

In 2003, one study estimated that state-specific, obesity-attributable medical expenditures ranged from $87 million in Wyoming to $7.7 billion in California. To assess the prevalence of obesity among adults by state and demographic characteristics since 1995, data were analyzed from the 1995, 2000, and 2005 BRFSS surveys. The results of these analyses indicated that 23.9% of U.S. adults were obese in 2005, and the prevalence of obesity increased during 1995-2005 in all states. To reverse this trend, a sustained and effective public health response is needed, including surveillance, research, policies, and programs directed at improving environmental factors, increasing awareness, and changing behaviors to increase physical activity and decrease calorie intake.

BRFSS data are used to track the prevalence of chronic disease risk factors and monitor progress toward state-specific health objectives. BRFSS is an ongoing, state-based, random-digit–dialed telephone survey of the noninstitutionalized, U.S. civilian population aged ≥18 years. BRFSS data files are weighted to the respondent's probability of being selected and to the age-, race-, and sex-specific populations from the annually adjusted census for each state. In 2005, response rates* among states ranged from 34.6% to 67.4% (median: 51.1%), based on Council of American Survey and Research Organizations (CASRO) guidelines. Cooperation rates{dagger} ranged from 58.7% to 85.3% (median: 75.1%). In 1995 and 2000, median CASRO response rates were 68.4% and 48.9%, and median cooperation rates were 71.3% and 53.2%, respectively.

Self-reported weight and height were used to calculate body mass index (BMI) (weight [kg] / height [m2]). Overweight was classified as BMI ≥25.0, obesity as BMI ≥30.0, and extreme (class III) obesity as BMI ≥40.0 kg/m2. To be consistent with previous analyses,4 data were excluded if a respondent's weight was ≥500 lbs or height was ≥7.0 ft.

In 2005, among the total U.S. adult population surveyed, 60.5% were overweight, 23.9% were obese, and 3.0% were extremely obese. Obesity prevalence was 24.2% among men and 23.5% among women and ranged from 17.7% among adults aged 18-29 years to 29.5% among adults aged 50-59 years. Among racial/ethnic populations, the greatest obesity prevalence was 33.9% for non-Hispanic blacks. Overall, age-adjusted obesity rates were 15.6%, 19.8%, and 23.7% for the 1995, 2000, and 2005 surveys, respectively.