
U.S. Adult Obesity Rate Tops 42 Percent; Highest Ever Recorded - bluedino
https://www.prnewswire.com/news-releases/us-adult-obesity-rate-tops-42-percent-highest-ever-recorded-301132778.html
======
lordnacho
Ask any traveller to the US what their trip was like, and at some point they
will mention how portion sizes are gigantic. I have to agree, every time I've
eaten there it's been way bigger than both what's good for me and what I was
happy to get get for the price. This doesn't seem to stop at restaurants, I
went to a supermarket and you can mega sized versions of just about anything.
Even the strawberries seem to be bigger. You can get buckets of jelly babies.
The ready made pizzas seem to be bigger. Just everything.

At the same time, most travellers will tell you the food was delicious. This
may be good for keeping customers happy, but it's going to tend to mean things
that our hunter gatherer ancestors wanted to stock up on, in quantities they
would rarely find.

Finally, sweets and junk food in America are like crack. I don't know what
they put in it, but just about everything in that category is more enticing
than the same categories in Europe.

My brother had a six pack before he moved there. Now he has a beer belly.

~~~
r00fus
> at some point they will mention how portion sizes are gigantic.

Do you generally have doggy-bags (leftovers carry-out) outside the US? The
portions sizes are large for a few reasons: 1) pricing needs to stay high as
rents are still high or the restaurant will fold (most do anyway). 2) people
often take leftovers home

So you pay higher prices for more food, and a 2nd (or sometimes 3rd) meal at
home.

I think the bigger issue is that due to sprawl and walk/bike-unfriendliness,
people take their cars everywhere. As a part of COVID restrictions my family
has started using bikes to things we would normally get in a car for - e.g.
get takeout or library - but most people don't.

~~~
WalterSear
The whole world uses take-home bags. They are just smaller in other countries.

~~~
swensel
I thought it was considered rude to ask for take-home bags in countries like
France. However, looks like that might be changing [1].

[1] [https://www.frenchtoday.com/blog/french-culture/french-
doggy...](https://www.frenchtoday.com/blog/french-culture/french-doggy-bag-
gourmet/)

~~~
yodsanklai
It is changing and it's great. It used to be unheard of (or even made fun of),
but nowadays it's acceptable in most places. That being said, I rarely have
the need for one except in Indian restaurants.

------
vmception
One aspect of this is that consensus shifts towards obese-normalization
despite no health consensus changing or scientific advancement supporting this
body form. It's merely rule by mob to accepting this because the mob is
overweight and obese.

Fascinating.

~~~
pm90
Body shaming is not a valid method of making people get in shape, so I don't
think there's anything wrong in the acceptance of people with more mass. We do
have other ways to encourage people to lose weight though, such as sugar
taxes, regulating processed foods' contents, investing in making fresh produce
widely available etc. which can make a difference.

~~~
zionic
>Body shaming is not a valid method of making people get in shape

Why not? It works. Are you more concerned with someones feelings than their
heart health? When they pass at a young age will their loved ones at their
funeral think "wow, at least nobody ever hurt their feelings"?

~~~
Barrin92
No it doesn't work, as in there is actual scientific evidence that disproves
that shaming is a valid way to modify behaviour towards better health. In fact
it's likely making things worse
([https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6565398/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6565398/))

 _The more people are exposed to weight bias and discrimination, the more
likely they are to gain weight and become obese, even if they were thin to
begin with. They’re also more likely to die from any cause, regardless of
their body mass index (BMI).

Fat shaming is also linked to depression, anxiety, low self-esteem, eating
disorders and exercise avoidance, Alberga said. There’s emerging evidence that
the severity of harm increases when people internalize weight bias and turn it
on themselves. In one study, participants with high levels of internalization
of weight-bias had three times greater odds of having metabolic syndrome than
those with low levels, even after controlling for BMI and other risk factors_

------
klmadfejno
The part about how food insecurity causes obesity is hard to understand. Its
well documented that poverty leads to unhealthier food. Its obvious that
poverty leads to food insecurity. Still, wrapping ones head around how not
having enough to eat leads one to be obese is tough to grok. Really emphasizes
just how bad cheap is for you.

The part about how 12 states have averages above 35%... didn't make sense to
me if the national average is 42. Maybe I missed something.

~~~
Spivak
A calorie's a calorie's a calorie. The food being cheap doesn't suddenly make
it more fattening. You can be skinny on a diet of birthday cake if you wanted
to.

* Not being sure that the next meal is coming means you have to pack on some lbs to reach the point where you can go a few days without a square meal.

* The not actually getting the next meal makes you ravenously hungry when it comes even if on average you're overeating. It's why people with EDs aren't automatically skinny -- if you restrict and then binge you can/will gain weight.

~~~
smilliken
There's a thermodynamic upper bound on the energy you can extract from a
dietary calorie. In that sense, the physical sense, a calorie is a calorie.

In the dietary sense, calories are NOT equal. It's easy to change a person's
body mass by changing their diet while keeping calories the same. Mixing
simple carbohydrates with fat is an effective way to get our metabolism to
generate body fat. Simple carbohydrates in general, really, since our body is
forced to process them into fat quickly or else our blood pH reaches harmful
levels.

Repeating "a calorie is a calorie" is harmful for people considering their
diet, and a truism if you're speaking to a physicist. In either case, not
helpful.

~~~
Spivak
See, I feel this is the exact opposite. Telling people that it’s possible to
lose weight without running a caloric deficit one way or another is the most
harmful piece of advice to give to anyone who’s on a diet.

I do not deny that it is probably possible to min max your diet and exploit
some of our bodies weirdness. But on a macro scale none of that shit matters.
If you run a caloric deficit it literally does not matter in the slightest
what your body does to the food: it can store in fat, it can burn it
immediately no matter what your body is still going to have to burn all of its
reserves to operate.

------
jefftk
Full report: [https://www.tfah.org/wp-
content/uploads/2020/09/TFAHObesityR...](https://www.tfah.org/wp-
content/uploads/2020/09/TFAHObesityReport_20.pdf)

p26 answers a question I had:

 _> WHY ARE REPORTED NATIONAL OBESITY RATES HIGHER THAN STATE-BY-STATE RATES?_

 _How is it that only 12 states have adult obesity rates exceeding 35 percent,
yet the national obesity rate is 42.4 percent? It’s because state obesity
rates are from the BRFSS, which collects self-reported height and weight.
Research has demonstrated that people tend to overestimate their height and
underestimate their weight. In fact, one study found that, due to this
phenomenon, the BRFSS may underestimate obesity rates by nearly 10 percent.256
NHANES, from which the national obesity rate is derived, calculates its
obesity rate based on measurements obtained at respondents’ physical
examinations. Accordingly, the higher rates found by NHANES are a more
accurate reflection of obesity in the United States.257_

------
partiallypro
I am 6' and weight 190-195, I was 175 before the pandemic. I am considered
overweight now, though I don't think I quite meet the obesity requirements. I
think the pandemic and its stress toll has given people something the
equivalent of the "Freshman 10."

~~~
neverminder
This. Before the whole corona hysteria I was well on track of getting into the
best shape in my life having lost 18 kg in 4 months and reduced body fat by
10%. The whole lockdown reversed all that and then some. They took away my
routine, my gym, even my food temporarily and put me under house arrest.

~~~
low_common
There's always the Great Outdoors. Go on a run, a bike ride, calisthenics.

~~~
SketchySeaBeast
Yup. I dropped my usual gym routine and went entirely to cardio because I
recognized if I didn't I was going to have problems - finished my first
(informal - just me and Strava) half marathon a couple of weeks back.

------
Ccecil
I live in the US. In passing I have noticed quite a bit about our culture
which lends to being overweight.

1) Structure: it is way too easy to get food that is horrible for you. Not
only that but in a way which you can eat it in the car on the way when you are
only "slightly hungry".

2) Commercial interests: Go into a Walmart and pay attention to the
organization. Everything which makes you fatter (and therefore consume more)
is directly in front of you and on the end of the aisles. You need to search
for the healthy food, and for some reason in my experience their limited
produce selection seems to spoil faster than other stores (how can my bananas
be green and rotten at the same time?)

3) Rewarding excess: It is in vogue to be wasteful. Being able to live in
excess and be wasteful is very popular in our culture this is not limited to
food, just look at the flatscreen TV count in houses, large inefficient cars
and houses, etc.

4) Exercise as an excuse: "I have a gym membership, I went this week...so I
can eat an extra 3000 calories today" That coupled with the lack of walking
from the car culture and you have a very low rate of calorie burn vs intake.

5) Sugar substitutes: Why does everything need sweetener? Does this sweetener
have effects we don't know about? There have been studies that say it also
causes obesity and diabetic issues. It is very common for people in this
country to drink several "diet" sodas a day and using that as reason to allow
themselves to have extra dessert/sweet things.

Just my observations, also, I fall into the overweight category even knowing
these things and making efforts to not continue the path which I was brought
up on. If I had not made an effort to change diet and exercise...who knows how
big I would be.

~~~
skim_milk
I agree but I wonder if there's more points?

6) Emotional support. I see less and less large people out and about and more
mostly attractive people hanging outside over the past decade. I have to
wonder if this is in part due to social media:

a) Less attractive people feel like they deserve less social status (not sure
if this is a USA-specific cultural thing but it's definitely a thing here)

b) Because of point a, spend more online because of the heightened feeling of
not deserving of making friends

c) Social media is absolute junk, the more time you spend on it naturally the
worse you're going to feel

d) Feedback loop of spending more time online, feeling bad, spending less time
outside with physical contact causing worse physical health, causing even more
time spent online, repeat for decades

More attractive people are naturally going to feel more deserving of love and
emotional support and more likely to seek it out because of our culture,
despite really we should all feel equally deserving of love and support. But
this feedback mechanism I think exists breaks that feeling of deserving
mental/physical fitness which is causes awful mental/physical fitness.

------
tabtab
I have three major comments about this. First, most countries use a lot of
public transportation, which often requires walking roughly a mile to and
again from work and commerce centers. This "forces" them to get regular
exercise. Our car culture cuts into that.

Second, we need better food labeling. "Serving size" is too arbitrary. Instead
use ratios: ratio per N calories, and ratio per weight. That way we can easily
compare across product types. It can be worded as "X units per N calories" and
"X units per gram", or the like. The units would be standardized.

Third, include percent of whole-ness of grain. It's hard to know otherwise. We
need to eat more whole grains, but 100% is not very tasty to most such that a
mix is decent compromise. But we need better numbers to know the mix percent.

~~~
angio
> Second, we need better food labeling. "Server size" is too arbitrary.
> Instead use ratios: ratio per N calories, and ratio per weight. That way we
> can easily compare across product types. It can be worded as "X units per N
> calories" and "X units per gram", or the like.

In Europe labels need to have nutritional information using standard units
(e.g. 100g or 100ml). It seems very odd they don't require that in the US too.

~~~
tabtab
That's part of the reason why Europeans are trimmer and healthier.

~~~
angio
I'm not sure that's the reason, but for sure things like standard nutritional
labels and semaphores on labels help making healthy choices.

------
mncharity
For anyone else who doesn't keep up with this, it seems at least some of
Chile's efforts[1] have survived the years US food industry lobbying,
lawsuits, and advertising, and have had some effect.[2] Brasil[3]... perhaps
has more pressing problems now.

Global push-back on Investor-State Dispute Settlement seems to have throttled
it's growth, and I don't quickly find any cases on food-health regulation
(though there's little transparency on threats of cases).

[1] [https://www.nytimes.com/2018/02/07/health/obesity-chile-
suga...](https://www.nytimes.com/2018/02/07/health/obesity-chile-sugar-
regulations.html) [2] [https://www.theguardian.com/world/2020/feb/11/chiles-
drastic...](https://www.theguardian.com/world/2020/feb/11/chiles-drastic-anti-
obesity-measures-cut-sugary-drink-sales-by-23) paper:
[https://journals.plos.org/plosmedicine/article?id=10.1371/jo...](https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003015)
[3]
[https://www.nytimes.com/interactive/2017/09/16/health/brazil...](https://www.nytimes.com/interactive/2017/09/16/health/brazil-
obesity-nestle.html)

------
tribune
Uh... _Mississippi has the highest adult obesity rate in the country at 40.8
percent and Colorado has the lowest at 23.8 percent._

Seems like this must be different (or old) data by State?

~~~
qntty
It seems that both numbers are from the same report. Here's an excerpt from
the report:

> How is it that only 12 states have adult obesity rates exceeding 35 percent,
> yet the national obesity rate is 42.4 percent? It’s because state obesity
> rates are from the BRFSS, which collects self-reported height and weight.
> Research has demonstrated that people tend to overestimate their height and
> underestimate their weight. In fact, one study found that, due to this
> phenomenon, the BRFSS may underestimate obesity rates by nearly 10 percent.
> NHANES, from which the national obesity rate is derived, calculates its
> obesity rate based on measurements obtained at respondents’ physical
> examinations. Accordingly, the higher rates found by NHANES are a more
> accurate reflection of obesity in the United States.

[https://www.tfah.org/wp-
content/uploads/2020/09/TFAHObesityR...](https://www.tfah.org/wp-
content/uploads/2020/09/TFAHObesityReport_20.pdf)

------
throw1234651234
This interesting to me, because I feel like more Americans are working out
than ever, but maybe it's just my environment. Naturally, working out usually
has second-order effects like watching nutrition.

~~~
chrisseaton
I guess it's bifurcated, like too many other things in our society are
becoming.

People are either doing no physical activity, or they're doing triathlons.

People either have multiple degrees, or they didn't finish high-school.

People either buy a house in their early 20s, or they're renting all their
lives.

People either read a book a week, or they never read a book at all.

(Obviously there are practically many people in between these extremes and
people are free to do whatever they want and many people are happy and
successful on both sides of each of these spectrums.)

~~~
thinkharderdev
Exactly this. It is astounding how extreme the difference can be sometimes.
You'll be in a major coastal city and it seems like everyone is relatively
trim, works out religiously and wouldn't touch a fast food hamburger. Then you
go to the midwest or the south and it seems like everyone you see is
overweight/obese, subsists on a diet of fast food and smokes cigarettes. I'm
shocked just noticing the number of people walking around smoking cigarettes
when I get out of East Coast metro areas. I literally don't know anyone where
I live who smoked anymore and rarely see anyone smoking on the street.

~~~
MiddleEndian
It's not JUST regional differences though. In 1990, the state with the
consistently highest obesity rate, Mississippi, only had 15% of the population
obese. Colorado, the leanest state, surpassed that in 2003 with 16% and got up
to 23.8% obese in 2019. As of 2019, Mississippi has climbed up to 40.8%. I
imagine in a decade or two Colorado will catch up, assuming no systematic
changes.

Source: [https://stateofchildhoodobesity.org/adult-
obesity/](https://stateofchildhoodobesity.org/adult-obesity/)

~~~
thinkharderdev
Right, there is definitely a broader change going on but I also don't think
looking at state level data really invalidates the urban/rural variance
divide. To take Colorado as an example, you see the same sort of divide I
mentioned when you go from Boulder/Denver to rural Western Colorado
(especially in the southwest in and around the reservations).

------
nprz
I'd be interested to see the rates segmented by generation. Everyone in my
generation (millennial) seems to be very sugar adverse, has that done anything
to lower obesity rates?

------
mensetmanusman
Covid has been particularly devastating for the obese and diabetic.

------
every
The ability to quickly and efficiently store fat would definitely have been a
positive trait under multigenerational "feast or famine" conditions. But not
so much for our relatively recent "perpetual feast" largess...

------
yodsanklai
No wonder, it's incredibly hard to eat healthy food in some parts of the US.
And many people seem to have no idea that their diet is terrible. I'm not even
sure they link their obesity to their diet.

~~~
WalterSear
Food deserts are a myth. Low SES people tend to eat lower quality foods for
reasons other than availability.

~~~
yodsanklai
> Food deserts are a myth

It's anecdotal evidence, but as a European frequently travelling in the US, I
do have a hard time finding what I consider healthy food. I usually skip one
meal each day and still put on weight. I suppose that if you're really careful
and cook your own food at each meal you can get by, but all the incentives are
there for you to eat a lot, and a lot of junk food.

~~~
ghaff
"Food desert" mostly doesn't refer to eating out but being able to buy
unprocessed food/produce/etc. which is hard to do if your only option is a
convenience store. But there mostly are supermarkets available if not as
plentiful or as good in low income areas.

I travel a lot in the US too though (as an American) and I've rarely (in
cities) had much of an issue finding restaurants I consider good--though I'm
not sure most meals I get on the road really qualify as "healthy" day after
day either in the US or most other places. And, certainly, if you're looking
for something quick and easy, that's probably going to be some fast food
franchise. I almost universally avoid but that assumes putting some time and
effort into finding better places when on the road.

------
vonwoodson
Relevant The Onion clip:
[https://youtu.be/hRoSJ1y1FSY](https://youtu.be/hRoSJ1y1FSY)

------
throwaway4good
What definition of obese is used here? 42% sounds like a lot.

~~~
save_ferris
CDC defines obesity as having a Body Mass Index above 30[0]. Per their
example, a 5'9 person weighing 203 lbs or more would be considered obese.

0:
[https://www.cdc.gov/obesity/adult/defining.html](https://www.cdc.gov/obesity/adult/defining.html)

~~~
elindbe2
And before anyone complains about BMI, it's useful as a population-level
measurement:

[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5896802/#:~:tex...](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5896802/#:~:text=The%20analysis%20has%20indicated%20that,known%20confounders%20were%20controlled%20for).

~~~
Spivak
Yeah, it's not a particularly good statistic about an individual person's body
except as a suuuuuper rough guideline but if everyone's BMI goes up
something's happening.

------
mcfunk
I find it interesting that I scrolled through this whole thread and there has
been little if any discussion of excessively poor health care in the United
States.

Also, things like how when people develop type 2 diabetes, the solution is
often getting them on expensive insulin that causes weight gain, causing more
insulin need, causing more weight gain etc. Look up Dr. Jason Fung for
detailed information on how the typical approach to diabetes management
actually just makes it, and weight gain, much worse.

Speaking of healthcare in the US, even for those who can afford a doctor -- I
personally have gone to the doctor when I had unexplained blood sugar drops
and weight gain despite being active (training for a century ride at the
time), counting calories and eating the oft-touted '5 small meals a day'. They
scoffed at me, told me they 'couldn't give me a pill to make me thin,' told me
my habits were fine and I should keep doing what I was doing. As it turned
out, and I learned through my own research, my frequent eating was causing me
to become insulin resistant, and once I moved to 2 meals a day and a longer
fast overnight my issues reversed. From talking to others there was nothing
unusual about my experience with the doctor -- in the US obesity is considered
a moral issue and not a health one, and our doctors have very little to offer
in terms of advice based on the underlying mechanisms of obesity or taking
patients seriously when they are concerned about weight gain.

We have all sorts of other things contributing to causing metabolic issues in
the first place -- our poorly regulated food and ag industries have been
pushing completely warped ideas of what makes a 'balanced' diet for decades --
e.g. milk and empty carbohydrates are 'a balanced breakfast,' the low fat
fiasco where processed foods with reduced fat and increased sugars were touted
as 'healthier', and for decades kids were taught in school the 'food pyramid'
which was a suggested diet written entirely by agriculture lobbyists rather
than the available science on nutrition.

We have an entire populace who, if they know anything about what is actually
healthy for humans, came by it through having to seek it out themselves and
wade through a lot of junk science sponsored by various corporate interests.

Also we are stuck in cycles of constant work, presenteeism and long hours in
sedentary jobs, no sick leave, little if any vacation, etc. etc. where Europe
etc. have much better work practices, not to mention less car culture, walk
and bikeable and transitable cities, all things that are aggressively opposed
in the US.

The problem is fueled by a number of systems. Imagining it to be a matter of
simple will power or portion size is inane.

------
Simulacra
From 2019’data. That’s an important distinction.

------
hi41
Is there truth to the fact that there are many body types and that each body
knows what the correct weight should be and they reach that weight by
consuming what is necessary?

For example, when I diet and reduce weight, I gain it back in few months. May
be I am meant to be at the higher weight. Many say that greedy corporations
have set up the numbers for diabetes and it’s okay to have higher A1C.

~~~
TACIXAT
Nope. My understanding is that fat cells do not go away initially but just
shrink. That is why it is easy to gain back recently lost weight. It takes a
sustained effort to lose and keep off weight.

You're of course free to do what you want, but being overweight leads to
health problems that you wouldn't otherwise have.

------
jononomo
There is a simple solution to the obesity epidemic: levy a heavy tax on any
kind of sugar or grain that enters the food system and use the money to
subsidize red meat.

A carnivore diet that avoids plant-based foods altogether is ideal for human
health and is almost impossible to remain obese on.

For faster or more thorough weight loss cut out dairy as well. Find more
information at [https://MeatRx.com/](https://MeatRx.com/)

~~~
sacred_numbers
That must be why India, with one of the lowest meat consumption rates in the
world, tops the obesity charts.

~~~
jononomo
In fact India does have a lot of obesity. The rates are not yet as high as
they are in the US because they are even more oppressed by poverty, meaning
that 1. even inexpensive food is in limited supply, and 2. many Indians still
rely on manual labor which keeps obesity rates down.

It is noteworthy that India has a massive problem with diabetes and also has
the lowest life expectancy in the world.

~~~
jbgud
>> India: lowest life expectancy

India is 145th out of 201 nations measured [1]. Not great, but it's not the
lowest as claimed.

[1]
[https://en.wikipedia.org/wiki/List_of_countries_by_life_expe...](https://en.wikipedia.org/wiki/List_of_countries_by_life_expectancy#List_by_the_United_Nations,_for_2010%E2%80%932015)

