How has the obesity rate in America changed?

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Obesity is an epidemic in the America. Four in 10 U.S. adults fit the medical definition of having obesity, which puts them at risk for serious health problems, including diabetes, heart disease and some types of cancer. New data shows a growing number of Americans are severely obese.

The federal Centers for Disease Control and Prevention found that nearly 10% of adults ages 20 and older had severe obesity last year, up from 7.7% in 2013. And 1 in 5 adults in the United States now live with obesity, the CDC said.

Obesity increases the risk of nearly 200 diseases and can cause serious health conditions like asthma, strokes, Type 2 diabetes and some types of cancers. It was a risk factor in 3.7 million deaths in 2021.

The findings come from a 2021-2023 National Health and Nutrition Examination survey of about 6,000 adults. Here's how the rates of obesity and severe obesity have changed in the past decade:

Severe obesity is on the rise From August 2021 to August 2023, the most recent data available, severe obesity prevalence was 9.4% in all adults. But the rate of severe obesity in women was nearly twice as high compared with their male counterparts.

Women ages 40 to 59 had the highest prevalence of severe obesity compared with all other ages. Nearly 15% of women in this age group reported living with severe obesity.

How do obesity rates vary by state? Recently released data from the CDC shows 23 states have an adult obesity prevalence at or above 35%, compared with 22 states in 2022 and 19 states in 2021.

Before 2013, no state passed the 35% threshold of adult obesity. A state-by-state look at adult obesity rates highlights the need for public health support at a more localized level, according to the CDC.

West Virginia had the highest rate of adults living with obesity, a prevalence of 41%. Obesity rates were highest in Southern and Midwestern states, the CDC found.

These states have the highest obesity prevalence among adults (35% or higher):

AlabamaAlaskaArkansasDelawareGeorgiaIllinoisIndianaIowaKansasLouisianaMichiganMississippiMissouriNebraskaNew MexicoNorth DakotaOhioOklahomaSouth CarolinaSouth DakotaTennesseeWest VirginiaWisconsin Guam and Puerto Rico have populations with an obesity prevalence above 35%.

Americans don't choose to be fat: Many live within a 'system they don't control.'

How can communities address obesity? Ensuring access to healthy foods, safe places for physical activity, stigma-free obesity prevention and treatment programs, and evidence-based health care services such as medication and surgery are examples of how to address and prevent obesity, according to the CDC.

Karen Hacker is director of the CDC’s National Center for Chronic Disease Prevention and Health Promotion. She said there is not a singular approach to addressing obesity: "Obesity is a disease caused by many factors, including eating patterns, physical activity levels, sleep routines, genetics and certain medications. This means that there is no one-size-fits-all approach.

"However, we know the key strategies that work include addressing the underlying social determinants of health, such as access to health care, healthy and affordable food, and safe places for physical activity.”

What is causing the obesity epidemic in America? USA TODAY analyzed how Americans’ weight has been changing in recent years, including advances in treatments and the scientific understanding of obesity. Reporters spoke with more than 50 experts – in nutrition, endocrinology, psychology, exercise physiology and neuroscience – and people who are intimately familiar with the challenges of extra pounds. Here is what they discovered.

More health stories from USA Today's Graphics and Data Visualization team:

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