Severely Obese Quadruple
By Kathleen Doheny -
HealthDay ReporterAmerica's obesity
epidemic is sobering enough, with predictions that the extra poundage will
bring on serious health problems such as heart trouble and diabetes.
But now, a new analysis finds the ranks of
the severely obese -- those who are roughly 100 pounds overweight -- are
growing twice as fast as the numbers of Americans who are simply obese.
"This is a much more serious problem than we
thought," says Roland Sturm, senior health economist at the Rand Corp. and
author of the report in the Oct. 13 issue of the Archives of Internal
"People have been talking about the social
burden of obesity," Sturm says. "This group [of severely obese] has much higher
"Health-care costs for a moderately obese
person are $1,000 more per year than for a normal weight person," he says,
citing data from another, as yet unpublished study he led. But for a severely
obese person, he says, the costs are $4,000 more per year than for a normal
For the Archives study, Sturm
extracted data from the Behavioral Risk Factor Surveillance System, a telephone
survey conducted by the U.S. Centers for Disease Control and Prevention (CDC)
between 1986 and 2000. Sturm evaluated information from 1.5 million respondents
who reported their height and weight, the basis on which body-mass index (BMI)
A BMI of under 25 is deemed desirable for
optimal health; a BMI of 30 is termed obese. Sturm found that between the years
studied, the number of adult Americans with a BMI of 40, considered severely
obese, or greater quadrupled from about one in 200 to one in 50. Those with a
BMI of 50 or greater, sometimes called super obesity, increased by a factor of
five, from one in 2,000 to one in 400.
During the same period, the number of people
with a BMI of 30 or more doubled, from one in 10 to one in 5, Sturm found.
A woman 5-foot-4 who weighs 140, for
instance, has a BMI of 24. If she weighs 175, her BMI would be 30, termed
obese. And if she weighs 250, her BMI would be 43, sometimes termed morbidly
Among the respondents who had a BMI of over
50, 150 or more pounds overweight, the typical man was 5-foot-10 and weighed
Sturm notes many hospitals and doctors'
offices are not equipped to care for these severely obese patients. Standard
wheelchairs, for instance, may not be wide enough to accommodate them.
While doctors who tend to consider severe
obesity rare and believe the very obese are a fixed portion of the population,
his analysis suggests severe obesity is part of the trend of growing obesity,
and that it's been underestimated.
The answers to the obesity or the
super-obesity epidemic aren't simple, says James Hill, a weight-control
researcher and director of the Center for Human Nutrition at the University of
Colorado Health Sciences Center.
"We have to prevent weight gain in the first
place," he suggests. "We have to prevent that one, two, three pound a year
gain." Once people get to the point of severe obesity, he notes, it's difficult
to take off enough weight to get down to a healthy BMI again.
Society as a whole, and individuals, should
ask themselves an important question, Hill says: "Are we really going to let
our kids grow up in an environment that will let them get to that [obese]
The problem is "a combination of food
availability and lack of exercise, complicated by stress," adds David Freedman,
an epidemiologist at the CDC who published a paper last year in the Journal
of the American Medical Association with similar findings.
Sadly, he adds, "these same trends are going
on in childhood obesity."
Indeed, a study being presented Monday shows
that, between 1996 and 2001, 2 million adolescents became obese, and that three
out of four of them remained obese as they reached adulthood.
Researchers at the University of North
Carolina at Chapel Hill found that problem was particularly acute among black
and Hispanic girls, but that the trend was across the board.
"This research highlights the critical
nature of the adolescent and young adult period for developing and continuing
obesity," Dr. Penny Gordon-Larsen, assistant professor of nutrition at the UNC
schools of public health and medicine, said in a statement.
The research was to be presented in Ft.
Lauderdale, Fla., at a meeting of the North American Association for the Study
For more information on overweight and
obesity, see the U.S.
Disease Control and Prevention and the
Copyright © 2002 ScoutNews, LLC. All rights
SOURCES: Roland Sturm, Ph.D., senior health
economist, Rand Corp., Santa Monica, Calif.; James Hill, Ph.D., director,
Center for Human Nutrition, University of Colorado Health Sciences Center, and
co-founder, America on the Move, an exercise motivation program; David
Freedman, Ph.D., epidemiologist, division of nutrition and physical activity,
U.S. Centers for Disease Control and Prevention, Atlanta; University of North
Carolina press release; Oct. 13, 2003, Archives of Internal Medicine