Table 1.
Trends in the observed 1999–2014 and projected 2020 and 2030 prevalence (%) of obesity, severe obesity and combined overweight and obesitya among US adults, by gender, ethnicity, level of education and poverty to income ratio: based on data from National Health and Nutrition Examination Survey (NHANES) 1999–2014b. PIR indicates ratio of income to the family’s appropriate poverty threshold set by the US Census Bureau in a given calendar year. The Census Bureau, working in accordance with the Statistical Policy Directive of the Office of Management and Budget, use a set of money income thresholds that vary by family size and composition to determine who is poor. Thresholds were updated annually for inflation by using the consumer price index
| Men |
Women |
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|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Annual increase rateb |
Projected prevalence in 2020 (95% CI) | Projected prevalence in 2030 (95% CI) | Annual increase rateb |
Projected prevalence in 2020 (95% CI) | Projected prevalence in 2030 (95% CI) | |||||||||||||
| β | SE | P | β | SE | P | |||||||||||||
| Obesity (BMI ≥30 kg/m2) | ||||||||||||||||||
| All (Age≥ 20) | 0.61 | 0.10 | *** | 39.6 | 36.4 | 42.8 | 45.7 | 40.2 | 51.2 | 0.47 | 0.11 | ** | 41.8 | 38.1 | 45.4 | 46.5 | 40.1 | 52.8 |
| By ethnicity | ||||||||||||||||||
| NH White | 0.53 | 0.12 | ** | 38.9 | 34.8 | 43.0 | 44.2 | 37.3 | 51.1 | 0.53 | 0.13 | ** | 40.3 | 35.7 | 45.0 | 45.6 | 37.8 | 53.4 |
| NH Black | 0.90 | 0.20 | ** | 46.1 | 39.1 | 53.2 | 55.1 | 43.4 | 66.8 | 0.59 | 0.23 | * | 60.4 | 52.7 | 68.1 | 66.3 | 53.2 | 79.4 |
| Mexican- American | 1.30 | 0.36 | * | 51.0 | 38.0 | 63.8 | 64.1 | 42.6 | 85.7 | 1.00 | 0.26 | ** | 56.0 | 47.5 | 64.5 | 66.0 | 51.2 | 80.8 |
| Others | 0.46 | 0.28 | 31.3 | 21.9 | 40.7 | 35.9 | 19.9 | 51.8 | −0.15 | 0.29 | 25.7 | 16.5 | 34.8 | 24.2 | 8.2 | 40.1 | ||
| By education | ||||||||||||||||||
| <High school | 0.70 | 0.26 | * | 38.3 | 29.2 | 47.4 | 45.3 | 29.9 | 60.6 | 0.81 | 0.30 | * | 48.6 | 38.7 | 58.5 | 56.8 | 39.8 | 73.7 |
| High school | 0.82 | 0.32 | * | 42.2 | 30.6 | 53.8 | 50.4 | 31.1 | 69.6 | 0.17 | 0.24 | 45.3 | 37.5 | 53.2 | 47.0 | 33.4 | 60.6 | |
| >High school | 0.59 | 0.12 | ** | 39.7 | 35.8 | 43.7 | 45.7 | 39.0 | 52.4 | 0.54 | 0.13 | ** | 41.5 | 37.4 | 45.5 | 46.9 | 39.8 | 54.0 |
| By PIR | ||||||||||||||||||
| <100%PIR | 0.43 | 0.21 | 33.3 | 26.0 | 40.6 | 37.6 | 25.4 | 49.8 | 0.49 | 0.18 | * | 48.3 | 42.1 | 54.4 | 53.2 | 42.6 | 63.7 | |
| 100–200% PIR | 0.80 | 0.20 | ** | 42.1 | 35.3 | 48.9 | 50.1 | 38.6 | 61.6 | 0.76 | 0.31 | * | 50.5 | 40.0 | 61.0 | 58.1 | 40.3 | 75.9 |
| >200% PIR | 0.63 | 0.16 | ** | 40.9 | 35.2 | 46.5 | 47.2 | 37.6 | 56.7 | 0.39 | 0.15 | * | 37.5 | 32.3 | 42.7 | 41.4 | 32.6 | 50.2 |
| Severe obesity (BMI ≥40 kg/m2) | ||||||||||||||||||
| All (Age ≥20) | 0.17 | 0.04 | ** | 6.2 | 4.7 | 7.7 | 7.9 | 5.4 | 10.5 | 0.22 | 0.06 | ** | 10.5 | 8.3 | 12.6 | 12.7 | 9.1 | 16.2 |
| By ethnicity | ||||||||||||||||||
| NH White | 0.15 | 0.06 | * | 5.8 | 3.8 | 7.9 | 7.3 | 3.9 | 10.7 | 0.23 | 0.06 | * | 9.8 | 7.4 | 12.1 | 12.1 | 8.2 | 15.9 |
| NH Black | 0.31 | 0.08 | ** | 10.1 | 7.3 | 12.8 | 13.2 | 8.6 | 17.7 | 0.31 | 0.13 | 19.1 | 14.5 | 23.7 | 22.2 | 14.4 | 30.0 | |
| Mexican-American | 0.24 | 0.09 | * | 6.8 | 3.4 | 10.2 | 9.3 | 3.8 | 14.8 | 0.20 | 0.10 | 9.8 | 6.1 | 13.6 | 11.9 | 5.7 | 18.0 | |
| Others | 0.08 | 0.11 | 3.4 | 0.0 | 6.8 | 4.2 | 0c | 10.1 | 0.05 | 0.11 | 5.7 | 2.3 | 9.1 | 6.2 | 0.1 | 12.3 | ||
| By education | ||||||||||||||||||
| <High school | 0.16 | 0.12 | 4.5 | 0.1 | 8.9 | 6.1 | 0.0c | 13.3 | 0.39 | 0.11 | ** | 10.3 | 6.3 | 14.4 | 14.2 | 7.6 | 20.8 | |
| High school | 0.08 | 0.13 | 5.2 | 0.8 | 9.7 | 6.0 | 0.0c | 13.5 | 0.09 | 0.13 | 9.8 | 5.3 | 14.2 | 10.7 | 3.2 | 18.2 | ||
| >High school | 0.17 | 0.05 | * | 6.3 | 4.7 | 7.9 | 8.1 | 5.3 | 10.8 | 0.20 | 0.06 | * | 10.0 | 7.9 | 12.2 | 12.1 | 8.4 | 15.7 |
| By PIR | ||||||||||||||||||
| <100%PIR | −0.004 | 0.14 | 3.3 | 0.0c | 7.8 | 3.2 | 0.0c | 11.0 | 0.29 | 0.14 | 14.2 | 9.6 | 18.7 | 17.1 | 9.3 | 25.0 | ||
| 100–200% PIR | 0.36 | 0.10 | ** | 10.2 | 6.4 | 14.1 | 13.8 | 7.6 | 20.0 | 0.36 | 0.13 | * | 13.5 | 8.8 | 18.2 | 17.1 | 9.2 | 24.9 |
| >200% PIR | 0.15 | 0.06 | * | 5.7 | 3.7 | 7.8 | 7.3 | 3.9 | 10.7 | 0.19 | 0.08 | * | 8.9 | 6.2 | 11.6 | 10.8 | 6.3 | 15.3 |
| Combined overweight and obesity (BMI ≥ 25 kg/m2) | ||||||||||||||||||
| All (Age≥ 20) | 0.40 | 0.09 | ** | 76.9 | 73.6 | 80.2 | 81.0 | 75.4 | 86.5 | 0.48 | 0.11 | ** | 70.2 | 66.5 | 73.9 | 74.9 | 68.6 | 81.2 |
| By ethnicity | ||||||||||||||||||
| NH Whitec | 0.40 | 0.11 | ** | 78.1 | 74.2 | 82.0 | 82.1 | 75.7 | 88.6 | 0.64 | 0.14 | ** | 69.6 | 64.9 | 74.2 | 76.0 | 67.9 | 84.0 |
| NH Blackc | 0.63 | 0.26 | 75.4 | 66.4 | 84.5 | 81.7 | 66.4 | 97.1 | 0.35 | 0.15 | 84.0 | 78.7 | 89.3 | 87.5 | 78.6 | 96.3 | ||
| Mexican-American | 1.10 | 0.20 | ** | 90.8 | 84.2 | 97.3 | 100c | 90.2 | 100c | 0.98 | 0.21 | ** | 88.2 | 81.4 | 95.0 | 98.0 | 86.2 | 100c |
| Others | −0.12 | 0.24 | 63.1 | 55.4 | 70.7 | 61.9 | 48.7 | 75.1 | −0.67 | 0.40 | 48.7 | 35.2 | 62.3 | 42.1 | 18.9 | 65.2 | ||
| By education | ||||||||||||||||||
| <High school | 0.69 | 0.29 | 80.9 | 71.1 | 90.7 | 87.8 | 71.1 | 100c | 0.51 | 0.27 | 80.9 | 71.5 | 90.4 | 86.0 | 70.2 | 100c | ||
| High school | 0.51 | 0.37 | 74.9 | 62.4 | 87.5 | 80.0 | 58.7 | 100c | 0.17 | 0.25 | 73.7 | 65.2 | 82.1 | 75.3 | 61.1 | 89.6 | ||
| >High school | 0.35 | 0.13 | * | 77.0 | 72.3 | 81.6 | 80.5 | 72.7 | 88.2 | 0.60 | 0.12 | ** | 69.8 | 66.0 | 73.7 | 75.8 | 69.2 | 82.5 |
| By poverty income ratio | ||||||||||||||||||
| <100%PIR | 0.21 | 0.35 | 65.5 | 53.2 | 77.8 | 67.6 | 46.9 | 88.3 | 0.70 | 0.16 | ** | 76.9 | 71.2 | 82.6 | 83.9 | 74.3 | 93.5 | |
| 100–200% PIR | 0.71 | 0.21 | * | 77.1 | 70.2 | 83.9 | 84.1 | 72.3 | 95.9 | 0.76 | 0.15 | ** | 79.1 | 73.9 | 84.3 | 86.7 | 77.9 | 95.5 |
| >200% PIR | 0.45 | 0.13 | * | 80.3 | 75.5 | 85.1 | 84.8 | 76.8 | 92.7 | 0.36 | 0.16 | 65.5 | 60.3 | 70.8 | 69.1 | 60.2 | 78.0 | |
P < 0.001, **P < 0.01, *P < 0.05.
We used the World Health Organization (WHO) BMI cut points for overweight and obesity and the US National Health, Lung, and Blood Institute BMI cut point for extreme obesity, BMI ≥25, 30 and 40 kg/m2, respectively.
Linear meta-regression models with year as the sole predictor was used to estimate annual increase rate and to project prevalence for the years of 2020 and 2030, overall and for each stratum by gender and ethnic groups based on the NHANES 1999–2014 data.
We truncated the prevalence and their 95% CI at 100 if they were >100%, and at 0 if they were <0, and indicated imprecise projection for those numbers.