Context The increasing prevalence of obesity is a major public health concern,
since obesity is associated with several chronic diseases.
Objective To monitor trends in state-specific data and to examine changes in the
prevalence of obesity among adults.
Design Cross-sectional random-digit telephone survey (Behavioral Risk Factor
Surveillance System) of noninstitutionalized adults aged 18 years or older
conducted by the Centers for Disease Control and Prevention and state health
departments from 1991 to 1998.
Setting States that participated in the Behavioral Risk Factor Surveillance
Main Outcome Measures Body mass index calculated from self-reported weight and height.
Results The prevalence of obesity (defined as a body mass index ≥30 kg/m2) increased from 12.0% in 1991 to 17.9% in 1998. A steady increase
was observed in all states; in both sexes; across age groups, races, educational
levels; and occurred regardless of smoking status. The greatest magnitude
of increase was found in the following groups: 18- to 29-year-olds (7.1% to
12.1%), those with some college education (10.6% to 17.8%), and those of Hispanic
ethnicity (11.6% to 20.8%). The magnitude of the increased prevalence varied
by region (ranging from 31.9% for mid Atlantic to 67.2% for South Atlantic,
the area with the greatest increases) and by state (ranging from 11.3% for
Delaware to 101.8% for Georgia, the state with the greatest increases).
Conclusions Obesity continues to increase rapidly in the United States. To alter
this trend, strategies and programs for weight maintenance as well as weight
reduction must become a higher public health priority.