Obesity Has the prevalence of overweight, obesity and central obesity levelled off in the United States? Trends, patterns, disparities, and future projections for the obesity epidemic Youfa Wang, 1,2 * † May A Beydoun, 3† Jungwon Min, 1,4† Hong Xue, 5 Leonard A Kaminsky 1 and Lawrence J Cheskin 6,7 1 Fisher Institute of Health and Well-Being, College of Health, Ball State University, Muncie, IN, USA, 2 Department of Nutrition and Health Sciences, College of Health, Ball State University, Muncie, IN, USA, 3 Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD, USA, 4 Healthcare Analytics Unit, Children’s Hospital of Philadelphia, Philadelphia, PA, USA, 5 Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, USA, 6 Johns Hopkins Weight Management Center, Department of Health, Behavior and Society, Johns Hopkins University, Baltimore, MD, USA and 7 Department of Nutrition and Food Studies, George Mason University, Fairfax, VA, USA *Corresponding author. Fisher Institute of Health and Well-Being, Health and Physical Activity Building (HP), Room 302, College of Health, Ball State University, 2000 W University Ave, Muncie, IN 47306, USA. E-mail: ywang26@bsu.edu, youfawang@gmail.com † These authors contributed equally to this work. Editorial decision 27 November 2019; Accepted 30 December 2019 Abstract Background: Obesity (OB) is a serious epidemic in the United States. Methods: We examined OB patterns and time trends across socio-economic and geographic parameters and projected the future situation. Large national databases were used. Overweight (OW), OB and severe obesity (SOB) were defined using body mass in- dex cut-points/percentiles; central obesity (CO), waist circumference cut-point in adults and waist:height ratio cutoff in youth. Various meta-regression analysis models were fit for projection analyses. Results: OB prevalence had consistently risen since 1999 and considerable differences existed across groups and regions. Among adults, men’s OB (33.7%) and OW (71.6%) levelled off in 2009–2012, resuming the increase to 38.0 and 74.7% in 2015–2016, respec- tively. Women showed an uninterrupted increase in OB/OW prevalence since 1999, reaching 41.5% (OB) and 68.9% (OW) in 2015–2016. SOB levelled off in 2013–2016 (men: 5.5–5.6%; women: 9.7–9.5%), after annual increases of 0.2% between 1999 and 2012. Non-Hispanic Blacks had the highest prevalence in women’s OB/SOB and men’s SOB. OB prevalence in boys rose continuously to 20.6% and SOB to 7.5% in 2015–2016, but not in girls. By 2030, most Americans will be OB/OW and nearly 50% of adults OB, VC The Author(s) 2020; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association 810 IEA International Epidemiological Association International Journal of Epidemiology, 2020, 810–823 doi: 10.1093/ije/dyz273 Advance Access Publication Date: 4 February 2020 Original article Downloaded from https://academic.oup.com/ije/article/49/3/810/5722224 by guest on 28 February 2023