Relation of demographics to morbid obesity

One of the "Healthy Year 2000" objectives is to reduce prevalence of overweight to < 20% among people aged 20 and older. Recent estimates have suggested that the prevalence of obesity has been increasing rather than declining since this objective was set. We hypothesized that certain groups of individuals may be at greater risk for obesity, especially morbid obesity. NHIS data from 1993 reveals that >60% of the adult, non-institutionalized, civilian population are at least 5% above their desirable body weight (1983 MLIC standard) and 19% are morbidly obese (>30% above desirable). Analysis by cross-tabulation tables reveals striking differences in patterns of morbid obesity by gender, race, income, geographic region, and residence. Women, blacks, those with annual incomes <$10,000, and those residing in a central city are much more likely than predicted to be among the morbidly obese. Being male or white, having an annual income >$50,000, living in the West, and residing in suburbia or a rural, non-farm area all offer protective effects against morbid obesity. In all cases, the direction of differences is similar between those < 65y and (65y, but the magnitude is greater in the younger group. It is unclear whether these demographic characteristics are additive in their impact on morbid obesity risk. Interventions designed to reduce overweight prevalence should focus on these high risk groups.