Overweight and Obesity

CDC (Centers for Disease Control and Prevention)

 Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and
Health Promotion (2019)

Obesity is a complex health issue to address. Obesity results from a combination

of causes and contributing factors, including individual factors such as behavior
and genetics. Behaviors can include dietary patterns, physical activity, inactivity,
medication use, and other exposures. Additional contributing factors in our
society include the food and physical activity environment, education and skills,
and food marketing and promotion.

Obesity is a serious concern because it is associated with poorer mental health

outcomes, reduced quality of life, and the leading causes of death in the U.S. and
worldwide, including diabetes, heart disease, stroke, and some types of cancer.

Behavior

Healthy behaviors include a healthy diet pattern and regular physical activity.
Energy balance of the number of calories consumed from foods and beverages
with the number of calories the body uses for activity plays a role in preventing
excess weight gain.  A healthy diet pattern follows the Dietary Guidelines for
1,2

Americansexternal icon which emphasizes eating whole grains, fruits, vegetables,

lean protein, low-fat and fat-free dairy products and drinking water. The Physical
Activity Guidelines for Americansexternal icon recommends adults do at least 150
minutes of moderate intensity activity or 75 minutes of vigorous intensity activity,
or a combination of both, along with 2 days of strength training per week.

Having a healthy diet pattern and regular physical activity is also important for
long term health benefits and prevention of chronic diseases such as Type 2
diabetes and heart disease.

For more, see Healthy Weight – Finding a Balance.

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Community Environment
People and families may make decisions based on their environment or
community. For example, a person may choose not to walk or bike to the store or
to work because of a lack of sidewalks or safe bike trails. Community, home, child
care, school, health care, and workplace settings can all influence people’s daily
behaviors. Therefore, it is important to create environments in these locations
that make it easier to engage in physical activity and eat a healthy diet.

Watch The Obesity Epidemicexternal icon to learn about the many community

environmental factors that have contributed to the obesity epidemic, as well as
several community initiatives taking place to prevent and reduce obesity.

Learn about strategies to improve the environment to make it easier to

be physically active.

Strategies to create a healthy environment are listed on the Strategies to Prevent

Obesity page. More specifically, strategies to create a healthy school environment
are listed on the CDC Adolescent and School Health website.

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Genetics

Do Genes Have a Role in Obesity?

Genetic changes in human populations occur too slowly to be responsible for the
obesity epidemic. Nevertheless, the variation in how people respond to the
environment that promotes physical inactivity and intake of high-calorie foods
suggests that genes do play a role in the development of obesity.

How Could Genes Influence Obesity?

Genes give the body instructions for responding to changes in its environment.
Studies have identified variants in several genes that may contribute to obesity by
increasing hunger and food intake.

Rarely, a clear pattern of inherited obesity within a family is caused by a specific

variant of a single gene (monogenic obesity). Most obesity, however, probably
results from complex interactions among multiple genes and environmental
factors that remain poorly understood (multifactorial obesity). 3,4
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What about Family History?

Health care practitioners routinely collect family health history to help identify
people at high risk of obesity-related diseases such as diabetes, cardiovascular
diseases, and some forms of cancer. Family health history reflects the effects of
shared genetics and environment among close relatives. Families can’t change
their genes but they can change the family environment to encourage healthy
eating habits and physical activity. Those changes can improve the health of
family members—and improve the family health history of the next generation. 3,4

Learn more about genetics and obesity here: Obesity and Genomics.

Other Factors: Diseases and Drugs

Some illnesses may lead to obesity or weight gain. These may include Cushing’s
disease, and polycystic ovary syndrome. Drugs such as steroids and some
antidepressants may also cause weight gain. The science continues to emerge on
the role of other factors in energy balance and weight gain such as chemical
exposures and the role of the microbiome.

A health care provider can help you learn more about your health habits and
history in order to tell you whether behaviors, illnesses, medications, and/or
psychological factors are contributing to weight gain or making weight loss hard.

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Consequences of Obesity

Health Consequences

People who have obesity, compared to those with a normal or healthy weight, are
at increased risk for many serious diseases and health conditions, including the
following:5,6,7

 All-causes of death (mortality)

 High blood pressure (Hypertension)
 High LDL cholesterol, low HDL cholesterol, or high levels of triglycerides
(Dyslipidemia)
  Type 2 diabetes
 Coronary heart disease
 Stroke
 Gallbladder disease
 Osteoarthritis (a breakdown of cartilage and bone within a joint)
 Sleep apnea and breathing problems
 Some cancersexternal icon (endometrial, breast, colon, kidney, gallbladder,
and liver)
 Low quality of life
 Mental illness such as clinical depression, anxiety, and other mental
disorders 8,9

 Body pain and difficulty with physical functioning 10

For more information about these and other health problems associated with
obesity, visit Health Effects of Obesity.

For more information about these and other health problems associated with
overweight and obesity, visit Clinical Guidelines on the Identification, Evaluation,
and Treatment of Overweight and Obesity in Adults  pdf icon[PDF 56KB]external
icon.

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Economic and Societal Consequences

Obesity and its associated health problems have a significant economic impact
on the U.S. health care system.  Medical costs associated with overweight and
11

obesity may involve direct and indirect costs.  Direct medical costs may include
12,13

preventive, diagnostic, and treatment services related to obesity. Indirect costs

relate to morbidity and mortality costs including productivity. Productivity
measures include ‘absenteeism’ (costs due to employees being absent from work
for obesity-related health reasons) and ‘presenteeism’ (decreased productivity of
employees while at work) as well as premature mortality and disability.  14

National Estimated Costs of Obesity

The medical care costs of obesity in the United States are high. In 2008 dollars,
these costs were estimated to be $147 billion. 15
The annual nationwide productive costs of obesity obesity-related absenteeism
range between $3.38 billion ($79 per obese individual) and $6.38 billion ($132 per
individual with obesity) . 16

In addition to these costs, data shows implications of obesity on recruitment by

the armed forces. An assessment was performed of the percentage of the US
military-age population that exceeds the US Army’s current active duty
enlistment standards for weight-for-height and percent body fat, using data from
the National Health and Nutrition Examination Surveys. In 2007-2008, 5.7 million
men and 16.5 million women who were eligible for military service exceeded the
Army’s enlistment standards for weight and body fat. 17

Strategy to Manage and Prevent Obesity

There is no single or simple solution to the obesity epidemic. It’s a complex

problem and there has to be a multifaceted approach. Policy makers, state and
local organizations, business and community leaders, school, childcare and
healthcare professionals, and individuals must work together to create an
environment that supports a healthy lifestyle. There are several ways state and
local organizations can create a supportive environment to promote healthy
living behaviors that prevent obesity.

State and Local Programs

Resources are available to help disseminate consistent public health

recommendations and evidence-based practices for state, local, territorial and
tribal public health organizations, grantees, and practitioners.

Knowing your body mass index (BMI), achieving and maintaining a healthy
weight, and getting regular physical activity are all actions you can take for
yourself to combat obesity.

Community Efforts

To reverse the obesity epidemic, community efforts should focus on supporting

healthy eating and active living in a variety of settings. Learn about different
efforts that can be used in early childhood care, hospitals, schools, and food
service venues.
Healthy Living

The key to achieving and maintaining a healthy weight isn’t short-term dietary
changes; it’s about a lifestyle that includes healthy eating and regular physical
activity.

 Assessing Your Weight

BMI and waist circumference are two screening tools to estimate weight
status and potential disease risk.
 Healthy Weight
A high BMI can be an indicator of high body fatness. Visit the Healthy
Weight Website; learn about balancing calories, losing weight, and
maintaining a healthy weight.
 ChooseMyPlateexternal icon
Healthy eating habits are a key factor for a healthy weight. Visit
the ChooseMyPlate Website; look up nutritional information of foods, track
your calorie intake, plan meals, and find healthy recipes.
 Physical Activity Basics
Physical activity is important for health and a healthy weight. Learn about
different kinds of physical activity and the guidelines for the amount
needed each day.
 Tips for Parents
Learn about the seriousness of childhood obesity and how to help your
child establish healthy behaviors.