The Center for Disease Control and Prevention (CDC) collects data from states on the Body Mass Index (BMI) of the adult population, which is a person’s weight divided by the square of their height. BMI is used as a screener for categories of body fat (underweight, healthy weight, overweight and obese) and potential health problems. However, it is not sufficient to determine the health of individuals, and health care providers consider it along with other biological measures (e.g. blood pressure, blood glucose & lipids, etc.) and lifestyle factors (e.g. dietary and activity patterns, smoking, etc.) Recently, health organizations have noted problems with its use for some race/ethnic groups, different ages, and with gender, as well as the harm that can come with the labeling of individuals based on their BMI category.
Looking at BMI across populations is informative for the health of the US population in general. The “maps” of obesity (BMI>30) show individuals states colored based on their prevalence of adult obesity. Starting in 1985, maps showed states in shades of blue (<10% and 10-14% obesity, adding in dark blue in 1991) and eventually yellow, orange, and red as obesity prevalence exceeded 30%. This made for a scary introduction to many presentations I attended at meetings, as speakers moved through the slides and the colors widened and darkened.
Updated maps from 2022 show twenty-two states with adult obesity at or above 35%; Wisconsin is at 37.7%. What is quite striking in this information is the differences between race/ethnic groups. In Wisconsin, the prevalence is 49.8% for non-Hispanic Blacks, 42.3% for American Indian or Alaskan Native, 35.5% for Hispanics, and 33.8% for Whites. The nutrition and health community continues research to better understand differences among people contributing to overweight and obesity, and to determine what supports and environments contribute to excess weight gain, and conversely those that help people obtain optimal health. We have learned a lot since 1985, and newer efforts focused on precision nutrition (nutrition optimized for individuals) and those that focus on policy, systems and environments show great potential.