New survey results suggest that Americans’ interest in weight loss may be waning despite rising obesity rates in the United States.
The survey, released in December 2019 from Gallup, found that an average of 28 percent of Americans said they weighed 200 pounds (lbs) or more from 2010 to 2019, up from 24 percent in the previous decade. The average weight has also risen for both men and women and now stands at 178 lbs, with an average increase of 4 lbs for men, from 192 to 196, and 3 lbs for women, from 156 to 159.
The increased weight hasn’t translated to an increased desire to shed the extra pounds, though, per the survey. The average percentage of Americans who say their weight is “about right” has increased from 53 to 56 percent, up 3 percentage points, and the percentage of Americans who want to lose weight dropped 5 percentage points, from 59 percent to 54 percent, the results suggest.
Obesity Rates Trending Upward in the United States
Obesity rates have continued to rise over the last decade, says Fatima Cody Stanford, MD, an instructor of medicine and pediatrics at Massachusetts General Hospital and Harvard Medical School in Boston, and an obesity expert. “There seems to be a general acceptance in this increase, as well as the weight-related illnesses that go with it, which have become more commonplace,” says Dr. Stanford. “I think that over time as people have continued to gain weight, they’ve become more accustomed to it.”
Although this shift has been gradual, now close to 40 percent of the U.S. adult population has the disease of obesity, according to Stanford. “But I think only a small percentage of those people might be aware or acknowledge that they actually have obesity,” she adds.
According to the Kaiser Family Foundation (KFF), a nonprofit that focuses on major healthcare issues in the United States, 65.4 percent of Americans are overweight or obese based on their body mass index (BMI). The Centers for Disease Control and Prevention (CDC) notes that BMI is a measurement tool that uses height and weight to determine if an individual is overweight or obese. Normal or healthy weight is indicated by a BMI between 18.5 and 24.9, overweight is between 25 and 29.9, and obese is 30 and above. For the majority of people who are less than 6 feet 4 inches tall, weighing more than 200 lbs would place them in the “overweight” or “obese” category, according to BMI calculations.
Disconnect Between 'Fat Acceptance' and Those Who Treat Obesity
In recent years, society has tended to promote body positivity and has discouraged shaming people for carrying extra weight, says Annmarie Belmonte, PsyD, health psychologist at the Northwestern Medicine Metabolic Health and Surgical Weight Loss Center at Delnor Hospital in Geneva, Illinois. “That’s a good message, but it doesn’t negate the importance of people engaging in healthy behaviors to improve their health,” says Dr. Belmonte.
One of the larger organizations behind the movement, Health at Every Size (HAES), tries to combat anti-obesity bias and encourages people to accept themselves no matter what their size, according to Belmonte. “The goal of the movement is acceptance, but not to normalize ill health,” adds Belmonte.
Stanford agrees that there are positive aspects to the idea of body positivity, such as trying to eliminate weight bias and stigma. But, she says, “the dynamic between the fat acceptance movement versus members of the medical community who are treating the disease of obesity reveals a bit of a disconnect,” she says. Although many people are resistant to viewing obesity as a treatable disease, there’s evidence that obesity does lead to more sickness and earlier death, says Stanford.
A study published in August 2016 in The Lancet looked at more than 10.6 million participants from 32 countries and found that people who were overweight or obese had an increased risk of dying prematurely, and the more excess weight a person carried, the more that risk increased. A BMI between 30 and 35 was associated with a 45 percent higher risk of early death compared with people with a BMI within the healthy range.
“Maintaining a healthy weight is important to preventing a host of chronic diseases, such as diabetes, many cancers, and heart disease,” says Stanford.
Survey Shows More People Comfortable With Their Weight
The data comes from Gallup’s Health and Healthcare survey, a component of the Gallup Poll Social Series (GPSS), a set of public opinion polls that are designed to monitor U.S. adults’ views on various topics. Gallup has been asking Americans about their current weight and ideal weight since 1990, and every year since 2001.
When people were asked what their ideal weight would be, Americans gave a higher estimate now than in the prior decade. Fourteen percent of people said their ideal weight was 200 lbs or more, compared with 11 percent of people polled from 2001 to 2009. The reported average ideal weights for men and women also grew from one decade to the next, from 180 to 184 lbs for men, and from 137 to 140 lbs for women.
A person can feel good about themselves yet also recognize that they need to make some changes to achieve a healthier weight, says Stanford. “Your weight doesn’t need to define your happiness; there are many aspects of life that can make you feel good about yourself,” she says. “You can say, ‘I feel good about the body I’m in, but I have the disease of obesity; I’m going to work to treat that disease,’” she says.
Try focusing on your individual health rather than numbers like BMI or weight, says Stanford. “BMI isn’t necessarily the best way to evaluate someone’s health or even their ideal weight,” she says. Stanford published a paper in the February 2019 issue of Mayo Clinic Proceedings that suggests it may be time to reconsider the one-size-fits-all approach of the BMI measurement and personalize it according to race, ethnicity, and sex.
Hyperfocusing on a certain weight can make some people feel like failures if they don’t hit their exact goal, says Stanford. “Personalize it. I work with people to find what is the healthiest weight that they can get to and maintain over their lifetime.”
A Focus on Diagnosing Obesity and Promoting Healthy Behaviors Needed
The results of this survey aren’t just about society adopting a different perspective on body acceptance, says Stanford. “We in the medical community need to do a better job of diagnosing obesity,” she says. “How can we expect that people with obesity will know what to do or even think this is a problem if they’re not getting proper care or diagnosis?”
There can be a variety of reasons for the lack of diagnosis, according to Stanford. “Often people don’t go to the doctor unless there’s something wrong, and in that case, it’s often the acute health issue that brought the person there that gets the attention,” she says.
Sometimes when people actually do get a diagnosis of obesity, it isn’t followed with suggestions or evidence-based ways to treat the disease, notes Stanford. “We must take a healthy approach to achieving and maintaining a healthy weight, which involves optimizing diet quality, physical activity, stress, and sleep,” she adds. “If further help is needed, I recommend seeking care from a primary care or obesity medicine physician such as myself."