The fattest states in America, according to the Centers for Disease Control (CDC), are Mississippi–where 35.1 percent of adults are obese–and West Virginia (35.1%) and the slimmest are Hawaii (21.8%) and Colorado (21.3%), but while there’s actually been a leveling off of the nationwide obesity rate, none of the 50 states have much to be proud of.
When the CDC first started collecting this data in 1995, not a single state had an obesity rate higher than 19 percent. Today, not a single state is lower than 20 percent. “So while we’ve seen this leveling off over the last couple of years, the trajectory over the last 20 years has been pretty staggering,” said Jeffrey Levi, executive director of of Trust for America’s Health. “It’s a combination of what we eat, how we eat and how active we are.”
Prevalence of Self-Reported Obesity Among U.S. Adults by State and Territory, BRFSS, 2013 (CDC map)
Obesity tends to be concentrated more in the southeast where there are strong cultural traditions centered around food. Levi says residents of states with the highest obesity rates are the least likely to be meeting the federal government’s guidelines of getting an hour of physical activity each day.
It’s a problem that’s straining the nation’s resources; chronic diseases associated with obesity account for almost three-fourths of America’s healthcare spending. But Levi does see some hopeful signs. “We are seeing some successes in communities around the country in either stabilizing child obesity rates or actually reducing them, especially when there are aggressive efforts that combine what’s happening in schools, at home and in the community,” Levi said. “We’re seen communities turn the tide.”
Turning the tide
The risk for diabetes is highest among women who suffer the greatest number of PTSD symptoms. Investigators used data from the large Nurse’s Health Study that followed 50,000 women over a 22-year period. More than 3,000 of them developed type 2 diabetes. Researchers found women who were diagnosed with six to seven symptoms of post-traumatic stress were almost twice as likely to develop the disease compared to women who did not suffer a traumatic event.
Epidemiologist Karestan Koenen of the Mailman School of Public Health at Columbia University in New York says the women who developed diabetes had been traumatized in a number of ways. “They have experienced child abuse, interpersonal violence, meaning domestic violence, mugging. They have also experienced other events including death of a child, miscarriage, exposure to disasters. So the whole range of experiences,” she said. Koenen says women who suffered from PTSD tended to be overweight, a risk factor for diabetes, and many were on antidepressant medication, which is thought to predispose patients to the disease.
A female U.S. Marine touches the grave of a friend at Arlington National Cemetery in Virginia.
Koenen says the findings provide more evidence of a strong link between the mind and physical well-being. “We are really learning that the mind and the body are not separate. In our medical system, we treat the brain and mental disorders as something completely separate from physical disorders and chronic disease, like diabetes, cardiovascular disease, et cetera," she said. "And I think we are learning more and more that the two are linked, that the brain affects the body and body affects the brain. And we need to think about that and how we integrate the two types of treatment in our medical system.”
Koenen says men who are veterans of the military who suffer from PTSD have also been shown to be twice as likely to develop diabetes. She says doctors treating both men and women for post-traumatic stress should have them followed closely for diabetes and other diseases. The study on post-traumatic stress in women and diabetes is published in the journal JAMA Psychiatry.
Women Suffering from Post-traumatic Stress Carry Diabetes Risk
Stunting - children too short for their age due to a poor diet - affects more than 160 million children under five years old, the International Food Policy Research Institute said in its Global Nutrition Report. The number of hungry people in the world fell, but obesity rose between 2010 and 2014 "in every single country", and one in 12 adults worldwide now has Type 2 diabetes, the report said. Adult diabetes is increasing in 185 countries and is decreasing or stable in just five. "Too often people think of malnutrition as just a problem of hungry kids in the poorest countries... (it) has many forms and affects all countries, rich and poor alike," Corinna Hawkes, co-author of the report, said in a statement. "The coexistence of nutritional problems associated with extreme deprivation and obesity is the real face of malnutrition."
Women sit on a bench in New York's Times Square
Globally, two billion people are not eating the proper amounts of vitamins and minerals, and thus face micronutrient malnutrition, while 1.9 billion adults are overweight or obese. Forty-five percent of all deaths of children under five are related to malnutrition, the report said. In five large developing countries - Bangladesh, the Democratic Republic of Congo, Ethiopia, Nigeria and Pakistan - the percentage of children under five who are not stunted or wasted (underweight for their age) ranges from 43 to 48 percent. Childhood malnutrition will have a dangerous impact on future development in those countries with fast-expanding populations, as children will not reach their full physical or intellectual potential as adults, it said.
The report, published before a United Nations summit to establish a new set of Sustainable Development Goals on reducing international poverty, said governments should spend more than the 1.3 percent of their budgets they currently allocate on average for nutrition-related programs. One dollar invested in nutrition-related programs offers a return of up to $16 in economic benefits, the report said, such as increased productivity and lower healthcare costs. "People cannot get anywhere near their full potential without first overcoming malnutrition," Lawrence Haddad, the report's lead author, said in a statement. "This not only jeopardizes the lives of those who are malnourished, but also affects the larger framework of economic growth and sustainable development."
Despite fall in hunger, obesity and diabetes worsen around the globe: report
The AspireAssist system consists of a thin tube implanted in the stomach, connecting to an outside port on the skin of the belly. About 20 minutes after finishing a meal, users connect the port to an external device, which drains some of the recently-consumed food into the toilet. The manufacturer — Aspire Bariatrics based in King of Prussia, Pennsylvania — says its system removes about 30 percent of food stored in the stomach before it begins causing weight gain. The Food and Drug Administration approved the device on Tuesday for adults who are obese, with a body mass index of 35 to 55, and have not been able to lose weight with other methods.
It's the latest option for millions of obese Americans who have been unable to lose weight via more traditional methods. Obesity is considered one of the nation's leading public health problems because it can trigger diabetes and lead to heart disease and other serious health problems. About 38 percent of all U.S. adults are obese. A 5-foot-9 person would be obese at 203 pounds. Last week the Centers for Disease Control and Prevention reported that rates of obesity among women had reached 40 percent for the first time. That compares to a 35 percent obesity rate for men.
The FDA said it approved the new device based on studies showing patients lost an average of 12 percent of their total body weight one year after the procedure. That compared to 3.6 percent weight loss for patients who didn't receive the device. Side effects seen with AspireAssist included nausea, vomiting, constipation and diarrhea. "Patients need to be regularly monitored by their health care provider and should follow a lifestyle program to help them develop healthier eating habits and reduce their calorie intake," said FDA deputy director Dr. William Maisel, in a statement. Weight loss surgery is recommended for those with a BMI of 40 or those with a BMI of 35 who have other risk factors like diabetes or high blood pressure.
Patients undergoing permanent weight loss surgery, such as gastric bypass surgery, generally lose about 34 percent of their total weight after one year. The 50-year-old procedure involves stapling a small pouch off from the rest of the stomach and connecting it to the small intestine Weight loss is significantly lower with reversible banding procedures, in which a small saline-filled band is wrapped around the stomach to reduce its size. Those patients generally see weight loss of 14 percent after one year. Potential side effects include esophagus irritation, infection and vomiting, in some cases.
FDA approves stomach-draining obesity treatment
