September 24, 2020, 12:49 pm Michael Devitt -- New obesity data released by the CDC provides a mixed bag of information for family physicians. A series of maps published by the agency earlier this month showed that the prevalence of obesity among American adults increased between 2017 and 2019, and that some racial and ethnic minority groups have been disproportionately affected, which puts these populations at increased risk of COVID-19 and associated outcomes such as severe illness and hospitalization.
At the same time, an accompanying summary statement provides recommendations to assist FPs and other health care professionals in helping patients take control of their weight and protect themselves and their families during the pandemic -- recommendations that can be used in conjunction with the Academy's vast resources on both topics.
The obesity prevalence maps analyzed data from the Behavioral Risk Factor Surveillance System, an ongoing telephone interview survey system conducted by state health departments with assistance from the CDC that compiles self-reported adult obesity prevalence based on location, race and ethnicity, among other factors.
The maps showed that in 2019, 12 states had an adult obesity prevalence of 35% or greater, up from nine states the previous year. In 2011, no U.S. state or territory had an adult obesity prevalence of more than 34.9%.
Most of the states with the highest prevalence of obesity were in the Midwest and the South. Mississippi had the highest adult obesity prevalence at 40.8%, while Colorado and the District of Columbia tied for the lowest (23.8%).
The data revealed notable differences in obesity based on age and education level. Young adults aged 18-24 had the lowest prevalence of self-reported obesity (18.9%) while adults aged 45-54 had the highest (37.6%). Similarly, adults who were college graduates had the lowest prevalence of self-reported obesity (25%) while adults without a high school degree or equivalent had the highest (36.2%).
Combining data from 2017 through 2019, the maps also showed notable differences in obesity rates among race and ethnicity. Non-Hispanic Black adults had the highest prevalence of self-reported obesity at 39.8%, almost 10% higher than non-Hispanic white adults (29.9%).
While the increase in adult obesity prevalence is concerning, the CDC's summary statement contained a number of helpful suggestions for FPs and their patients regarding obesity, race and COVID-19. This information is especially useful given recently published research that shows associations between obesity, risk of COVID-19 infection and poor health outcomes.
The statement acknowledged the role that social determinants such as neighborhood design and access to good nutrition can play in obesity rates.
The statement also acknowledged that like long-term weight loss, systemic change takes time. While community leaders and policymakers must take action to provide long-term solutions, individuals can make immediate and short-term changes in the meantime. These include
Amy Mullins, M.D., the AAFP's medical director for quality and science, noted some of the difficulties FPs and their patients may face in attaining these objectives.
"Managing weight and obesity is difficult in the short term and in the long term," Mullins said. "Many barriers exist that make this difficult. Asking patients to spend time exercising makes sense, but many have no safe place to take a walk or they have no time between the multiple jobs they hold to support their family. Also, choosing healthy foods seems like a simple option, but it is often the most expensive option.
"We need accessible, affordable, healthy foods in all the places on the obesity maps to help fight this crisis."
The summary statement emphasized that combating obesity will require the support of FPs and other health care professionals, especially in light of the ongoing pandemic.
"The epidemic of obesity is impacting the severity of the COVID-19 pandemic," the summary statement said. "Given the added risks associated with COVID-19, we need to support all individuals, especially members of racial and ethnic minority groups, to live active, healthy lives."
Since the Trump administration officially declared the pandemic a national emergency in March, the AAFP has been at the forefront of providing its members with information they can use to provide optimal patient care. FPs are invited to visit the Academy's COVID-19: Clinical Resources & Patient Education page, which is routinely updated to feature the latest tools and resources.
Many FPs have also turned to telehealth during the pandemic, offering virtual visits to address clinical, behavioral and social factors related to obesity as well as other conditions. The Academy's Using Telehealth to Care for Patients During the COVID-19 Pandemic page provides members with the latest news as well as updates on payment, coding and other aspects of telehealth.
And FPs can turn to the Academy's Neighborhood Navigator to assist in addressing social determinants of health. This interactive tool can be used by AAFP members at the point of care to connect patients with social services and other resources in their neighborhoods, including food pantries, community gardens and links to nutrition education programs.