Obesity Rates Have Increased Across the Country. Early Intervention is Key, Doctors Say.

A new Lancet study has found that almost three-quarters of adults in the U.S. are overweight or obese, calling it a “crisis point” for the country. In 1990, about half of adults fit that definition. And now, people are becoming obese at younger ages, according to the study.

Dr. Steven Gortmaker, director of the Harvard Chan School of Public Health’s Prevention Research Center on Nutrition and Physical Activity, says the study reflects long-term trends.

“Massachusetts is doing pretty well relative to the rest of the country. But of course, rates of obesity are still going up,” Gortmaker said. “It’s something that’s been happening for the last 30 years.”

Obesity puts people at a higher risk for diabetes, heart disease and other comorbidities, and experts say the upward trend puts a strain on the medical system.

The Lancet study used body mass index to evaluate people. While researchers acknowledged that using BMI as a metric of health can be an incomplete picture, it was used because it still provides a standard data point.

The authors found significant increases in obesity rates among young people: About half of all young adults between ages 15 and 24 are either overweight or obese, up from 29% in 1990.

Gortmaker says the shift is partly the result of commercial influences, such as how sugary food and beverages are marketed and the lower price of unhealthy fast food and processed food.

“Their prices dropped. And so it’s becoming easier for the population to consume a lot of excess calories,” he said.

Dr. Allison Wu, an assistant professor at Harvard Medical School and attending physician at Boston Children’s Hospital, has seen the effects of this trend in her own research and practice. She says there has been an increase in early diagnoses of conditions like Type 2 diabetes, hypertension and metabolic syndrome among young patients.

“This is a major public health issue, and as the article refers to, a crisis,” Wu said. “Our health system is not going to be well set up to adequately care for this youth who will develop these adiposity-based chronic diseases into adulthood.”

Prior research shows racial and ethnic disparities. Recent data from the Centers for Disease Control and Prevention shows that in Massachusetts, the obesity rate is higher for American Indian or Alaska Native, Black and Hispanic adults than it is for white adults.

The Lancet study did not break down the data according to race or ethnicity, but the authors acknowledged that obesity is caused by a combination of complex factors, which can include genetics, food access, availability of open public spaces and wealth inequality.

“A bigger concern that I have as a GI and nutrition clinician is that many of my patients … not only do they have food insecurity, but there’s also nutrition insecurity, which is the lack of access to nutritious foods that promote and optimize health,” Wu said.

The study researchers suggested legislative policies that encourage greater access to healthy foods and more regulations about how food is marketed. For a local example, Wu pointed to organizations like Project Bread and the Greater Boston Food Bank.

“The team there is very focused on ensuring that nutritious foods in the form of fresh produce [are] provided, not just shelf stable, processed foods,” Wu said.

Gortmaker says that early intervention is important. He points to programs like healthier school lunches, more physical activity during school hours and providing more access to water in school cafeterias.

“One thing about Massachusetts — they were very early on in improving school meals,” he said.

Weight loss drugs such as Wegovy and Zepbound have recently been getting more attention. But Gortmaker notes that while they can be effective for people with excess weight, they are expensive and the long term effects aren’t yet known.

“One of the points of this Lancet paper was that, sure, these [drugs] can be important, but the bottom line is what you want to do is not develop that excess weight in the first place,” he said. “And that’s certainly the case with children.”

By Meghan Smith, Senior Digital Producer, Equity and Justice