Obesity rates could exceed 60% in 13 states by 2030, CAD rates to increase 10x

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Obesity rates, and associated diseases and healthcare costs, are projected to rise in every U.S. state over the next 20 years, according to a report by Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation (RWJF).

The annual report, titled “F as in Fat: How Obesity threatens America’s Future 2012,” forecasts adult obesity rates to 2030 in each state and the likely resulting rise in obesity-related disease rates and healthcare costs. It also includes projections on how much states could save if they reduced average body mass index by 5 percent over that time span.

"This study shows us two futures for America's health," Risa Lavizzo-Mourey, MD, RWJF president and CEO, said in a release. "At every level of government, we must pursue policies that preserve health, prevent disease and reduce health care costs. Nothing less is acceptable."

Based on current trajectories, 13 states could have adult obesity rates higher than 60 percent by 2030, according to the report. All states could have rates above 44 percent. At the top of the list of most obese states is Mississippi, which would have an obesity rate of 66.7 percent if current trends held. Oklahoma, Delaware, Tennessee and South Carolina round out the list of top five most obese states, with the study authors noting that states with the highest obesity risk are clustered in the South and Midwest.

Colorado, which currently has the lowest obesity rate at 20.7 percent, would remain the least obese state, though the obesity rates there are projected to rise to 44.8 percent.

The number of new cases of type 2 diabetes, coronary artery disease (CAD), stroke, hypertension and arthritis could increase 10 fold by 2020, and double again by 2030, if current projections hold true.

Rising disease rates would, in turn, drive medical costs higher. By 2030, the report forecasts that annual medical costs associated with treating preventable obesity-related diseases in the U.S. will increase by between $48 billion to $66 billion per year, with a loss of economic productivity as high as $580 billion annually. Current estimates on the annual cost of obesity peg the number somewhere between $147 billion and $210 billion, according to the report.

There is a silver lining in the data. A 5 percent reduction in BMI—equivalent to a six-foot-tall person who weighs 200 pounds shedding roughly 10 pounds—would have massive benefits. Nearly every state could save between 6.5 percent and 7.9 percent in healthcare costs, with only Florida saving less due to that state’s older population. A 5 percent reduction in BMI would put a dent in disease rates, resulting in 656,970 fewer cases of CAD and stroke in California, 20,540 fewer cases of obesity-related cancer in Texas, and 219,567 fewer cases of hypertension in New York, to cite a few examples from the report.

"We know a lot more about how to prevent obesity than we did 10 years ago," said Jeff Levi, PhD, executive director of TFAH. "This report outlines how policies like increasing physical activity time in schools and making fresh fruits and vegetables more affordable can help make healthier choices easier. Small changes can add up to a big difference. Policy changes can help make healthier choices easier for Americans in their daily lives."

TFAH and RWJF recommend investments in obesity prevention and support for federal food programs and the Prevention and Public Health Fund. They also recommend new standards for school meals and physical education.

The analysis was conducted by the National Heart Forum on behalf of TFAH and RWJF and is based on a peer-reviewed model published last year in The Lancet. The full report is available at www.healthyamericans.org.