Between 1988-1994 the prevalence of obesity was 22.9%. Between 1999-2000, in a sample of 4115 adult men and women, obesity rates had climbed to 30.5%. In these same two time frames extreme obesity rose from 2.9% to 4.7% and the overweight population from 55.9% to 64.5%. The problem was most acute among non-hispanic black women with more than half aged 40 and over classed as obese and more than 80% overweight (Flegal 2002).
Despite continued and sustained health messages regarding the dangers of obesity the rates for overweight, obese and extreme obesity continue to rise. It is estimated that 9 million Americans have an obesity problem and also smoke. Poorer black Americans are most likely to fall into this category. Men are more likely to combine obesity and smoking (5.3% compared with 4.2% women).
Obesity is linked to very high rates of chronic illnesses, higher than living in poverty, and much higher than smoking or drinking. Rand Health point out that, "Americans are exercising less while maintaining at least the same caloric intake. Desk jobs, an increase in the number of hours devoted to television watching, and car-friendly (and pedestrian- and bike-hostile) urban environments are some of the environmental changes that have combined to discourage physical activity."
In terms of chronic conditions, being obese is like aging from 30 to 50. Obesity increases the risk of illness and death due to diabetes, stroke, coronary artery disease, hypertension, high cholesterol, and kidney and gallbladder disorders. Obesity may also increase the risk for some types of cancer, osteoarthritis and sleep apnea. Smoking on top of obesity simply increases these risks further.
Katherine M. Flegal, PhD; Margaret D. Carroll, MS; Cynthia L. Ogden, PhD; Clifford L. Johnson, MSPH, JAMA. 2002;288:1723-1727.
Sturm R. The Effects of Obesity, Smoking, and Problem Drinking on Chronic Medical Problems and Health Care Costs. Health Affairs. 2002;21(2):245-253.
May 13, 2006 British Medical Journal