Obesity rates decline for first time in a decade
Click Here to Manage Email Alerts
Key takeaways:
- Mean population BMI decreased between 2022 and 2023.
- The South experienced the most notable decline in obesity, which aligned with high GLP-1 dispensing.
The prevalence of obesity decreased in the United States in 2023 for the first time since 2013, results from a cross-sectional study published in JAMA Health Forum showed.
The study findings revealed a slight decrease in mean population BMI in 2023 compared with the previous year after nearly a decade of steady increases.
“We know [glucagon-like peptide-1 receptor agonists] work at an individual level, but there’s this feature of obesity getting worse and worse,” Benjamin Rader, PhD, MPH, an assistant professor of anesthesia at Harvard University, told Healio. “When we went into this, we wanted to see what the population looked like, and we were quite surprised to see a drop.”
The findings mark an encouraging change in obesity trends. Healio previously reported that the prevalence of obesity in the U.S. more than doubled from 1990 to 2021, while 23 states had an adult obesity prevalence of 35% or higher in 2022.
According to Rader and colleagues, long-term forecasts for obesity are mixed, with some predicting a continued upward trajectory and others a plateau.
They added that near-term obesity changes “are unclear” amid increasing use of weight loss medications.
The researchers assessed national trends for obesity, BMI and GLP-1 receptor agonist dispensing between Jan. 1, 2023, and Dec. 31, 2023, using medical and insurance claims and electronic health record data.
Overall, the analysis included 16,743,822 adults aged 18 years or older (51.3% women) who contributed 47,939,382 BMI measurements.
The researchers found that the mean population BMI rose annually from 2013 (29.65 kg/m2) to 2021 (30.23 kg/m2), plateaued at 30.24 kg/m2 in 2022 and slightly decreased to 30.21 kg/m2 in 2023.They observed this same pattern in percentage changes of adults with obesity.
Rader and colleagues observed a decline in obesity among those living in the South, those aged 66 to 75 years and women.
GLP-1 receptor agonist dispensing per capita among a subset of 10,625,745 adults with 2023 insurance claim data entailed:
- 6% in the South;
- 5.1% in the Midwest;
- 4.4% in the Northeast; and
- 3.4% in the West.
The researchers pointed out that GLP-1 dispensing “does not necessarily mean uptake,” adding that the South had disproportionately high COVID-19 mortality among people with obesity.
They also explained that obesity and BMI — the latter oft criticized due to several limitations — are “imperfect proxies” for adiposity.
“Thus, future studies should investigate alternative body composition measures and potential causes for the observed shifts, including GLP-1 receptor agonist proliferation (eg, out-of-pocket purchases) or pandemic-associated demographic and behavior changes,” they wrote.
The researchers said study limitations included possible selection bias, while BMI recorded during medical visits may have affected the estimates.
Rader pointed out that some demographic groups, such as Asian populations, still experienced increases in obesity.
“This is encouraging [but] there is still a lot of work to go,” he told Healio. “We showed some loose evidence to connect this drop GLP-1s, but more evidence is needed.”
Perspective
Back to Top
This study highlights evolving trends in obesity in U.S. adults, a very important metric regarding health of a population. The slight decline in obesity prevalence in 2023, particularly in regions with higher GLP-1 receptor agonist use, raises questions about the role of medication accessibility and behavioral shifts. However, the reliance on BMI as a primary metric underscores the need for broader assessments of metabolic health in clinical practice because they are not alone indicators of good health.
Counseling patients on lifestyle changes and navigating the growing landscape of pharmacological interventions are paramount for family physicians across the U.S. We need to use vigilance in addressing potential disparities in treatment uptake and effectiveness, especially given demographic variability in use due to cost. As GLP-1 medications continue to expand in use for obesity and other indications, safety monitoring will need to continue to be addressed closely.
Collapse
Read more about
Click Here to Manage Email Alerts