Pat Crawford, DrPH, RDDirector, Atkins Center for Weight &

HealthCooperative Extension Nutrition and

Obesity Specialist University of California at Berkeley

An Overview of the Obesity Epidemic in California

Senate Committee on Health February 12, 2014

Synthesizing the science

Atkins Center for Weight & Health Funded in 1999

Evaluating programs

and policies

Conducting research to

answer critical

questions

Working in partnerships

with communities,

government and organizations

Translation and

dissemination

3

Rates of obesity/overweight

Context of rates

Obesity Trends* Among U.S. AdultsBRFSS, 1985

No Data <10% 10%–14%

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

Obesity Trends* Among U.S. AdultsBRFSS, 1986

No Data <10% 10%–14%

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

Obesity Trends* Among U.S. AdultsBRFSS, 1987

No Data <10% 10%–14%

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

Obesity Trends* Among U.S. AdultsBRFSS, 1988

No Data <10% 10%–14%

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

Obesity Trends* Among U.S. AdultsBRFSS, 1989

No Data <10% 10%–14%

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

Obesity Trends* Among U.S. AdultsBRFSS, 1990

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14%

Obesity Trends* Among U.S. AdultsBRFSS, 1991

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19%

Obesity Trends* Among U.S. AdultsBRFSS, 1992

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19%

Obesity Trends* Among U.S. AdultsBRFSS, 1993

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19%

Obesity Trends* Among U.S. AdultsBRFSS, 1994

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19%

Obesity Trends* Among U.S. AdultsBRFSS, 1995

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19%

Obesity Trends* Among U.S. AdultsBRFSS, 1996

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19%

Obesity Trends* Among U.S. AdultsBRFSS, 1997

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% ≥20%

Obesity Trends* Among U.S. AdultsBRFSS, 1998

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% ≥20%

Obesity Trends* Among U.S. AdultsBRFSS, 1999

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% ≥20%

Obesity Trends* Among U.S. AdultsBRFSS, 2000

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% ≥20%

Obesity Trends* Among U.S. AdultsBRFSS, 2001

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

Obesity Trends* Among U.S. AdultsBRFSS, 2002

No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

Obesity Trends* Among U.S. AdultsBRFSS, 2003

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

Obesity Trends* Among U.S. AdultsBRFSS, 2004

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

Obesity Trends* Among U.S. AdultsBRFSS, 2005

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

Obesity Trends* Among U.S. AdultsBRFSS, 2006

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

Obesity Trends* Among U.S. AdultsBRFSS, 2007

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

Obesity Trends* Among U.S. AdultsBRFSS, 2008

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

Obesity Trends* Among U.S. AdultsBRFSS, 2009

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

Obesity Trends* Among U.S. AdultsBRFSS, 2010

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

Change in Adult Obesity* in California

Years % ObeseNumber of

years

1985-1990 < 10% 6 years

1991-1996 10-14% 6 years

1997 -2002 ** 15-19% 6 years

2003 -2011 20-24% 9 years

2012*** 25-<30% 1 year

* Obesity defined as Body Mass Index wt(kg)/m2 > 30** 2001-20—24%*** Methodological changes make comparisons not possible with those before 2011Ref: BRFSS, 1985-2012

Obesity in Adults

US CA

All 28% 25%

Men 28%   26% 

Women  28% 24%

Ref: BRFSS, 2012

Overweight (and obesity) in adults

US CA

All 60% 64%

Men 67%   70%

Women  54% 58%

Ref: BRFSS, 2012

Overweight (and obesity) in adults by race

US CA

White 63% 58%

Black 71%   74%

Hispanic  67% 70%

Other 53% 40%

Ref: BRFSS, 2012

Obesity in low-income children

US CA

All 14% 16%

Ref: PedNSS, 2011Note: Hispanic rate of obesity 50% higher

Overweight (and obesity) in low-income children

US CA

All 30% 33%

Ref: PedNSS, 2011

Overweight (and obesity) in children by race*

All girls 30% All boys 33%

White 26% White 30%

Black 41% Black 37%

Hispanic 39% Hispanic 40%

* Ages 2-19Ref: Ogden, NHANES, 2012

Adults* United States California

Total population

316,128,839 38,332,521

% White 78% 74%

% African-American

13% 7%

% Hispanic 17% 38%Children+ United States California

% White 52% 27%

% African-American

14% 6%

% Hispanic 24% 52%

Race/Ethnicity – US vs. CA

*U.S. Census Bureau: State and County QuickFacts.

+ kidsdata.org 

Adults* United States California

% Below federal poverty level

14.9% 15.3%

Children+ United States California

% Below federal poverty level

22.6% 23.8%

Poverty level – US vs. CA

*U.S. Census Bureau: State and County QuickFacts.

+ kidsdata.org 

Fitnessgram testing

2001 2005 2008 200910

15

20

25

30

35

All Boys BMI > 95th percentile

BMI

2001 2005 2008 200910

15

20

25

30

35

Hispanic boys BMI > 95th percentile

BMI

2001 2003 2008 200910

15

20

25

30

35

Asian boys BMI > 95th percentile

BMI

2001 2007 2008 200910

15

20

25

30

35

American Indian boys BMI > 95th percentile

BMI

2001 2005 2008 200910

15

20

25

30

35

Non-Hispanic White boys BMI > 95th percentile

BMI

2001 2005 2008 200910

15

20

25

30

35

All girls BMI > 95th percentile

BMI

2001 2008 2008 200910

15

20

25

30

35Black girls BMI > 95th percentile

BMI

2001 2005 2008 200910

15

20

25

30

35

Hispanic girls BMI > 95th percentileBM

I

2001 2008 200910

15

20

25

30

35

American Indian girls BMI > 95th percentile

BMI

2001 2005 2008 200910

15

20

25

30

35

Non-Hispanic White girls BMI > 95th percentile

BMI

Policy Evaluation in Student BMI

Ref: Sanchez-Vaznaugh, Crawford, 2010

Ref: CCPHA

• Annualize the adjusted decrease in prevalence

from peak to 2008

• Assume that annual decrease continues until

2015

• Apply this to ALL kids in CA

• ~ 100,000 kids DROP OUT of the obese

category

• Assuming a savings of $220 per child**

• Savings of about $20 million

Medical cost savings per child*

* Madsen K, UC Berkeley, personal communication**(based on MEPS data from 2001 to 2003, as reported in NY state comptroller report from Oct 2012)

GIRLS

Remission 2008 to 2015

SAVINGS

White  11,024  $2,425,337

African American  -    -  

Latina  8,772  $1,929,798

Asian  2,443  $537,360

American Indian  -    -  

TOTAL (By race)  22,239  $4,892,495

BOYSRemission: 2008 to 2015

Savings*

White  27,165  $5,976,209

African American  7,971  $1,753,643

Latino  30,373  $6,682,012

Asian  4,419  $972,107

American Indian  3,881  $853,816

TOTAL (By race)  73,808  $16,237,787

The human cost of obesity: diabetes and pre-diabetes in adolescence

2001 20090

5

10

15

20

25

Human cost - Adult

or pictorially NowThen

Key messages

Invest in prevention

Create a culture of health

Utilize the resources of the University

THANK YOU