A Hint of a Drop in Obesity Prevalence

Let’s be quite clear. This is encouraging news, but it is nothing more than a glimmer of a possibility that there is a drop in U.S. obesity prevalence showing up in 2023. The data come from electronic health records.

From a sample of 16,743,822 U.S. adults, Benjamin Rader, Rebecca Hazan, and John Brownstein analyzed 47,939,382 BMI measurements. They found that average BMI in the population rose every year from 2013 to 2021.  And then, in 2023, it decreased very slightly. The decline was especially notable in the South, in people 66 to 75 years old, and in women.

JAMA Health Forum published their findings yesterday.

Why?

Of course, the authors are eager to speculate about why this might have happened. They write:

“These findings suggest that BMI and obesity prevalence in the US decreased in 2023 for the first time in more than a decade. The most notable decrease was in the South, which had the highest observed per capita GLP-1RA dispensing rate. However, dispensing does not necessarily mean uptake, and the South also experienced disproportionately high COVID-19 mortality among individuals with obesity.”

So maybe GLP-1 use had something to do with it. Or maybe deaths from COVID in people with obesity resulted in a tick down in obesity prevalence immediately after the pandemic. All of this is speculation.

Beware the Blip

As we think about this suggestion of a drop in obesity prevalence, heeding the cautious words of endocrinologist Michael Weintraub would be wise:

“I find the data exciting, and with it the prospect that we could be at the precipice of a shift in this obesity epidemic. But I hesitate to call this down-trending value in 2023 yet a trend.

“We’ve been fooled by fluctuations in obesity prevalence in the past. We got excited about down-trending pediatric obesity rates in the early 2000s with data from CDC, only for them to shoot up in the subsequent years.”

This might be a little blip. It might be the beginning of a trend. Only time will tell.

Click here for the paper by Rader et al, here and here for further perspective.

Return from the Forest, painting by Giovanni Segantini / WikiArt

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December 14, 2024