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Explaining adult obesity, severe obesity, and BMI: Five decades of change

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Kranjac, Ashley W., Kranjac, Dinko·2023·Heliyon
DOI 10.1016/j.heliyon.2023.e16210PMC PMC10213181
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Abstract

Obesity rates have increased across all segments of society since the late 1970s, but the reason behind population-level increases in body weight remains unclear. We used the 1971–2020 NHANES data to examine whether the observed trend in obesity prevalence is attributable to changing public health behaviors (i.e., intracohort change) or changing publics (i.e., cohort replacement). We partitioned total change in mean BMI, and rates of obesity and severe obesity, into its IC and CR components using linear and algebraic decomposition methods. We found that the IC mechanism (i.e., broad sectors of individuals changing) plays a dominant role in the overall increase in mean BMI, and obesity and severe obesity prevalence. Birth cohort membership (i.e., the CR mechanism) is also influencing mean BMI, and rates of obesity and severe obesity, but in differing ways. Specifically, the large positive IC and the small positive CR effects are amplifying one another, thus creating a steep increase in the observed rates of severe obesity. Conversely, the large positive IC effect is offset by a small negative CR effect, which created a more gradual rise in mean BMI and rates of obesity. Furthermore, we computed total change for models that entered separately sociodemographic, lifestyle, nutritional, and physical activity measures to estimate differences in mean BMI, and rates of obesity and severe obesity, among cohorts and time periods. Adjustment for all the compositional differences among the cohorts during the study period indicate that a combination of a more pronounced IC and a less pronounced CR drove the observed increase in mean BMI, and rates of obesity and severe obesity. Thus, "universal prevention" (i.e., entire community) strategies for healthy weight promotion may need to be combined with "selective prevention" (i.e., at-risk groups) and/or "targeted prevention" (i.e., at-risk individuals) approaches in order to reverse the obesity epidemic.

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Authors
Kranjac, A. W., & Kranjac, D.
Affiliations
  • Chapman University (US)
  • University of La Verne (US)
Corresponding author
Kranjac, Ashley W.
ORCID
Venue
Heliyon
Publisher
Elsevier BV
Published
2023-05
Volume
9
Issue
5
Pages
e16210
ISSN
2405-8440 (ISSN-L)
DOI
10.1016/j.heliyon.2023.e16210
PMC
PMC10213181
OpenAlex
W4377086831
Cited by
53
References
5
Citations by year
2026: 14 · 2025: 22 · 2024: 17
FWCI
12.35
Type
journal article
Language
en
Open access
Licence
Locations
  • Heliyon (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • Chapman University Digital Commons (Chapman University) (submittedVersion, cc-by-nc-nd)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
  • Health Sciences › Health Professions › Pharmacy › Obesity and Health Practices
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords
adult obesity, morbid obesity, body mass index trends, cohort replacement, obesity prevalence, NHANES, public health behavior, sociodemographic factors, lifestyle factors, dietary factors, physical activity, obesity prevention strategies, universal prevention, targeted prevention

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