Prevalence of Overweight, Obesity, and Severe Obesity Among Adults Aged 20 and Over: United States, 1960–1962 Through 2017–2018

by Cheryl D. Fryar, M.S.P.H., Margaret D. Carroll, M.S.P.H., and Joseph Afful, M.S., Division of Health and Nutrition Examination Surveys

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This report was revised on January 29, 2021, to update Table 3 with overall estimates of obesity by race and Hispanic origin.

Results from the 2017–2018 National Health and Nutrition Examination Survey (NHANES), using measured heights and weights, indicate that an estimated 42.5% of U.S. adults aged 20 and over have obesity, including 9.0% with severe obesity, and another 31.1% are overweight. Body mass index (BMI), expressed as weight in kilograms divided by height in meters squared  (kg/m2), is used commonly to classify overweight (BMI 25.0–29.9), obesity (BMI at or above 30.0), and severe obesity (BMI at or above 40.0).

Age-adjusted trends in overweight, obesity, and severe obesity prevalence from 1960–1962 through 2017–2018 are shown in Table 1. Because surveys before 1988 did not include persons over age 74, Table 1 shows the prevalence for adults aged 20 and over since 1988, and for adults aged 20–74 for all survey periods dating back to 1960. The age-adjusted sex-specific trends of overweight, obesity, and severe obesity among adults aged 20–74 from 1960–1962 through 2017–2018 are shown in the  Figure. Table 2 contains the prevalence of obesity by age for men and women since 1988–1994, and Table 3 contains the age-adjusted prevalence of obesity by race and Hispanic origin for men and women since 1988–1994.

The prevalence of obesity as measured by BMI among non-Hispanic Asian adults is consistently lower than that reported for non-Hispanic white, non-Hispanic black, and Hispanic adults. Although BMI is widely used as a measure of body fat, at a given BMI level, body fat may vary by sex, age, and race and Hispanic origin. In particular, research suggests that health risks may begin at a lower BMI among Asian persons compared with others (1,2).

NHANES, conducted by the National Center for Health Statistics, is a stratified, multistage probability sample of the civilian noninstitutionalized population of the United States. The survey began oversampling non-Hispanic Asian persons in 2011–2012 and the total Hispanic population in 2007–2008. Beginning in 2007–2008, Mexican-American persons were no longer oversampled but are included in the oversampled total Hispanic population.

A household interview and a physical examination are conducted for each survey participant. During the physical examination, conducted in a mobile examination center, height and weight are measured as part of a comprehensive set of body measurements. These measurements are taken by trained health technicians, using standardized measuring procedures and equipment. Observations for pregnant women and for persons missing a valid height or weight measurement are not included in the data analysis.

For additional information on NHANES methods, visit: https://wwwn.cdc.gov/nchs/nhanes/analyticguidelines.aspx.

For more detailed estimates, see:

  • Flegal KM, Carroll MD, Ogden CL, Johnson CL. Prevalence and trends in obesity among US adults, 1999–2000. JAMA 288(14):1723–7. 2002.
  • Ogden CL, Carroll MD, Curtin LR, McDowell MA, Tabak CJ, Flegal KM. Prevalence of overweight and obesity in the United States, 1999–2004. JAMA 295(13):1549–55. 2006.
  • Ogden CL, Carroll MD, McDowell MA, Flegal KM. Obesity among adults in the United States—No statistically significant change since 2003–2004. NCHS Data Brief, no 1. Hyattsville, MD: National Center for Health Statistics. 2007.
  • Flegal KM, Carroll MD, Ogden CL, Curtin LR. Prevalence and trends in obesity among US adults, 1999–2008. JAMA 303(3):235–41. 2010.
  • Flegal KM, Carroll MD, Kit BK, Ogden CL. Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999–2010. JAMA 307(5):491–7. 2012.
  • Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of childhood and adult obesity in the United States, 2011–2012. JAMA 311(8):806–14. 2014.
  • Flegal KM, Kruszon-Moran D, Carroll MD, Fryar CD, Ogden CL. Trends in obesity among adults in the United States, 2005 to 2014. JAMA 315(21):2284–91. 2016.
  • Hales CM, Fryar CD, Carroll MD, Freedman DS, Ogden CL. Trends in obesity and severe obesity prevalence in US youth and adults by sex and age, 2007–2008 to 2015–2016. JAMA 319(16):1723–5. 2018.
  • Ogden CL, Fryar CD, Martin CB, Freedman DS, Carroll MD, Gu Q, Hales CM. Trends in obesity prevalence by race and Hispanic origin—1999–2000 to 2017–2018. JAMA 324(12):1208–10. 2020. doi:10.1001/jama.2020.14590.

References

1. Deurenberg P, Deurenberg-Yap M, Guricci S. Asians are different from Caucasians and from each other in their body mass index/body fat per cent relationship. Obes Rev 3(3):141–6. 2002.
2. Zheng W, McLerran DF, Rolland B, Zhang X, Inoue M, Matsuo K, et al. Association between body-mass index and risk of death in more than 1 million Asians. N Engl J Med 364(8):719–29.

This Health E-Stat supersedes the earlier version, “Prevalence of Overweight, Obesity, and Severe Obesity Among Adults Aged 20 and Over: United States, 1960–1962 Through 2015–2016”.

Suggested Citation

Fryar CD, Carroll MD, Afful J. Prevalence of overweight, obesity, and severe obesity among adults aged 20 and over: United States, 1960–1962 through 2017–2018. NCHS Health E-Stats. 2020.

Figure

Figure. Age-adjusted trends in overweight, obesity, and severe obesity among men and women aged 20–74: United States, 1960–1962 through 2017–2018

The figure shows six line graphs showing trends in overweight, obesity, and severe obesity among adults in the United States from 1960–1962 through 2017–2018

NOTES: Data are age adjusted by the direct method to U.S. Census 2000 estimates using age groups 20–39, 40–59, and 60–74. Overweight is body mass index (BMI) of 25.0–29.9 kg/m2. Obesity is BMI at or above 30.0 kg/m2. Severe obesity is BMI at or above 40.0 kg/m2. Pregnant women are excluded from the analysis.
SOURCES: National Center for Health Statistics, National Health Examination Survey and National Health and Nutrition Examination Surveys.

Tables

Table 1. Age-adjusted prevalence of overweight, obesity, and severe obesity among adults, by sex: United States, 1960–1962 through 2017–2018

Age group and
Survey period
Sample (n)
All Men Women
Overweight Obesity Severe
obesity
Overweight Obesity Severe
obesity
Overweight Obesity Severe
obesity
20 and over1:                                                                                                             Percent (standard error)
   1988–1994 16,235 33.1 (0.6) 22.9 (0.7) 2.8 (0.2) 40.7 (0.8) 20.2 (0.7) 1.7 (0.3) 25.9 (0.7) 25.4 (0.9) 3.9 (0.3)
   1999–2000 4,117 34.0 (1.0) 30.5 (1.5) 4.7 (0.6) 39.7 (1.4) 27.5 (1.5) 3.1 (0.7) 28.6 (1.6) 33.4 (1.7) 6.2 (0.7)
   2001–2002 4,413 35.1 (1.1) 30.5 (1.1) 5.1 (0.5) 42.2 (1.3) 27.7 (1.0) 3.6 (0.6) 28.2 (1.7) 33.2 (1.5) 6.5 (0.6)
   2003–2004 4,431 34.1 (1.1) 32.2 (1.2) 4.8 (0.6) 39.7 (1.5) 31.1 (1.3) 2.8 (0.4) 28.6 (1.2) 33.2 (1.7) 6.9 (0.9)
   2005–2006 4,356 32.6 (0.8) 34.3 (1.4) 5.9 (0.5) 39.9 (1.3) 33.3 (2.0) 4.2 (0.5) 25.5 (1.2) 35.3 (1.4) 7.4 (0.7)
   2007–2008 5,550 34.3 (0.8) 33.7 (1.1) 5.7 (0.4) 40.1 (1.4) 32.2 (1.4) 4.2 (0.5) 28.6 (1.2) 35.4 (1.1) 7.3 (0.6)
   2009–2010 5,926 33.0 (1.0) 35.7 (0.9) 6.3 (0.2) 38.4 (1.1) 35.5 (1.7) 4.4 (0.3) 27.9 (1.4) 35.8 (0.9) 8.1 (0.5)
   2011–2012 5,181 33.6 (1.3) 34.9 (1.4) 6.4 (0.6) 37.8 (1.5) 33.5 (1.4) 4.4 (0.9) 29.7 (1.8) 36.1 (1.7) 8.3 (0.7)
  2013–2014 5,455 32.5 (0.8) 37.7 (0.9) 7.7 (0.7) 38.7 (1.2) 35.0 (1.1) 5.5 (0.6) 26.5 (0.8) 40.4 (1.3) 9.9 (0.9)
  2015–2016 5,337 31.6 (0.8) 39.6 (1.6) 7.7 (0.6) 36.5 (1.6) 37.9 (2.3) 5.6 (0.7) 26.9 (1.0) 41.1 (1.6) 9.7 (0.7)
  2017–2018 5,120 30.7 (1.1) 42.4 (1.8) 9.2 (0.9) 34.1 (1.8) 43.0 (2.7) 6.9 (1.0) 27.5 (1.0) 41.9 (2.0) 11.5 (1.3)
20–742:
  1960–1962 6,126 31.5 (0.5) 13.4 (0.5) 0.9 (0.1) 38.7 (0.7) 10.7 (0.7) 0.3 (0.1) 24.7 (0.8) 15.8 (0.6) 1.4 (0.2)
  1971–1974 12,911 32.7 (0.6) 14.5 (0.4) 1.3 (0.2) 41.7 (1.1) 12.1 (0.6) 0.6 (0.2) 24.3 (0.7) 16.6 (0.6) 2.0 (0.3)
  1976–1980 11,765 32.1 (0.6) 15.0 (0.4) 1.4 (0.1) 39.9 (0.8) 12.7 (0.6) 0.4 (0.1) 24.9 (0.8) 17.0 (0.6) 2.2 (0.3)
  1988–1994 14,319 32.6 (0.6) 23.2 (0.7) 3.0 (0.3) 40.3 (0.8) 20.5 (0.7) 1.8 (0.3) 25.1 (0.8) 25.9 (1.0) 4.1 (0.3)
  1999–2000 3,603 33.6 (1.1) 30.9 (1.6) 5.0 (0.6) 39.2 (1.5) 27.7 (1.6) 3.3 (0.7) 28.0 (1.7) 34.0 (1.8) 6.6 (0.8)
   2001–2002 3,916 34.4 (1.1) 31.2 (1.1) 5.4 (0.5) 41.5 (1.4) 28.3 (1.1) 3.9 (0.7) 27.3 (1.6) 34.1 (1.6) 6.8 (0.6)
  2003–2004 3,756 33.4 (1.2) 32.9 (1.3) 5.1 (0.6) 39.4 (1.5) 31.7 (1.4) 3.0 (0.4) 27.3 (1.3) 34.0 (1.9) 7.3 (1.0)
   2005–2006 3,835 32.2 (0.9) 35.1 (1.5) 6.2 (0.5) 39.7 (1.3) 33.8 (2.2) 4.3 (0.5) 24.7 (1.3) 36.3 (1.5) 7.9 (0.8)
  2007–2008 4,876 33.6 (0.8) 34.3 (1.2) 6.0 (0.4) 39.4 (1.4) 32.5 (1.5) 4.4 (0.5) 27.9 (1.2) 36.2 (1.3) 7.6 (0.6)
  2009–2010 5,279 32.7 (1.0) 36.1 (0.9) 6.6 (0.2) 38.0 (1.2) 35.9 (1.7) 4.6 (0.4) 27.5 (1.5) 36.1 (0.9) 8.5 (0.5)
  2011–2012 4,674 33.3 (1.4) 35.3 (1.4) 6.6 (0.6) 37.3 (1.5) 33.9 (1.5) 4.5 (1.0) 29.5 (2.0) 36.6 (1.6) 8.6 (0.7)
  2013–2014 4,940 31.9 (0.8) 38.2 (1.0) 8.1 (0.8) 38.2 (1.3) 35.5 (1.2) 5.7  (0.7) 25.8 (0.9) 41.0 (1.4) 10.5 (1.0)
  2015–2016 4,778 31.0 (0.8 40.0 (1.8) 8.0 (0.6) 35.8 (1.8) 38.3 (2.4) 5.9 (0.8) 26.3 (1.1) 41.6 (1.7) 10.1 (0.7)
  2017–2018 4,536 30.3 (1.2) 42.8 (1.9) 9.6 (1.0) 33.7 (1.9) 43.5 (2.7) 7.3 (1.0) 26.9 (0.9) 42.1 (2.1) 12.0 (1.5)

1Age adjusted by the direct method to the U.S. Census 2000 estimates using the age groups 20–39, 40–59, and 60 and over. Crude estimates (not age adjusted) for 2017–2018 are 31.1% for overweight, 42.5% for obesity, and 9.0% for severe obesity categories.
2Age adjusted by the direct method to the U.S. Census 2000 estimates using the age groups 20–39, 40–59, and 60–74. The 1960–1962 National Health Examination Survey included adults aged 18–79, and the 1971–1974 and 1976–1980 National Health and Nutrition Examination Surveys did not include individuals over age 74.
NOTES: Overweight is body mass index (BMI) of 25.0–29.9 kg/m2, obesity is BMI at or above 30.0 kg/m2, and severe obesity is BMI at or above 40.0 kg/m2. Pregnant women are excluded from the analysis.
SOURCES: National Center for Health Statistics, National Health Examination Survey, 1960–1962; and National Health and Nutrition Examination Surveys, 1971–1974, 1976–1980, 1988–1994, and 1999–2018.

Table 2. Prevalence of obesity among adults aged 20 and over, by sex and age: United States, 1988–1994 through 2017–2018

Survey period
All Men Women
20–39 40–59 60 and over 20–39 40–59 60 and over 20–39 40–59 60 and over
                                                                                                            Percent (standard error)
1988–1994  17.7 (0.7)  27.9 (1.1) 23.7 (0.9) 14.8 (0.8) 25.4 (1.2)  21.2 (1.4) 20.7 (1.3) 30.3 (1.5) 25.6 (1.1)
1999–2000 26.0 (1.3) 33.5 (3.0) 33.5 (1.7) 23.7 (1.6) 28.8 (2.9) 31.7 (2.2) 28.3 (2.0) 37.7 (3.3) 35.0 (2.2)
2001–2002 26.1 (1.4) 33.9 (1.5) 32.8 (1.6) 22.3 (1.5) 32.2 (1.7) 29.9 (2.0) 29.8 (2.1) 35.7 (2.1) 35.0 (2.0)
2003–2004 28.5 (1.5) 36.8 (1.8) 31.0 (1.3) 28.0 (2.2) 34.8 (2.5) 30.4 (1.9) 28.9 (2.3) 38.8 (2.7) 31.5 (1.7)
2005–2006 29.1 (2.0) 40.4 (2.0) 33.4 (1.1) 27.9 (2.8) 39.6 (2.9) 32.2 (2.1) 30.5 (2.3) 41.1 (2.3) 34.4 (2.3)
2007–2008 30.7 (2.0) 36.2 (1.7) 35.1 (1.0) 27.4 (1.9) 34.2 (2.3) 37.0 (2.0) 34.0 (2.5) 38.1 (2.2) 33.5 (1.7)
2009–2010 32.6 (1.7) 36.6 (1.0) 39.7 (1.5) 33.2 (2.7) 37.2 (1.8) 36.6 (2.4) 31.9 (1.6) 36.0 (1.7) 42.3 (1.9)
2011–2012 30.3 (1.9) 39.5 (1.6) 35.4 (2.0) 29.0 (2.6) 39.4 (1.6) 32.0 (2.2) 31.8 (1.7) 39.5 (2.2) 38.1 (2.9)
2013–2014 34.3 (1.5) 41.0 (2.1) 38.5 (1.6) 31.6 (2.1) 37.2 (2.4) 37.5 (3.0) 37.0 (1.3) 44.6 (2.6) 39.4 (1.9)
2015–2016 35.7 (1.9) 42.8 (2.6) 41.0 (1.9) 34.8 (2.8) 40.8 (2.9) 38.5 (1.8) 36.5 (1.6) 44.7 (3.1) 43.1 (2.8)
2017–2018 40.0 (2.6) 44.8 (1.9) 42.8 (2.5) 40.3 (3.8) 46.4 (3.2) 42.2 (3.3) 39.7 (2.7) 43.3 (2.7) 43.3 (3.0)

NOTES: Obesity is body mass index at or above 30.0 kg/m2. Pregnant women are excluded from the analysis.
SOURCE: National Center for Health Statistics, National Health and Nutrition Examination Surveys, 1988–1994 and 1999–2018.

Table 3. Age-adjusted prevalence of obesity among adults aged 20 and over, by sex and race and Hispanic origin: United States, 1988–1994 through 2017–2018

Survey period
Non-Hispanic white Non-Hispanic black Non-Hispanic Asian Hispanic Mexican American
All                                                                                                             Percent (standard error)
1988–1994 21.6 (0.8)  30.7 (0.9) – – – – – – 29.4 (0.9)
1999–2000 28.7 (1.8) 39.7 (1.6) – – – – – – 34.3 (2.5)
2001–2002 30.2 (1.2) 39.0 (1.8) – – – – – – 31.0 (2.1)
2003–2004 30.6 (1.3) 45.0 (2.2) – – – – – – 36.8 (1.8)
2005–2006 32.9 (1.6) 45.8 (1.7) – – – – – – 33.9 (1.0)
2007–2008 32.4 (1.8) 43.9 (2.0) – – – 38.7 (2.6) 40.3 (3.1)
2009–2010 34.3 (1.2) 49.5 (2.3) – – – 39.1 (1.9) 40.4 (1.8)
2011–2012 32.6 (1.8) 47.8 (1.6) 10.8 (1.4) 42.5 (1.7) 46.6 (2.1)
2013–2014 36.4 (1.1) 48.4 (2.0) 12.6 (1.3) 42.6 (2.1) 46.4 (2.1)
2015–2016 37.9 (1.8) 46.8 (2.3) 12.7 (1.1) 47.0 (2.1) 49.4 (1.9)
2017–2018 42.2 (2.5) 49.6 (1.5) 17.4 (1.3) 44.8 (1.6) 50.4 (2.0)
Men
1988–1994 20.3 (0.9) 21.1 (1.0) – – – – – – 23.9 (1.0)
1999–2000 27.3 (1.8) 27.9 (1.6) – – – – – – 28.9 (1.9)
2001–2002 29.0 (1.3) 27.9 (2.0) – – – – – – 25.9 (2.0)
2003–2004 31.1 (1.5) 34.0 (3.5) – – – – – – 31.6 (2.5)
2005–2006 33.0 (2.2) 37.0 (2.4) – – – – – – 27.0 (1.9)
2007–2008 31.9 (1.9) 37.2 (2.5) – – – 34.2 (3.0) 35.8 (3.5)
2009–2010 36.2 (2.1) 38.8 (2.3) – – – 37.0 (2.2) 38.6 (2.4)
2011–2012 32.4 (1.3) 37.1 (1.9) 10.0 (1.6) 40.1 (2.1) 44.0 (2.6)
2013–2014 34.7 (1.6) 38.0 (2.5) 12.6 (1.8) 37.9 (2.8) 42.2 (2.5)
2015–2016 37.9 (2.7) 36.9 (2.5) 10.1 (1.3) 43.1 (2.9) 46.2 (2.6)
2017–2018 44.7 (3.7) 41.1 (2.2) 17.5 (2.1) 45.7 (1.8) 51.1 (2.4)
Women
1988–1994 22.9 (1.1)  38.4 (1.4) – – – – – – 35.4 (1.4)
1999–2000 30.1 (2.1) 49.5 (3.0) – – – – – – 39.5 (3.9)
2001–2002 31.2 (1.6) 48.2 (2.7) – – – – – – 37.0 (3.2)
2003–2004 30.2 (2.1) 53.9 (3.0) – – – – – – 42.3 (2.7)
2005–2006 32.9 (1.8) 52.9 (2.1) – – – – – – 42.1 (2.8)
2007–2008 33.0 (1.8) 49.4 (2.0) – – – 43.0 (2.6) 45.1 (3.1)
2009–2010 32.2 (1.4) 58.5 (2.8) – – – 41.4 (2.0) 44.9 (1.6)
2011–2012 32.8 (2.7) 56.6 (2.1) 11.4 (2.2) 44.4 (2.1) 49.2 (3.4)
2013–2014 38.2 (1.6) 57.2 (1.7) 12.4 (2.1) 46.9 (2.7) 50.9 (3.1)
2015–2016 38.0 (1.9) 54.8 (2.3) 14.8 (1.3) 50.6 (2.1) 52.3 (2.1)
2017–2018 39.8 (2.9) 56.9 (1.9) 17.2 (1.3) 43.7 (2.0) 49.6 (4.0)

– – – Data not available.
NOTES: Obesity is body mass index at or above 30.0 kg/m2. Age adjusted by the direct method to U.S. Census 2000 estimates using the age groups 20–39, 40–59, and 60 and over. Pregnant women are excluded from the analysis.
SOURCE: National Center for Health Statistics, National Health and Nutrition Examination Surveys, 1988–1994 and 1999–2018.