Have Americans Given Up Trying to Lose Weight?

America’s battle with the bulge is well documented. Now, a research letter in JAMA reports that data from a well-known health survey show that many of those who are overweight or obese are waving the white flag, rather than continuing the fight.

Researchers from the Georgia Southern University School of Public Health compared responses of overweight and obese people who took part in the National Health and Nutrition Examination Survey (NHANES) over 3 stretches between 1988 and 2014.

The researchers found 27,350 participants who were aged 20 to 59 years, who were overweight (their body mass index [BMI] was at least 25 and less than 30 kg/m^{2 ]} or obese (their BMI was at least 30). All had replied to the question, “During the past 12 months, have you tried to lose weight?”

Over time, the rates of being overweight and obese increased: from 1988 to 1994, it was 53%; from 1999 to 2005, it was 62%; and from 2009 to 2014, it was 66%. But the share of people who were overweight and trying to lose it fell and then leveled off: it was 56% in the first interval, then 47%, then 49%.

The researchers noted that African American women had both a sharp rise in obesity—reaching 55% between 2009 and 2014—and a large drop (11%) in the percentage who were trying to lose weight. This has important health implications, because African Americans have higher rates of diabetes, and rates of breast cancer in African American women are rising. Both of which are linked to obesity.

The authors cited earlier research in the journal Obesity that found a “generational shift” has made being overweight the new normal. The researchers found that among women, the tendency to describe oneself as overweight fell the most among those aged 35 or younger, while among men, the decline was more evenly distributed across age groups. “As a result, people may be less likely to desire weight loss than previously limiting the effectiveness of public health campaigns aimed at weight reduction,” that study found.

While it’s possible that perceptions of one’s weight may contribute to a lack of desire to slim down, the Georgia Southern team speculated that people who try and fail to lose weight—or cannot keep it off—simply give up. A landmark study in the New England Journal of Medicine in 2011 shows how the body adapts to weight loss, and in fact rebounds and works at regaining the weight.

“The longer adults live with obesity, the less they may be willing to attempt weight loss, in particular if they had attempted weight loss multiple times without success,” the researchers wrote.

Reference

Snook KR, Hansen AR, Duke CH. Change in percentages of adults with overweight or obesity trying to lose weight, 1988-2014. JAMA; 2017;317(9):971-973. doi:10.1001/jama.2016.20036