Often the result of poor nutrition and misinformation, obesity brings with it a host of debilitating health problems and a hefty economic price tag. Virginia is committed to promoting a healthy lifestyle, starting in childhood, to help citizens avoid obesity and live long, productive lives.
Why is This Important?
A healthy community is one in which individuals adopt healthy behaviors such as eating nutritious foods and being physically active, both of which can prevent or control the devastating effects of obesity. Obesity often results in lost workdays, lower productivity, and negative health outcomes, including diabetes and depression; it also strains private and government health care programs.
The good news is that, for the first time in decades, 2012-13 adult obesity rates in the United States have remained level in nearly every state -- hopeful signs that increased awareness and emphasis on preventive care may be starting to reverse the tide. Virginia's own outcomes show definite progress, and the state continues to be committed to healthcare programs that help residents avoid or at least reduce the health and economic consequences of obesity. Such measures appear to be paying off, although Virginia's aging populations are still at increased risk of developing obesity-related illnesses.
How is Virginia Doing?
Consistent with trends nationwide, obesity rates in Virginia had been steadily rising for the last decade and more. But the state's current (2012) 27.4 percent obesity rate is now slightly lower than the national average (27.6%), which itself dropped a bit from the previous year. Virginia's rate was also lower than its peer states; at 27.6 percent, Maryland matches the national average, while North Carolina (29.6%) and Tennessee (31.1%) have risen above it. Colorado, which has led the nation in lowest obesity rates since 2000, again led in 2012 with 20.5 percent.
Within Virginia, obesity rates have dropped in most regions, though the Valley and Eastern regions saw their rates rise. The Southside region had the highest obesity rate at 35.9 percent in 2012, though that is a decline since 2011. It was followed by the Eastern (35.2%) and Southwest (34.6%) regions. The Northern region had the lowest rate of obesity at 20.4 percent.
The 2011 National Survey of Children's Health found that just under 30 percent (29.8%) of Virginia's 10-to-17-year-olds were overweight or obese, a decrease since 2007 of 1.2 percentage points. This figure puts Virginia below the national average of 31.3 percent and ranks the state 23rd highest in the country for percentage of overweight or obese children. Virginia's rate was lower than North Carolina (31.4%), Maryland (31.6%), and Tennessee (34.1%). Utah was again lowest in the U.S. at 22.1 percent. Of the states tracked here, only Maryland showed an increase in percentage of overweight or obese children in 2011 compared with the previous 2007 results.
F as in FAT. An August 2013 report published by the Trust for America's Health (TFAH) and the Robert Wood Johnson Foundation warns that -- if current efforts to alter the average American's diet and exercise habits are not maintained and even strengthened -- the adult obesity rate in the United States would soar to 50-60 percent (or higher) in all but a handful of states by 2030.
While adult obesity rates have held steady for the first time in years, the nation is by no means in the clear. At particular risk are Baby Boomers (age 45-64), who not only represent a bulge in the overall population, but are as a generation reaching those years where obesity-related illnesses, such as Type 2 diabetes and heart disease, tend to manifest themselves. The rate of obese Baby Boomers in Virginia is 34.2 percent, over 7 percentage points higher than the overall adult obesity rate.
However, this same study found that losing just a small amount of weight could significantly alter outcomes. An adult is considered obese if his or her body mass index (a measurement of fatty to lean tissue) is 30 or above. If Virginia could reduce the average body mass index (BMI) of its residents by just 5 percent, for example, the state could help prevent thousands of cases of Type 2 diabetes, coronary heart disease and stroke, hypertension, cancer, and arthritis. Virginia would also save thousands in health care dollars per resident. For a 6-foot-tall person weighing 200 pounds, a 5 percent reduction in BMI would be the equivalent of losing approximately 10 pounds.
Using data from the National Heart Forum, the TFAH analysis makes detailed projections about the obesity-related incidence of disease. For instance, if average BMI is reduced by 5 percent by 2020 in the Commonwealth, over 345,000 cases of obesity-related disease could be avoided, for a potential cost savings of nearly $6.3 billion.
Failing Standards. All 50 states are engaged in at least a few standardized practices in their public schools to combat obesity. Every state, for example, has a physical education requirement and most have a health education requirement; about two-thirds have adopted Nutritional Standards for Competitive Foods (vending machines and other non-school-provided meals), while not quite half have also adopted the federal Nutritional Standards for School Meals.
Of the nine widely accepted Obesity-Related Standards in School, Trust for America's Health's 2012 study found that Virginia met only four (after having added standards in 2009 and 2010):
- nutritional standards for competing foods such as vending machines (added in 2010)
- physical education
- health education
- farm-to-school programs (programs which encourage the supply of fresh local produce to schools; added in 2009)
It did not meet the standards for:
- school meals meeting the latest nutritional standards
- limited access to competing foods (e.g., vending machines)
- physical activity
- collection of BMI or health information
- diabetes screening
Peer states North Carolina and Tennessee met 7 of the 9 standards, while Maryland met five; Virginia was in a group of 20 states -- among them Alaska, Idaho, Georgia, Kansas, Missouri, Washington, and Wyoming -- meeting 4 or fewer standards.
What Influences Obesity?
Body weight is the result of genes, metabolism, behavior, environment, culture and socioeconomic status. Being overweight or obese typically results from an energy imbalance that involves eating too many calories and not getting enough physical activity to use those calories up. Misinformation, as well as personal behaviors -- including poor nutritional, environmental, or exercise choices -- play a large role in causing people to be overweight and obese.
What is the State's Role?
The state's primary role in obesity prevention and control is to ensure the development of an aggressive, coordinated strategic plan. Through its Healthy Eating and Active Living (HEAL) progarm, the Virginia Department of Health is developing partnerships with local communities, schools, and medical providers to both educate local populations on obesity issues and develop local initiatives to improve nutrition and physical activity.
State rankings are ordered so that #1 is understood to be the best.
Data and Definitions
State and Regional Obesity Data: Centers for Disease Control and Prevention (CDC). Behavioral Risk Factor Surveillance System Survey (BRFSSS) Data. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2012.
NOTE: 2011-2012 BRFSS results cannot be compared to earlier years because of changes in the sampling methodology.
Childhood Obesity Action Network. State Obesity Profile Comparison, 2007 and 2012. National Initiative for Children's Healthcare Quality, Child Policy Research Center, and Child and Adolescent Health Measurement Initiative.
Trust for America's Health and the Robert Wood Johnson Foundation. F as in Fat: How Obesity Threatens America's Future, 2013.
Trust for America's Health. Legislative Supplement: Obesity-related Legislative Action in States (Update 2011). (PDF)
Virginia Department of Health, Healthy Eating and Active Living program.
Information on the cost of obesity is available at the Centers for Disease Control and Prevention. (source updated August 2013)
See the Data Sources and Updates Calendar for a detailed list of the data resources used for indicator measures on Virginia Performs.