More than half of current children and teens in the United States could be obese by the time they are 35, according to a new study.
Unless the trend is reversed, this will have a devastating impact on the health of those Americans in years to come, along with the country’s healthcare system and economy.
Using a computer simulation, researchers estimated that 57 percent of today’s youth ages 2 through 19 years will be obese when they are 35 years old.
Ken Thorpe, PhD, chairman for the Partnership to Fight Chronic Disease, called the results “startling, both in terms of health and healthcare spending.”
To put this into perspective, currently 35 to 40 percent of 35-year-olds are obese, study author Zachary Ward of Harvard T.H. Chan School of Public Health in Boston told Reuters Health.
Researchers found that a 2-year-old who is obese has a 75 percent chance of being obese at age 35.
This risk increased as they got older, rising to 88 percent at age 19.
For non-obese youth, the risk of being obese when they are 35 years old decreased with age, falling from 58 percent at age 2 to 44 percent at age 19.
“The persistence of elevated risk is striking,” wrote the authors. “A 2-year-old who is obese is more likely to be obese at 35 years of age than an overweight 19-year-old.”
Also, there remain significant disparities for some parts of the population.
Hispanics and African-Americans showed higher rates of obesity at all age levels.
However, having a healthy weight as a child was no guarantee of staying that way later on.
Researchers found that although obese children were more likely to be obese as adults, most 35-year-olds weren’t obese as children.
In adults, obesity increases the risk of heart disease, type 2 diabetes, high blood pressure, some cancers, and other chronic diseases.
During childhood, obesity increases the chance that a youth will have high blood pressure, high cholesterol, type 2 diabetes, joint problems, asthma, and other health conditions.
“This is the problem with obesity. It affects youth now when they’re children and adolescents, but it manifests itself over the years,” Kurt Mosley, vice president of strategic alliances at Merritt Hawkins healthcare consultants, told Healthline.
Obesity is defined as having a body mass index of 30 or higher. BMI is calculated from a person’s height and weight. In children, age and sex are also taken into account.
Study fits with rising obesity trends
Although this is a sobering finding, the research fits with the steady rise of obesity levels in the United States over the past two decades.
According to the Centers for Disease Control and Prevention (CDC), 30 percent of all adults were obese in 1999-2000, rising to almost 40 percent in 2015-16.
Over that same period, the prevalence of obesity among youth rose from almost 14 percent to 18 percent.
The CDC also reports that adult African-Americans have the highest rate of obesity (48 percent) followed by Hispanics (42 percent).
Past studies have found that children who are overweight are at least two times as likely to be overweight as adults, compared to normal-weight children. The risk was even higher for obese children.
In the new study, researchers only looked at future obesity rates for current children and teens, not the whole population.
Previous studies, though, have projected that 40 to 42 percent — or as high as 51 percent — of all Americans will be obese by 2030.
The new study was published in The New England Journal of Medicine.
Researchers used data from five studies that were representative of the current U.S. population. From this, they created “virtual populations” of 1 million children who were 19 years of age or younger.
They then simulated how the height and weight of the individuals changed until they were age 35.
Costs of rising obesity
A 2012 study in the National Bureau of Economic Research estimates that the United States spent as much as $190 billion on healthcare related to obesity and obesity-related disease in 2005.
This represents 20 percent of all healthcare costs.
“Rising rates of obesity drive up chronic disease and drive up healthcare spending,” said Thorpe.
The CDC estimates that 86 percent of the $2.7 trillion that the country spends on healthcare is for people with chronic conditions and mental health conditions.
According to Harvard T.H. Chan School of Public Health, obesity also leads to other costs that are harder to measure.
Workers who are obese miss more days of work than non-obese workers due to illnesses, disability, and early death.
Employers also pay more for life insurance premiums and workers’ compensation for obese workers.
Some studies have also found that the wages of obese workers are lower than those of non-obese workers.
All of these costs are expected to rise as obesity and related chronic disease increase.
“If the obesity trends continue, then our ability to really slow the growth in healthcare costs per person [is] going to be very limited,” said Thorpe.
A study earlier this year in Population Health Management estimates that the prevalence of diabetes will increase by 54 percent by 2030.
By that time, medical and other costs for just this disease will reach $622 billion.
However, reversing the obesity trend could mean billions of dollars in potential savings.
If obesity levels were to remain steady through 2030, it could save the United States $549 billion in obesity-related medical expenses, according to a 2012 study in the American Journal of Preventive Medicine.
The study also estimates that if obesity rates were to hold steady at the Healthy People 2020 target level — 15 percent — the savings by 2030 would be almost $2 trillion.
Heading off obesity early
There are signs that some progress is being made in the United States.
A study last year in Journal of the American Medical Association (JAMA) found that obesity rates declined recently among children aged 2 to 5 years, and leveled off in 6-year-olds to 11-year-olds.
But this is a small dent in the overall epidemic. And as the new study shows, even normal-weight children are at risk of being obese when they are adults.
A number of factors have contributed to the epidemic, some of them out of the control of people who are affected.
Diet and physical activity are involved, as are genetic factors. But our modern world also promotes a more sedentary lifestyle.
“With the advent of electronics, inactivity has grown dramatically. When I was young, on a nice day our parents wouldn’t let us stay in. We had to go out,” Mosley said.
Many environmental factors also make it harder for people to eat healthy and stay physically active.
This includes long work hours, lack of access to healthy foods, and living in areas where it’s unsafe to go for a walk or a bike ride.
“People in poor neighborhoods don’t always have a choice,” said Mosley. “They live far away from a supermarket. So their only choice sometimes is a convenience store or a fast food restaurant — and those aren’t healthy.”
Experts say that the food industry bears some responsibility as well.
“Unhealthy foods are marketed all the time. But you rarely see ads for kale or other vegetables,” said Mosley.
Reversing the obesity epidemic won’t be cheap, but some experts argue the investment will be worth it — especially with the billions of dollars that the disease costs us each year.
Dr. Leonardo Trasande, an associate professor in pediatrics, environmental medicine, and population health at the NYU School of Medicine, wrote in a 2010 Health Affairs study that “spending $2 billion a year would be cost-effective if it reduced obesity among 12-year-olds by one percentage point.”
The government is starting to realize that spending money up front on chronic diseases can save more money in the long run.
The Medicare Diabetes Program, which starts in April, helps older adults at risk of diabetes improve their diet, stay physically active, and maintain a healthy weight.
An earlier study of this type of lifestyle intervention showed that on average people lost more than 12 pounds after almost three years. Diabetes cases dropped by 58 percent, compared to a control group with no intervention.
Thorpe said this type of program is easy to replicate for non-Medicare populations.
This includes attacking the obesity epidemic in all age groups and corners of society.
“We really need to find programs and approaches that are effective in schools, in workplaces, and in communities,” said Thorpe.
Much of the healthcare debate in recent months, though, has focused on lowering insurance premiums and prescription drug prices.
What some politicians fail to realize is that many of these costs are driven by preventable chronic diseases like obesity, diabetes, heart disease, and some cancers.
Tackling obesity now means healthier Americans now and later, which means lower healthcare costs.
“The key to healthcare reform is identifying more effective models to manage people with multiple chronic conditions,” said Thorpe, “and putting into place models that can reverse this obesity trend.”