Obesity on Rise in U.S. Adults With Diabetes

Text Size:
Obesity on Rise in U.S. Adults With Diabetes

Among adults with diabetes in the United States, the proportion with obesity has increased over two decades, while improvement was seen in blood lipid (cholesterol and triglyceride) management, according to a new analysis published in the journal Obesity.

Obesity is a well known risk factor for diabetes, which is believed to be in part because certain types of fat tissue increase insulin resistance in your body. Not surprisingly, different weight-loss approaches for obesity have been shown to reduce the risk for type 2 diabetes. But obesity has also been shown to increase the risk for type 1 diabetes in teens, underscoring the complicated role that obesity may play in other health conditions.

In people with diabetes, obesity is linked to a higher risk for chronic kidney disease and nonalcoholic fatty liver disease (NAFLD), among other potential health problems. Some health experts believe that for people with both type 2 diabetes and obesity, obesity should be the main treatment target, since substantial weight loss can greatly improve or even resolve elevated blood glucose levels. While both genetic and social factors have been linked to obesity and type 2 diabetes, many experts believe that foods high in easily digested carbohydrates are a major cause of the obesity epidemic.

To get cutting-edge diabetes news, strategies for blood glucose management, nutrition tips, healthy recipes, and more delivered straight to your inbox, sign up for our free newsletters!

Increase in prevalence of obesity among adults with diabetes

For the latest analysis, researchers looked at trends related to diabetes and obesity among participants in the U.S. National Health and Nutrition Examination Survey (NHANES), an ongoing study that looks at many different health and nutrition trends in a nationally representative sample of U.S. adults. Only adults who reported a diagosis of diabetes were included in the analysis. Between 1999-2002 and 2015-2020, the overall prevalence of obesity among adults with diabetes increased from 46.9% to 58.1%. The prevalence of class 2 obesity — as indicated by a body-mass index (BMI, a measure of body weight that takes height into account) of 35 to 39.9 — increased from 14.1% to 16.6%, while the prevalence of class 3 obesity — a BMI of 40 or greater — increased from 10.3% to 14.8%.

At the same time, there was some improvement seen in blood lipid and blood pressure management, while blood glucose control improved then got worse again. The proportion of participants who had a non-HDL (non-high-density-liporotein, or “bad”) cholesterol below 130 mg/dl increased throughout the study period, as did the proportion with blood pressure below 140/90 mmHg. The proportion of participants with an A1C level (a measure of long-term blood glucose control) below 7% increased from 42.5% in 1999-2002 to 51.8% in 2007-2010, but then decreased to 48.0% in 2015-2020. The proportion of participants who were at or below these targets for cholesterol, blood pressure, and A1C increased from 8.3% in 1999-2002 to 21.2% in 2011-2014, then decreased to 18.5% in 2015-2020. Participants with obesity tended to have worse non-HDL cholesterol and A1C levels than those without obesity.

These results suggest there may be strong merits to focusing on body weight control as part of treating type 2 diabetes, the researchers noted in an article on the study at Healio. But they also suggest that health care providers aren’t doing enough to support weight-loss efforts in their patients with diabetes, despite the evidence supporting several different approaches to weight loss for adults with obesity.

Want to learn more about weight management? Read “Seven Ways to Lose Weight,” “Losing Weight Without Feeling Hungry,” and “Tried and True Weight-Loss Techniques.” 

Living with type 2 diabetes? Check out our free type 2 e-course!

Quinn Phillips

Quinn Phillips

Quinn Phillips on social media

A freelance health writer and editor based in Wisconsin, Phillips has a degree from Harvard University. He is a former Editorial Assistant for Diabetes Self-Management and has years of experience covering diabetes and related health conditions. Phillips writes on a variety of topics, but is especially interested in the intersection of health and public policy.

Get Diabetes-Friendly Recipes In Your Inbox

Sign up for Free

Stay Up To Date On News & Advice For Diabetes

Sign up for Free

Get On Track With Daily Lifestyle Tips

Sign up for Free

Save Your Favorites

Save This Article