Attempts To Lose Weight Among Adults In The United States, 2013-2016

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NCHS Data Brief No. 313 July 2018Attempts to Lose Weight Among Adults in theUnited States, 2013–2016Crescent B. Martin, M.P.H., M.A., Kirsten A. Herrick, Ph.D., M.Sc., Neda Sarafrazi, Ph.D., andCynthia L. Ogden, Ph.D., M.R.P.Key findingsData from the NationalHealth and NutritionExamination SurveyIn 2013–2016, 49.1% ofU.S. adults tried to lose weightin the last 12 months. A higher percentage ofwomen (56.4%) than men(41.7%) tried to lose weight. A lower percentage ofnon-Hispanic Asian adults(41.4%) than non-Hispanicwhite (49.4%), non-Hispanicblack (48.0%), and Hispanic(49.1%) adults tried to loseweight.Almost 40% of adults in the United States had obesity in 2015–2016 (1).Obesity is associated with a range of serious health risks (2). Individuals mayhave multiple motivations for trying to losing weight, including health andappearance reasons (3). This report describes the percentage of U.S. adultswho tried to lose weight in the past year by sex, age, race and Hispanic origin,family income, and weight status, based on data collected in the NationalHealth and Nutrition Examination Survey (NHANES) from 2013–2016.Keywords: National Health and Nutrition Examination Survey weight loss NHANESWhat percentage of adults tried to lose weight in 2013–2016? Nearly one-half (49.1%) of adults tried to lose weight within the last 12months (Figure 1).Figure 1. Percentage of adults aged 20 and over who tried to lose weight, by sex and age:United States, 2013–201620 and overThe percentage of adultswho tried to lose weightincreased with family incomeand with weight status category. 20–3940–5960 and over706050Among adults who triedto lose weight, the mostcommonly reported methodswere exercising (62.9%) andeating less food (62.9%),followed by consuming morefruits, vegetables, and salads(50.4%).Percent 49.1 149.7156.452.442.724041.7 240.5244.121159.3 60.245.139.93020100AllMenWomenSignificantly different from those aged 60 and over.Significantly different from women of the same age group.NOTES: Estimates for adults aged 20 and over were age adjusted by the direct method to the 2000 U.S. census population usingthe age groups 20–39, 40–59, and 60 and over. Crude estimates are 48.7% for total, 41.6% for men, and 55.4% for women.Access data table for Figure 1 at: https://www.cdc.gov/nchs/data/databriefs/db313 table.pdf#1.SOURCE: NCHS, National Health and Nutrition Examination Survey, 2013–2016.12U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICESCenters for Disease Control and PreventionNational Center for Health Statistics

NCHS Data Brief No. 313 July 2018 A lower percentage of older adults aged 60 and over (42.7%) tried to lose weight thanyounger adults aged 20–39 (49.7%) and middle-aged adults aged 40–59 (52.4%). Nosignificant difference was observed between younger and middle-aged adults. Among women, the pattern by age was similar to the overall adult population. Among men,no significant differences were observed by age group. A higher percentage of women (56.4%) than men (41.7%) tried to lose weight, overall andwithin each age group.Were there differences in the percentage of adults who tried to lose weightby race and Hispanic origin in 2013–2016? The percentage of non-Hispanic Asian adults (41.4%) who tried to lose weight was lowercompared with non-Hispanic white (49.4%), non-Hispanic black (48.0%), and Hispanic(49.1%) adults (Figure 2). The pattern among women was similar to the overall adult population. A lower percentageof non-Hispanic Asian women (44.8%) tried to lose weight than did non-Hispanic white(56.9%), non-Hispanic black (56.4%), and Hispanic (57.2%) women. Among men, the percentage who tried to lose weight was lower among non-Hispanic black(37.9%) than non-Hispanic white (42.1%) or Hispanic (41.1%) men.Figure 2. Age-adjusted percentage of adults aged 20 and over who tried to lose weight, by sex and race and Hispanicorigin: United States, 2013–2016Non-Hispanic whiteNon-Hispanic blackNon-Hispanic 0AllMenWomenSignificantly different from non-Hispanic white persons.Significantly different from non-Hispanic black persons.Significantly different from Hispanic persons.4Significantly different from women of the same race and Hispanic origin.NOTES: All estimates are age adjusted by the direct method to the 2000 U.S. census population using the age groups 20–39, 40–59, and 60 and over. Accessdata table for Figure 2 at: https://www.cdc.gov/nchs/data/databriefs/db313 table.pdf#2.SOURCE: NCHS, National Health and Nutrition Examination Survey, 2013–2016.123 2

NCHS Data Brief No. 313 July 2018 Within each race and Hispanic-origin group, a higher percentage of women than men triedto lose weight.Were there differences in the percentage of adults who tried to lose weightby family income in 2013–2016? The percentage of adults who tried to lose weight increased with family income level. Overall, 53.7% of adults with higher family income (greater than 350% of federal povertylevel [FPL]), 48.7% of adults with middle family income (greater than 130% to less than orequal to 350% of FPL), and 42.9% of adults with lower family income (less than or equal to130% of FPL) tried to lose weight (Figure 3). Similar patterns were observed among both men and women. Within each income group, a higher percentage of women than men tried to lose weight.Figure 3. Age-adjusted percentage of adults aged 20 and over who tried to lose weight, by sex and family income:United States, 2013–2016Less than or equal to130% of FPLGreater than 130% to less thanor equal to 350% of FPLGreater than 350% of 9.834.33020100All1Men1Women1Significant increasing linear trend.Significantly different from women in same family income level.NOTES: FPL is federal poverty level. All estimates are age adjusted by the direct method to the 2000 U.S. census population using the age groups 20–39, 40–59,and 60 and over. Access data table for Figure 3 at: https://www.cdc.gov/nchs/data/databriefs/db313 table.pdf#3.SOURCE: NCHS, National Health and Nutrition Examination Survey, 2013–2016.12 3

NCHS Data Brief No. 313 July 2018Were there differences in the percentage of adults who tried to lose weight,by weight status in 2013–2016? The percentage of adults who tried to lose weight increased with weight status category,overall and among both men and women. Overall, 66.7% of adults with obesity, 49.0% of overweight adults, and 26.5% ofunderweight or normal weight adults tried to lose weight (Figure 4). Within each weight status category, a higher percentage of women than men tried to loseweight.Figure 4. Age-adjusted percentage of adults aged 20 and over who tried to lose weight, by sex and weight status:United States, 2013–2016Underweight or normal gnificant increasing linear trend.Significantly different from women in same weight status category.NOTES: All estimates are age adjusted by the direct method to the 2000 U.S. census population using the age groups 20–39, 40–59, and 60 and over. Accessdata table for Figure 4 at: https://www.cdc.gov/nchs/data/databriefs/db313 table.pdf#4.SOURCE: NCHS, National Health and Nutrition Examination Survey, 2013–2016.12 4

NCHS Data Brief No. 313 July 2018What ways to lose weight were reported by adults who tried to lose weightin 2013–2016?Among adults who tried to lose weight, the most commonly reported ways were exercising(62.9%); eating less food (62.9%); eating more fruits, vegetables, and salads (50.4%); drinking alot of water (44.7%); and eating less junk food or fast food (42.4%) (Figure 5).Figure 5. Ways of trying to lose weight used by adults aged 20 and over who tried to lose weight: United States,2013–2016Exercised62.9Ate less62.9Ate more fruits, vegetables, or salads50.4Drank a lot of water44.7Ate less junk food or fast food42.4Changed eating habits38.7Ate less sugar, candy, or sweets38.6Switched to foods with lower calories35.3Ate fewer carbohydrates30.4Ate less fat29.2Skipped meals16.4010204030506070PercentNOTES: Respondents could report multiple ways to lose weight; 88.3% of adults who tried to lose weight reported using two or more ways. Ways reported by lessthan 10% of adults who tried to lose weight are not shown separately. Access data table for Figure 5 at:https://www.cdc.gov/nchs/data/databriefs/db313 table.pdf#5.SOURCE: NCHS, National Health and Nutrition Examination Survey, 2013–2016. 5

NCHS Data Brief No. 313 July 2018SummaryIn 2013–2016, almost one-half of U.S. adults tried to lose weight within the last year. A higherpercentage of younger adults aged 20–39 and middle-aged adults aged 40–59 tried to lose weight,compared with older adults aged 60 and older. A higher percentage of women than men tried tolose weight, overall and within each age group.Patterns by race and Hispanic origin differed between men and women. Among women, a lowerpercentage of non-Hispanic Asian women tried to lose weight, compared with all other race andHispanic-origin groups. Among men, a lower percentage of non-Hispanic black men tried to loseweight than did non-Hispanic white men or Hispanic men.The percentage of adults who tried to lose weight increased with family income and with weightstatus. Among adults who tried to lose weight, the most commonly reported ways were exercising(62.9%) and eating less food (62.9%). A majority of adults who tried to lose weight reportedusing two or more methods (88.3%).DefinitionsTried to lose weight: Based on two questions. Participants whose self-reported current weightwas at least 10 pounds lower than their reported weight a year ago were asked if that weightchange was intentional; those who answered yes were categorized as having tried to lose weight.All other participants, including those who reported an unintentional weight loss of 10 pounds ormore, were asked directly, “During the past 12 months, have you tried to lose weight?”Federal poverty level (FPL): Based on the income-to-poverty ratio, a measure of the annual totalfamily income divided by the poverty guidelines, adjusted for family size and inflation.Weight status: Body mass index (BMI) was calculated as measured weight in kilograms dividedby measured height in meters squared, rounded to one decimal place. Overweight was defined asa BMI greater than or equal to 25 and less than 30. Obesity was defined as a BMI greater than orequal to 30. Normal or underweight was defined as a BMI less than 25. 6

NCHS Data Brief No. 313 July 2018Data source and methodsNHANES is a cross-sectional survey conducted by the National Center for Health Statisticsdesigned to monitor the health and nutritional status of the civilian noninstitutionalized U.S.population (4). It consists of home interviews followed by standardized physical examinations,including measured height and weight, in mobile examination centers.The NHANES sample is selected through a complex, multistage probability design. In2013–2016, non-Hispanic black, non-Hispanic Asian, and Hispanic persons were oversampled;for more information, visit the NHANES website. Race and Hispanic origin-specific estimatesreflect individuals reporting only one race; those reporting more than one race are included in thetotal but are not reported separately. Pregnant females were excluded from analyses.Examination weights were used to account for the differential probabilities of selection,nonresponse, and noncoverage. Taylor series linearization was used to compute varianceestimates. Prevalence estimates for the adult population aged 20 and over were age adjustedusing the direct method to the 2000 projected U.S. census population using the age groups 20–39,40–59, and 60 and over. Differences between groups were tested using a univariate t statistic.Test for trends by family income and weight status were evaluated using orthogonal polynomialsto determine linear trends. The significance level for statistical testing was set at p 0.05. Alldifferences reported are statistically significant unless otherwise indicated. Data management andstatistical analyses were conducted using SAS System for Windows version 9.4 (SAS Institute,Inc., Cary, N.C.) and SUDAAN version 11.0 (RTI International, Research Triangle Park, N.C.).About the authorsCrescent B. Martin was a student volunteer with CDC’s National Center for Health Statistics,Division of Health and Nutrition Examination Surveys and a graduate student at the GeorgeWashington University Milken Institute School of Public Health during the analysis and writingof this report. Kirsten A. Herrick, Neda Sarafrazi, and Cynthia L. Ogden are with the NationalCenter for Health Statistics, Division of Health and Nutrition Examination Surveys.References1. Hales CM, Carroll MD, Fryar CD, Ogden CL. Prevalence of obesity among adults and youth:United States, 2015–2016. NCHS Data brief, no 288. Hyattsville, MD: National Center for HealthStatistics. 2017.2. National Institutes of Health. National Heart, Lung, and Blood Institute. Clinical guidelineson the identification, evaluation, and treatment of overweight and obesity in adults—Theevidence report. Obes Res 6(Suppl 2):51s–209s. 1998.3. Levy AS, Heaton AW. Weight control practices of U.S. adults trying to lose weight. AnnIntern Med 119(7 Pt 2):661–6. 1993.4. Johnson CL, Dohrmann SM, Burt VL, Mohadjer LK. National Health and NutritionExamination Survey: Sample design, 2011–2014. National Center for Health Statistics. VitalHealth Stat 2(16 2). 2014. 7

U.S. DEPARTMENT OFHEALTH & HUMAN SERVICESFIRST CLASS MAILPOSTAGE & FEES PAIDCDC/NCHSPERMIT NO. G-284Centers for Disease Control and PreventionNational Center for Health Statistics3311 Toledo Road, Room 4551, MS P08Hyattsville, MD 20782–2064OFFICIAL BUSINESSPENALTY FOR PRIVATE USE, 300For more NCHS Data Briefs, .htm.NCHS Data Brief No. 313 July 2018Suggested citationMartin CB, Herrick KA, Sarafrazi N, OgdenCL. Attempts to lose weight among adults inthe United States, 2013–2016. NCHS DataBrief, no 313. Hyattsville, MD: NationalCenter for Health Statistics. 2018.Copyright informationAll material appearing in this report is inthe public domain and may be reproducedor copied without permission; citation as tosource, however, is appreciated.National Center for HealthStatisticsCharles J. Rothwell, M.S., M.B.A., DirectorJennifer H. Madans, Ph.D., AssociateDirector for ScienceDivision of Health and NutritionExamination SurveysKathryn S. Porter, M.D., M.S., DirectorRyne Paulose-Ram, M.A., Ph.D., AssociateDirector for ScienceFor e-mail updates on NCHS publicationreleases, subscribe online at:https://www.cdc.gov/nchs/govdelivery.htm.For questions or general informationabout NCHS:Tel: 1–800–CDC–INFO (1–800–232–4636)TTY: 1–888–232–6348Internet: https://www.cdc.gov/nchsOnline request form: https://www.cdc.gov/infoISSN 1941–4927 Print ed.ISSN 1941–4935 Online ed.DHHS Publication No. 2018–1209CS294233

What ways to lose weight were reported by adults who tried to lose weight in 2013-2016? Among adults who tried to lose weight, the most commonly reported ways were exercising (62.9%); eating less food (62.9%); eating more fruits, vegetables, and salads (50.4%); drinking a lot of water (44.7%); and eating less junk food or fast food (42.4%)

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