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California Value:
Percentage of adults age 65 and older who have a body mass index of 30.0 or higher based on reported height and weight
California Rank:
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Percentage of adults age 65 and older who have a body mass index of 30.0 or higher based on reported height and weight
US Value: 30.6%
Top State(s): Hawaii: 18.0%
Bottom State(s): Louisiana: 37.3%
Definition: Percentage of adults age 65 and older who have a body mass index of 30.0 or higher based on reported height and weight
Data Source and Years(s): CDC, Behavioral Risk Factor Surveillance System, 2022
Suggested Citation: America's Health Rankings analysis of CDC, Behavioral Risk Factor Surveillance System, United Health Foundation, AmericasHealthRankings.org, accessed 2024.
Adults with obesity are at increased risk of developing serious health conditions such as hypertension, Type 2 diabetes, stroke, sleep apnea and other breathing problems, osteoarthritis, certain cancers and mental illnesses like depression and anxiety. Research suggests that the strength of the association between obesity and mortality risk increases with age, making obesity among older adults an area of particular concern. Contributing factors for obesity include behaviors such as poor diet and physical inactivity, certain health conditions, genetic predisposition and environmental elements like neighborhood safety, food access and infrastructure.
While body mass index (BMI) can serve as an easily accessible proxy for population health, it has its limitations. BMI does not distinguish excess fat from muscle or bone mass, and the relationship between BMI and body fat is influenced by sex, age and ethnicity. BMI cannot adequately capture the complexity of human health: Some individuals may have a high BMI and good cardiovascular health, while others may have what is categorized as a “healthy” or “normal” BMI and poor cardiovascular health. The American Medical Association has adopted a new policy recognizing BMI as an imperfect clinical measure of health and recommending it only be used in clinical settings alongside other metrics like body composition or genetic factors.
Furthermore, weight stigma — also known as weight-based discrimination or weight bias — has harmful effects on health and can lead to mood and anxiety disorders and avoidance of exercise. Weight stigma has been pervasive in health care, with reports of medical professionals spending less time with higher-weight patients, engaging in less education and even being reluctant to perform certain procedures on patients with a higher BMI. Weight stigma in the clinical environment can make patients feel uncomfortable or marginalized, causing many individuals to avoid seeking health care.
According to America’s Health Rankings analysis, the prevalence of obesity is higher among:
Key strategies for decreasing and preventing obesity target individual behaviors as well as environmental factors. Successful interventions include:
The Centers for Disease Control and Prevention provides useful strategies for community-level interventions and healthy living tips designed to prevent obesity. The Community Preventive Services Task Force recommends a combined built environment approach to make it easier for people to engage in physical activity. This involves improving land use design by adding pedestrian and cycling paths, ensuring local access to stores and enhancing proximity to parks.
Healthy People 2030 includes several weight-related goals, including:
Bales, Connie W., and Kathryn N. Porter Starr. “Obesity Interventions for Older Adults: Diet as a Determinant of Physical Function.” Advances in Nutrition 9, no. 2 (March 1, 2018): 151–59. https://doi.org/10.1093/advances/nmx016.
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Gutin, Iliya. “In BMI We Trust: Reframing the Body Mass Index as a Measure of Health.” Social Theory & Health 16, no. 3 (August 2018): 256–71. https://doi.org/10.1057/s41285-017-0055-0.
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Masters, Ryan K., Daniel A. Powers, and Bruce G. Link. “Obesity and US Mortality Risk Over the Adult Life Course.” American Journal of Epidemiology 177, no. 5 (February 3, 2013): 431–42. https://doi.org/10.1093/aje/kws325.
Papas, Mia A., Anthony J. Alberg, Reid Ewing, Kathy J. Helzlsouer, Tiffany L. Gary, and Ann C. Klassen. “The Built Environment and Obesity.” Epidemiologic Reviews 29 (2007): 129–43. https://doi.org/10.1093/epirev/mxm009.
Patsalos, Olivia, Johanna Keeler, Ulrike Schmidt, Brenda W. J. H. Penninx, Allan H. Young, and Hubertus Himmerich. “Diet, Obesity, and Depression: A Systematic Review.” Journal of Personalized Medicine 11, no. 3 (March 3, 2021): 176. https://doi.org/10.3390/jpm11030176.
Steele, C. Brooke, Cheryll C. Thomas, S. Jane Henley, Greta M. Massetti, Deborah A. Galuska, Tanya Agurs-Collins, Mary Puckett, and Lisa C. Richardson. “Vital Signs: Trends in Incidence of Cancers Associated with Overweight and Obesity — United States, 2005–2014.” MMWR. Morbidity and Mortality Weekly Report 66, no. 39 (October 3, 2017): 1052–58. https://doi.org/10.15585/mmwr.mm6639e1.
Tomiyama, A. Janet, Deborah Carr, Ellen M. Granberg, Brenda Major, Eric Robinson, Angelina R. Sutin, and Alexandra Brewis. “How and Why Weight Stigma Drives the Obesity ‘Epidemic’ and Harms Health.” BMC Medicine 16, no. 1 (December 2018): 123. https://doi.org/10.1186/s12916-018-1116-5.
Tomiyama, A. Janet, J. M. Hunger, J. Nguyen-Cuu, and C. Wells. “Misclassification of Cardiometabolic Health When Using Body Mass Index Categories in NHANES 2005–2012.” International Journal of Obesity 40, no. 5 (May 2016): 883–86. https://doi.org/10.1038/ijo.2016.17.
U.S. Department of Agriculture and U.S. Department of Health and Human Services. “Dietary Guidelines for Americans, 2020-2025.” Washington, D.C.: U.S. Department of Agriculture and U.S. Department of Health and Human Services, December 2020. https://www.dietaryguidelines.gov/sites/default/files/2020-12/Dietary_Guidelines_for_Americans_2020-2025.pdf.
U.S. Department of Health and Human Services. “Physical Activity Guidelines for Americans, 2nd Edition.” Washington, D.C.: U.S. Department of Health and Human Services, 2018. https://health.gov/sites/default/files/2019-09/Physical_Activity_Guidelines_2nd_edition.pdf.
America’s Health Rankings builds on the work of the United Health Foundation to draw attention to public health and better understand the health of various populations. Our platform provides relevant information that policymakers, public health officials, advocates and leaders can use to effect change in their communities.
We have developed detailed analyses on the health of key populations in the country, including women and children, seniors and those who have served in the U.S. Armed Forces, in addition to a deep dive into health disparities across the country.