International Research Journal of Gastroenterology and Hepatology

Background: Obesity is a chronic condition described as excessive fat accumulation, which has the potential to severely impact one’s health. It develops through a combination of several factors such as genetics, metabolic conditions, diet, physical activity and much more. The rates of obesity have increased over the decades and continue to rise, with non-Hispanic Blacks having the highest rates, and Asian populations continuously maintaining the lowest rates. Numerous gastrointestinal, mental and cardiovascular conditions are associated with obesity, such as GERD, metabolic dysfunction-associated steatotic liver disease (MASLD), Barrett’s esophagus, pancreatitis, several cancers, acute coronary syndrome, kidney failure and more. Obesity is not evenly distributed across the United States. This is due to many factors such as race, ethnicity, socioeconomic status, education level, financial knowledge, and access to better food options and healthcare. This study brings attention to the trend of obesity rates by region, income, gender, and ethnicity.

Methods: Data were obtained from the National Health and Nutrition Examination Survey (NHANES) between 2011 and 2023. Obesity prevalence was stratified by race/ethnicity and geographic region (South, Midwest, West, Northeast). Descriptive statistics and graphical illustrations were used to identify trends. Findings were contextualized with peer-reviewed literature addressing the associations and prevalence of obesity and sociodemographic variables with relation to primary care interventions.

Results: The study found that obesity has a high prevalence in the South and Midwest areas, with females having slightly higher median and mean values compared to men (female obesity rate distribution mean=30.842, median=30.600, whereas male obesity rate has a mean=30.625, median=30.700). The graphical illustration shows that non-Hispanic Black and Hawaiian/Pacific Islanders individuals generally have the highest rates of obesity, with regional/state-wise distribution. Non-Hispanic blacks(Odd ratio at 95%CI of 1.65 (1.58–1.72) in the South with high prevalence of obesity.

Overall, obesity rates increased steadily for each income group. Within populations that earned less than $15,000 per year, the obesity rate was consistently higher across almost all the years except for 2022.In the Midwest, obesity rates also fluctuated, rising above 40% from 2019-2021 and again in 2023. While the obesity rate rose slightly in Asian individuals between 2011 and 2023 up to almost 25%, they still had consistently lower rates of obesity than every other race/ethnicity. Hawaiian/Pacific Islander, Hispanic, Non-Hispanic Black, and American Indian/Alaska Native groups consistently had higher obesity rates, almost always above 30%. The obesity rate in Non-Hispanic White, Other, and those identifying as 2 or more races fluctuated between 30-35%. In 2023, there was a sharp increase to 40% observed for Hawaiian/Pacific Islanders in 2023.

Conclusion: Populations in the South and Midwest consistently had higher obesity rates, as did those who had a lower socioeconomic status. In terms of race, the Asian population tended to have the lowest rates of obesity, whereas non-Hispanic Black populations and Hawaiian/Pacific Islander populations tended to have higher rates of obesity. Among Non-Hispanic Black populations, the South exhibits particularly elevated and rising rates, consistent with broader patterns of inequity in access to resources. In regard to gender, females and males have similar average obesity rates, 30.843 and 30.625, respectively. This study highlights certain areas in which social determinants of health, such as income, race, gender, and geographic location, impact health trends. The obesity rate in United States is high and is increasing yearly, and thus interventions that take these factors into consideration need to be further studied and implemented in a region-specific manner to have a positive impact on the health of the nation.