Explaining Trends in Body Mass Index Using Demographic Counterfactuals

The United States is experiencing a major public health problem relating to increasing levels of excess body fat. This paper is about the relationship in the United States between trends in the distribution of body mass index (BMI), including trends in overweight and obesity, and demographic change. We provide estimates of the counterfactual distribution of BMI that would have been observed in 2003–2008 had demographics remained fixed at 1980 values, roughly the beginning of the period of increasing overweight and obesity. We find that changes in demographics are partly responsible for the changes in the population distribution of BMI and are capable of explaining about 8.6% of the increase in the combined rate of overweight and obesity among women and about 7.2% of the increase among men. We also use demographic projections to predict a BMI distribution and corresponding rates of overweight and obesity for 2050.