Obesity prevalence varies significantly among Asian American subgroups

Overall, Asian Americans had a 11.7% obesity prevalence, but rates varied from as high as 16.8% in Filipino Americans and 15.3% in Japanese Americans to 6.5% in Chinese Americans and 6.3% in Vietnamese Americans.

The prevalence of obesity among subgroups of Asian Americans varies substantially, a large cross-sectional study found.

Researchers conducted a cross-sectional study among 2,882,158 adults ages 18 years or older involved in the U.S. Behavioral Risk Factor Surveillance System surveys from 2013 to 2020. Obesity prevalence adjusted for age and sex was calculated using both standard body mass index (BMI) thresholds (≥30 kg/m2) and BMI thresholds modified for Asian adults (≥27.5 kg/m2), based on self-reported height and weight. Results were published Oct. 4 by Annals of Internal Medicine.

Overall, Asian Americans had a 11.7% obesity prevalence compared to 39.7% and 29.4% in Black and White Americans, respectively. However, using a combined Asian American cohort and standard BMI threshold masked significant variance among subgroups and underrecognized obesity among Asian American adults, the study found. Obesity prevalence was 16.8% (95% CI, 15.2% to 18.5%) in Filipino Americans, 15.3% (95% CI, 13.2% to 17.5%) in Japanese Americans, 11.2% (95% CI, 10.2% to 12.2%) in Asian Indian Americans, 8.5% (95% CI, 6.8% to 10.5%) in Korean Americans, 6.5% (95% CI, 5.5% to 7.5%) in Chinese Americans, and 6.3% (95% CI, 5.1% to 7.8%) in Vietnamese Americans. Identifying and addressing the Asian subgroup-specific factors that contribute to obesity is necessary to mitigate the potential lifetime consequences of overweight and obesity, the authors wrote.

The findings highlight the limits of BMI as an indirect measure for body fat, said an accompanying editorial, because the correlations between BMI and adiposity vary substantially across populations and are influenced by factors such as age, sex, and ethnicity. The study also adds new complexity to existing research indicating that Asian Americans meet criteria for obesity at lower BMI thresholds than White Americans, the editorial said. While some guidelines have begun to acknowledge the influence of race and ethnicity on overweight and obesity thresholds, guidelines provide little guidance specific to Asian American populations and the lack of recommendations specific to patients of Asian descent puts them at risk for delayed treatment, the editorial noted.

“Many decades into our ‘war against obesity,’ [the study authors] remind us that one size does not fit all,” the editorial stated. “We have made progress, but let's not leave anyone behind.”