Statistical Brief #37 

Trends in Adult Obesity in the United States, 1987 and 2001: Estimates for 

the Noninstitutionalized Population, Age 20 to 64 

By: Jeffrey A. Rhoades, PhD, Barbara M. Altman, PhD, and Llewellyn J. Cornelius, PhD 

Introduction 

This Statistical Brief presents data from the National Medical Expenditure Survey (NMES) and 

the Medical Expenditure Panel Survey (MEPS) concerning the prevalence of obesity in the adult 

(age 20 to 64) population. Data are presented for calendar years 1987 and 2001. Emphasis is 

placed on whether the relationships between obesity and various socioeconomic and 

demographic characteristics of the population remained stable over that period. The variables of 

interest include sex, race/ethnicity, education level, and poverty and health insurance status. Only 

differences that are statistically significant at the 0.05 level are discussed in the text. 

Highlights 

• For both males and females, there was an increase in the percentage of individuals that 

were obese between 1987 and 2001, a relative 76 percent and 78 percent increase, 

respectively. 

• All race/ethnic categories of the adult population showed an increase in obesity from 

1987 to 2001. Blacks were the most likely to be obese in 1987 and 2001, 19.7 percent and 

32.5 percent, respectively. 

• Adults with higher levels of education (some college) were the least likely to be obese 

(20.8 percent) in 2001. 

• Adults with higher incomes (400 percent or more of the poverty level) were the least 

likely to be obese in 1987 and 2001, 11.3 percent and 20.7 percent, respectively. 

• Adults with public only health insurance were the most likely to be obese in both 1987 

(22.8 percent) and 2001 (31.1 percent). 

Findings 

Sex 

For both adult (age 20 to 64) males and females, there was an increase in the percentage of 

individuals that were obese between 1987 and 2001. For males, the percentage of obese 

individuals increased from 13.3 percent to 23.4 percent, representing a 76 percent relative 

increase in obesity between the two years. For females, the percentage of obese individuals 

increased from 13.8 percent to 24.5 percent (a 78 percent relative increase) (figure 1). 
Race/ethnicity 

All race/ethnic categories of the adult population showed an increase in obesity from 1987 to 

2001. Whites and others showed a relative increase of 79 percent in obesity, going from 12.6 

percent in 1987 to 22.5 percent in 2001. Hispanics went from 14.5 percent in 1987 to 24.9 

percent in 2001, a relative increase of 72 percent. Blacks were the most likely to be obese in both 

years, 19.7 percent in 1987 and 32.5 in 2001 (figure 2). 

Education 

Individuals with higher levels of education (some college) were the least likely to be obese in 

1987 (10.9 percent) and in 2001 (20.8 percent). However, there was a 91 percent relative 

increase in obesity between the two years for such individuals. In 2001, individuals that did not 

graduate from high school (27.1 percent obese) or did graduate from high school (27.2 percent 

obese) were more likely to be obese when compared to those with some college education (20.8 

percent) (figure 3). 

Poverty status 

Individuals with the highest income (400 percent or more of the poverty level) were the least 

likely to be obese in 1987 (11.3 percent) and in 2001 (20.7 percent). At the same time, there was 

an 83 percent relative increase in obesity between the two years for those in this highest income 

group. In 1987, poor (17.6 percent), near poor (17.2 percent), and low-income individuals (17.5 

percent) were more likely to be obese when compared to those with higher incomes (figure 4). 

Health insurance status 

For all categories of health insurance status, there was an increase in obesity from 1987 to 2001. 

Adults with public only health insurance were the most likely to be obese in 1987 (22.8 percent) 

and 2001 (31.1 percent), a 36 percent relative increase over the period. There was a relative 

increase in obesity of 84 percent for individuals with private health insurance (from 12.8 percent 

to 23.6 percent) and a relative increase of 60 percent for the uninsured (from 13.9 percent to 22.2 

percent) (figure 5). 

Definitions/Methodology 

Obesity 

An individual is defined as obese if his or her body mass index (BMI) is equal to or greater than 

30. BMI is equal to an individual’s weight in kilograms divided by his or her height in meters 

squared (kg/m2

). Height and weight are self-reported. 

Race/ethnicity 

The Hispanic grouping can include black Hispanic, white Hispanic, and other Hispanic; the race 

categories of black, white, and other do not include Hispanic. Only data for individuals identified 

as Hispanic (of any race), non-Hispanic black, and non-Hispanic white and other are included in 

this analysis. 
Education level 

Respondents were asked to report the highest grade or year of schooling ever completed by each 

family member as of the date of the interview: not a high school graduate (grade less than 12), 

high school graduate (grade 12), and some college. 

Poverty status 

Each person in the survey sample was classified according to the total yearly income of his or 

her family. Within a household, all individuals related by blood, marriage, or adoption were 

considered to be a family. Personal income from all family members was summed to create 

family income. Poverty status is the ratio of family income to the Federal poverty thresholds, 

which control for family size and age of the head of family. Categories are defined as follows: 

– Poor: This refers to persons in families with income less than or equal to the poverty line and 

includes those who reported negative income. 

– Near poor: This group includes persons in families with income over the poverty line through 

125 percent of the poverty line. 

– Low income: This category includes persons in families with income over 125 percent 

through 200 percent of the poverty line. 

– Middle income: This category includes persons in families with income over 200 percent 

through 400 percent of the poverty line. 

– High income: This category includes persons in families with income over 400 percent of the 

poverty line. 

Health insurance status 

– Uninsured: Adults classified as uninsured did not have public or private health insurance 

coverage. People covered only by noncomprehensive state-specific programs (e.g., Maryland 

Kidney Disease Program) or private single-service plans (e.g., coverage for dental or vision 

care only, coverage for accidents or specific diseases) were not considered to be insured. 

– Public coverage: Adults were considered to have public only health insurance coverage if 

they were not covered by private insurance, and they were covered by Medicare, Medicaid, 

TRICARE, or other public hospital and physician coverage. 

– Private coverage: Private health insurance coverage was defined as nonpublic insurance that 

provided coverage for hospital and physician care (including Medigap coverage). 

About MEPS and NMES 

The estimates presented in this Statistical Brief come from the NMES Household Survey and the 

MEPS Household Component. NMES and MEPS are nationally representative surveys of the 

U.S. civilian noninstitutionalized population that collect detailed data for both individuals and 

households on demographic characteristics, health conditions, health status, use of medical care 

services, charges and payments, access to care, satisfaction with care, health insurance coverage, 

income, and employment. 

NMES and MEPS data are released to the public in public use data files. The numbers shown in 

this Statistical Brief are drawn from analyses conducted by MEPS staff from the following 1987 

and 2001 full-year public use files: PUF 13 (NMES) and HC-055 (MEPS). PUF 13 is contained 

within the 1987 NMES Household Survey and Health Insurance Plans Survey Data CD-ROM, 
order number AHCPR 98-DP02, available from the AHRQ Publications Clearinghouse (E-mail: 

ahrqpubs@ahrp.gov). MEPS HC-55 is available on the MEPS Web site 

(www.meps.ahrq.gov/). 

References 

For a detailed description of the MEPS-HC survey design, sample design, and methods used to 

minimize sources on nonsampling error, see the following publications (available on the MEPS 

Web site: www.meps.ahrq.gov/): 

Cohen, J. Design and Methods of the Medical Expenditure Panel Survey Household Component. 

MEPS Methodology Report No. 1. AHCPR Pub. No. 97-0026. Rockville, Md.: Agency for 

Health Care Policy and Research, 1997. 

Cohen, S. Sample Design of the 1996 Medical Expenditure Panel Survey Household Component. 

MEPS Methodology Report No. 2. AHCPR Pub. No. 97-0027. Rockville, Md.: Agency for 

Health Care Policy and Research, 1997. 

For more information on the NMES survey design, see the following publications: 

Cohen, S., R. DiGaetano, and J. Waksberg. Sample design of the 1987 Household Survey. 

AHCPR Pub. No. 91-0037. National Medical Expenditure Survey Methods 3. Agency for 

Healthcare Policy and Research. Rockville, Md.: U.S. Department of Health and Human 

Services, Public Health Service, 1991. 

Edwards, W. and M. Berlin. Questionnaires and data collection methods for the household 

survey and the survey of American Indians and Alaskan Natives. DHHS Pub. No. (PHS) 89-

3450. National Medical Expenditure Survey Methods 2. National Center for Health Services 

Research and Health Care Technology Assessment. Rockville, Md.: U.S. Department of Health 

and Human Services, Public Health Service, 1989. 
Source: Center for Financing, Access,

noninstitutionalized population, by sex, 1987 and 2001 

13.3 13.8 

24.5 23.4 

0 

10 

20 

30 

Male Female 

1987 2001 

Percent 

were obese between 1987 and 2001. 

 and Cost Trends, AHRQ, 1987 National 

Medical Expenditure Survey and 2001 Medical Expenditure Panel Survey 

Figure 1: Percentage of obese adults, age 20–64, U.S. 

Note: For both males and females, there was an increase in the percent of individuals that 
Source: Center for Financing, Access,

12.6 

19.7 

14.5 

24.9 

32.5 

22.5 

0 

10 

20 

30 

40 

White and other Black Hispanic 

1987 2001 

Percent 

Note: Blacks were the most likely to be obese in 1987 and 2001. 

 and Cost Trends, AHRQ, 1987 National 

Medical Expenditure Survey and 2001 Medical Expenditure Panel Survey 

Figure 2: Percentage of obese adults, age 20–64, U.S. 

noninstitutionalized population, by race/ethnicity, 1987 and 2001 
Source: Center for Financing, Access,

18.9 

13.9 10.9 

20.8 

27.1 27.2

0 

10 

20 

30 

Not high school 

graduate 

High school 

graduate 

Some college 

1987 2001 

Percent 

 and Cost Trends, AHRQ, 1987 National 

Medical Expenditure Survey and 2001 Medical Expenditure Panel Survey 

Figure 3: Percentage of obese adults, age 20–64, U.S. 

noninstitutionalized population, by education level, 1987 and 2001 

Note: Adults with greater amounts of education were the least likely to be obese in 2001. 
Source: Center for Financing, Access,

13.2 11.3 

17.6 17.2 17.5

28.6 

20.7 

27.2 26.7 

25.7 

0 

10 

20 

30 

Poor Near poor Low income Middle 

income 

High income 

1987 2001 

Percent 

 and Cost Trends, AHRQ, 1987 National 

Medical Expenditure Survey and 2001 Medical Expenditure Panel Survey 

Figure 4: Percentage of obese adults, age 20–64, U.S. 

noninstitutionalized population, by poverty status, 1987 and 2001 

Note: Adults with higher incomes were the least likely to be obese in 1987 and 2001. 
Source: Center for Financing, Access,

population, by health insurance status, 1987 and 2001 

12.8 

22.8 

13.9 

22.2 

31.1 

23.6 

0 

10 

20 

30 

40 

Private Public only Uninsured 

1987 2001 

Percent 

 and Cost Trends, AHRQ, 1987 National 

Medical Expenditure Survey and 2001 Medical Expenditure Panel Survey 

Figure 5: Percentage of obese adults, age 20–64, U.S. noninstitutionalized 

Note: Adults with public only health insurance were the most likely to be obese in 1987 and 2001.