Addressing the obesity epidemic:
Why should psychologists care?
BY DR. SUZANNE BENNETT JOHNSON • APA PRESIDENT
Obesity has reached epidemic proportions in the United States. More than one-
third of U.S. adults and 50 percent of African-American women are obese. 1
The number of obese Americans rapidly increased from 13 percent of the
population in 1960–62 to 35 percent in 2005–06.2 Obesity is now the second
leading cause of death in the United States, and is likely to become the first. 3
Unless this epidemic is successfully addressed, U.S. life
expectancy will decline. 4 Meanwhile, the economic costs of
obesity are enormous. Health-care costs of patients who are
obese are 42 percent greater than the health-care costs of
normal weight individuals.5 The human toll is worse. Not only
is obesity associated with higher mortality rates and shorter life
expectancy, it also diminishes quality of life. Obese people are
far more likely to suffer from diabetes and its complications
(kidney failure, blindness, leg amputations), as well as stroke,
breast and colorectal cancer, osteoarthritis and depression. 6
Unfortunately, the obesity epidemic is not confined to
adults: 17 percent of all U.S. children are obese, with obesity
rates highest for African-American adolescent girls ( 29 percent)
and Hispanic adolescent boys ( 27 percent). 7 Childhood obesity
is linked to psychological problems, asthma, diabetes and
cardiovascular risk factors in childhood. Because obese children
often grow up to become obese adults, childhood obesity is
strongly linked to mortality and morbidity in adulthood. 8
The obesity epidemic is not a product of changing genes or
biology. It has its roots in the social environment and human
behavior. Psychologists are experts at understanding human
behavior as well as initiating and maintaining behavior change.
Many psychologists have contributed to our understanding of
obesity, its treatment and prevention, yet most psychologists are
unaware of the obesity epidemic or view it as the domain of the
Expanding psychology’s role in advancing health is one
of the core elements of APA’s strategic plan. To successfully
address this goal, psychology must play a larger role in
addressing the obesity epidemic, from basic science to
prevention to treatment to public policy. I have spent my
career helping children who have diabetes and their families.
For many years, all of my patients had Type- 1 diabetes, a
form of the disease usually diagnosed in childhood that
results from complete pancreatic failure. A few years ago, I
started to see children and adolescents with Type- 2 diabetes.
This was a shocking development since Type- 2 diabetes is a
disease of overweight older adults. It soon became apparent
that Type- 2 diabetes in childhood was the consequence of the
childhood obesity epidemic consuming our nation. I found
that 30 percent of children in our local school system entered
kindergarten overweight or obese. These rates escalated to
41 percent of sixth graders, with African-American girls ( 43
percent) and Hispanic boys ( 46 percent) most affected.
1 JAMA. 2010;303:235–241.
2 National Center for Health Statistics Health E-Stats. 2010. Available at: www.
3 JAMA. 2004;291:1238-45.
4 Ann of Intern Med. 2003;138: 24-32.
5 Health Affairs. 2009; 28(5):w822–w831.
6 Women’s Health Med. 2004; 1: 38-41.
7 National Center for Health Statistics Health E-Stat. 2010. Available at: www.
8 Arch Dis of Childhood.2003;88:748-752.
9 J of School Health. 2007;77:630-636.