Women and the Obesity Epidemic: What the Numbers Reveal

The average clothing size of American women has gone up. Here's why the numbers matter.

child helping adult fix a healthy meal

Medically reviewed in June 2021

Updated on February 16, 2022

The average American woman now wears a misses size 16-18, or a woman’s plus size 20, according to a 2016 study published in the International Journal of Fashion Design, Technology and Education. That’s a significant leap from the size 14 average of 10 years prior.

While the study’s authors point out that the fashion industry is failing to design clothes for the average woman, their findings reach beyond the dressing room to highlight alarming health trends among American women.

Obesity and health
Obesity in the United States is very common. In 2017-2018, 42 percent of U.S. residents were considered obese, and over 9 percent have severe or morbid obesity, according to data from the National Health and Nutrition Examination Survey. These numbers have risen since 1999-2000.

Obesity is a risk factor for several health conditions, including heart disease, diabetes, and cancer. In fact, a 2017 study from the Centers for Disease Control and Prevention (CDC) found that more than half of the cancers diagnosed in women—including breast and ovarian cancer—are linked to being overweight or obese.

The social stigma attached to obesity can be devastating and may in itself also help explain some of the associated risks. Media portrayals are often cruel and inaccurate. It can be difficult for fat people to find stylish clothing, enjoy a restaurant meal, or travel by air or train, causing frequent frustration and stress.

Years of childhood and workplace bullying as well as employment discrimination may also contribute to the sort of chronic stress that can harm health. (And women are more likely to face discrimination based on their weight compared with men.) Evidence also suggests that many healthcare professionals hold negative and biased attitudes toward people with obesity, which may make it more difficult to obtain appropriate and timely medical care.

What’s behind the numbers?
The reasons for the obesity epidemic are complex. Causes include a lack of access to fresh fruits and vegetables in low-income neighborhoods, along with the higher cost of healthful foods and the generally low nutritional content of more affordable foods. Changes in the gut microbiome, which may relate to unhealthful diets and exposure to toxins or antibiotics, could also be contributing.

But the CDC also points to the fact that 25 percent of American adults are physically inactive. Regular physical activity not only helps you manage your weight, but it can also reduce your risk of life-threatening medical conditions.

You can take charge of your health
No matter what your size, you can work to improve your health. If you decide to improve your eating habits as part of this journey, one way to begin is to start a food and activity journal. This can be a handy way to spot trends you wouldn’t have noticed otherwise. For example, there may be entire food groups—like nuts or dairy—that are absent from your diet and others that you can make efforts to reduce, like sugar or refined carbs.

Keep your journal for at least a week. If you notice unhealthy eating patterns, this information can help you plan a more nutritious diet around what you learn. It’s also useful if you decide to reach out to a healthcare provider, dietitian, or personal trainer for extra guidance. Knowledge is power. Evidence suggests that people who keep food journals are more successful at losing unwanted excess weight.

Try to get enough exercise
At any weight, physical activity is crucial to good health. Aim for 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity aerobic activity, like biking or jogging, every week. Adults should also do strength training, exercising every major muscle group, at least two days a week.

Haven’t been moving in a while? Don’t feel you need to make up for lost time all at once. Start with walking. Just 30 minutes of walking a day can clear your mind and improve your mood, and you can do it in 10-minute chunks if that’s more convenient. Plus, it lowers your risk of conditions like high blood pressure, arthritis, and stroke. Take a furry friend with you or start a walking group for an added social benefit: It’ll make exercise more enjoyable, and socializing is good for your emotional and physical health, too.

Article sources open article sources

Christel DA, Dunn SC. Average American women’s clothing size: Comparing national health and nutritional examination surveys (1988–2010) to ASTM international misses & women’s plus size clothing. International Journal of Fashion Design, Technology and Education. 2017 May 4;10(2):129-36.
Centers for Disease Control and Prevention. Cancers Associated with Overweight and Obesity Make up 40 percent of Cancers Diagnosed in the United States. October 3, 2017.
Katherine D. McManus. Harvard Health Blog. Why keep a food diary? January 31, 2019.
Hales CM, Carroll MD, Fryar CD, Ogden CL. Prevalence of obesity and severe obesity among adults: United States, 2017–2018. NCHS Data Brief, no 360. Hyattsville, MD: National Center for Health Statistics. 2020
Lawrence BJ, Kerr D, Pollard CM, et al. Weight bias among health care professionals: A systematic review and meta-analysis. Obesity (Silver Spring). 2021;29(11):1802-1812.
O'Donoghue G, Cunningham C, King M, O'Keefe C, Rofaeil A, McMahon S. A qualitative exploration of obesity bias and stigma in Irish healthcare; the patients' voice. PLoS One. 2021;16(11):e0260075. Published 2021 Nov 29.
Roberts KJ, Polfuss ML, Marston EC, Davis RL. Experiences of weight stigma in adolescents with severe obesity and their families. J Adv Nurs. 2021;77(10):4184-4194.
Puls HC, Schmidt R, Zenger M, et al. Sex-Specific Mediation Effects of Workplace Bullying on Associations between Employees' Weight Status and Psychological Health Impairments. Nutrients. 2021;13(11):3867. Published 2021 Oct 29.
Haqq AM, Kebbe M, Tan Q, Manco M, Salas XR. Complexity and Stigma of Pediatric Obesity. Child Obes. 2021;17(4):229-240.
Sagi-Dain L, Echar M, Paska-Davis N. Experiences of weight stigmatization in the Israeli healthcare system among overweight and obese individuals. Isr J Health Policy Res. 2022;11(1):5. Published 2022 Jan 31.
Phelan SM, Burgess DJ, Yeazel MW, Hellerstedt WL, Griffin JM, van Ryn M. Impact of weight bias and stigma on quality of care and outcomes for patients with obesity. Obes Rev. 2015;16(4):319-326.
Rubino F, Puhl RM, Cummings DE, et al. Joint international consensus statement for ending stigma of obesity. Nat Med. 2020;26(4):485-497.
Spahlholz J, Baer N, König HH, Riedel-Heller SG, Luck-Sikorski C. Obesity and discrimination - a systematic review and meta-analysis of observational studies. Obes Rev. 2016;17(1):43-55.
Harvard T.H. Chan School of Public Health. Eating healthy vs. unhealthy diet costs about $1.50 more per day. December 5, 2013.
Kern DM, Auchincloss AH, Stehr MF, et al. Neighborhood Prices of Healthier and Unhealthier Foods and Associations with Diet Quality: Evidence from the Multi-Ethnic Study of Atherosclerosis. Int J Environ Res Public Health. 2017;14(11):1394. Published 2017 Nov 16.
Centers for Disease Control and Prevention. Adult Physical Inactivity Prevalence Maps by Race/Ethnicity. Page last reviewed January 21, 2022.
Mayo Clinic. How much should the average adult exercise every day? September 22, 2021.
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