Obesity problem in United States (© andriano_cz - stock.adobe.com)
Nearly half of adolescents and three-quarters of adults in the U.S. were classified as being clinically overweight or obese in 2021. The rates have more than doubled compared with 1990.
Without urgent intervention, our study forecasts that more than 80% of adults and close to 60% of adolescents will be classified as overweight or obese by 2050. These are the key findings of our recent study, published in the journal The Lancet.
Synthesizing body mass index data from 132 unique sources in the U.S., including national and state-representative surveys, we examined the historical trend of obesity and the condition of being overweight from 1990 to 2021 and forecast estimates through 2050.
For people 18 and older, the condition health researchers refer to as “overweight” was defined as having a body mass index, or BMI, of 25 kilograms per square meter (kg/m²) to less than 30 kg/m² and obesity as a BMI of 30 kg/m² or higher. For those younger than 18, we based definitions on the International Obesity Task Force criteria.
This study was conducted by the Global Burden of Disease Study 2021 U.S. Obesity Forecasting Collaborator Group, which comprises over 300 experts and researchers specializing in obesity.
Why it matters
The U.S. already has one of the highest rates of obesity and people who are overweight globally. Our study estimated that in 2021, a total of 208 million people in the U.S. were medically classified as overweight or obese.
Obesity has slowed health improvements and life expectancy in the U.S. compared with other high-income nations. Previous research showed that obesity accounted for 335,000 deaths in 2021 alone and is one of the most dominant and fastest-growing risk factors for poor health and early death. Obesity increases the risk of diabetes, heart attack, stroke, cancer and mental health disorders.
The economic implications of obesity are also profound. A report by Republican members of the Joint Economic Committee of the U.S. Congress, published in 2024, predicted that obesity-related health care costs will rise to US$9.1 trillion over the next decade.
The rise in childhood and adolescent obesity is particularly concerning, with the rate of obesity more than doubling among adolescents ages 15 to 24 since 1990. Data from the National Health and Nutrition Examination Survey revealed that nearly 20% of children and adolescents in the U.S. ages 2 to 19 live with obesity.
By 2050, our forecast results suggest that 1 in 5 children and 1 in 3 adolescents will experience obesity. The increase in obesity among children and adolescents not only triggers the early onset of chronic diseases but also negatively affects mental health, social interactions and physical functioning.
What other research is being done
Our research highlighted substantial geographical disparities in overweight and obesity prevalence across states, with southern U.S. states observing some of the highest rates.
Other studies on obesity in the United States have also underscored significant socioeconomic, racial and ethnic disparities. Previous studies suggest that Black and Hispanic populations exhibit higher obesity rates compared with their white counterparts. These disparities are further exacerbated by systemic barriers, including discrimination, unequal access to education, health care and economic inequities.
Another active area of research involves identifying effective obesity interventions, including a recent study in Seattle demonstrating that taxation on sweetened beverages reduced average body mass index among children. Various community-based studies also investigated initiatives aimed at increasing access to physical activity and healthy foods, particularly in underserved areas.
Clinical research has been actively exploring new anti-obesity medications and continuously monitoring the effectiveness and safety of current medications.
Furthermore, there is a growing body of research examining technology-driven behavioral interventions, such as mobile health apps, to support weight management. However, whether many of these programs are scalable and sustainable is not yet clear. This gap hinders the broader adoption and adaptation of effective interventions, limiting their potential impact at the population level.
What’s next
Our study forecasts trends in overweight and obesity prevalence over the next three decades, from 2022 to 2050, assuming no action is taken.
With the advent of new-generation anti-obesity medications, obesity management could change substantially. However, the extent of this impact will depend on factors such as cost, accessibility, coverage, long-term efficacy and variability in individual responses. Future research will need to leverage the most up-to-date evidence.
Marie Ng is an affiliate associate professor of Global Health at the University of Washington.
This article is republished from The Conversation under a Creative Commons license. Read the original article.
Insanity! BMI must have been normed against Auschwitz survivors, At 5″9″ and 177 the chart has me as Obese II and >50 lbs overweight despite a 36″ waist. The problem is the BMI is so far out of touch with reality, comments based on it lose credibility. Obesity is a problem, but so are articles like this.
Americans are lazy. Myself and a friend are the same age and height. He hires some one to do all of the work around the house and yard his wife can’t do. For meals they always have deserts and lots of snacks like cookies and such always available. He’s 40 lbs overweight. I might add we’re both 77.
I don’t hire people to do anything I can’t do myself. I rarely have desert but occasionally have a snack like cookies and such. My weight is pretty much right on and I really don’t deprive myself of anything!
That being said, I also do all my own shopping, he doesn’t.
When I go to the market I always see what other people may have in their basket. People who are morbidly obese have every thing you shouldn’t be eating. It will be loaded down with snacks, just too many to name. You don’t even have to see in their basket just follow them down an isle and watch the stuff they put into their basket. 90% junk.
We’ve become a very lazy society and it’s killing and bankrupting us. Everything nowadays is geared towards not doing anything physical. From TV changers to someone to do everything for us, laundry, yardwork, cleaning house, and the list goes on and on.
I remember in my high school, 1960’s, of around 3000 students. You could have counted the number of overweight people on one hand, but none were morbidly obese. Today it’s a very high percentage in many of our schools. I live near a high school and an elementary school and can see the problem first hand.
Back in my younger days we walked or rode our bikes everywhere. If you weren’t far enough away there was no bus, you walked or rode your bike.
We’ve created this problem and now we want to take the easy way, which is dubious to say the least, that somehow a shot will solve this problem of our own making. Just crazy.
Why should the taxpayer pay for this high priced weight loss drug, when the problem is mostly due to lifestyle choices. If you need to lose weight, look at what you are consuming and what your activity level is. Granted, some people do have metabolic problems that result in weight gain, but the vast majority are overweight due to their own personal choices. If they want the easy fix of a pill, they should pay the price themselves.
It’s interesting that insurance companies will charge you extra premium if you are a cigarette smoker, but you are bashed if you even suggest they should charge extra premium for those who are overweight or to those who use marijuana and other recreational drugs. They claim the extra premium for smokers is due to potential medical issues that arise from smoking, yet the same logic could apply to the overweight and the recreational drug user. Lots of medical problems arise from being obese and sedentary.
I had weight loss surgery 19 years ago. Weight loss has enhanced my life considerably. While I had surgery, it hasn’t been easy to maintain my weight loss all these years. I went from size 28 to a size 6 but every day I still think about what I eat, when I eat and how much I eat. It takes commitment no matter how you try to lose weight. I think it is the commitment to losing weight that in the end mark s success or failure. I don’t see these drugs as a free ride to skinny. For many people my road would have not been acceptable because of the inherent dangers and in having surgery. This was a big deal. But in the end for me, it was the right decision. Had there been a drug that could’ve helped me would I have taken it ? Certainly, I would’ve at least tried it. in the end ,the long in the short is that there is no easy road. And no weight loss Aid is going to do the job for you. It’s up to the individual to develop the habits that will help them maintain the weight loss. Drugs and surgery make it a good start But without that commitment, you will not in the end be successful
We should cancel the tax breaks to the millionaires and billionaires. Why do we always question whatever helps the less unfortunate people in the society. A healthier nation benefits us all more and not tax breaks for the extra rich people.
All this obese people have to do is quit eating junk food and eat fruits and vegetables. They need to take responsibility and help themselves
I believe there may be cases where this would help obese people but I also think it is all the chemicals and additives being placed in the consumers food. I also think we need to follow a more healthy life style. Some of the foods here in the USA are banned in the EU what does that tell you. Look back in the 60’s & 70’s at the numbers of obese people compared to today’s numbers.
Most obese ppl. have one thing in common…they eat too much & they eat unhealthy food.
Don’t believe me? How many obese ppl. do you see in South America, Europe, Canada?
There is a fast food place on every street in America. One only needs to go to Disneyland to see obese families. It’s shocking. How many obese ppl. do you see at the gym, cycling, walking?
Sitting is the new cancer. It’s not rocket science …eat healthy and get off your ass…..
The BMI doesn’t take in to account muscle mass. You can have little body fat, but if you have a lot of muscle, you can still be classified a overweight or obese
I’m tired of hearing “It’s the food.” If you don’t eat it, it won’t make you fat. Being fat is 100% a choice. People do realize they need to walk through the vegetable department at the supermarket to get to the cookie aisle? The milk is right next to the coffee creamer… The raw chicken is in the fridge right next to the chicken nuggets…
you are absolutely wrong, you need to do some research on glp-1 hormones insulin in the body and its role and blood sugar, yes food choices contribute . i hope you are a healthy weight and fit, i also hope you never have to deal with constant non stop hunger even when full and cravings.
High fructose corn syrup. the worst thing you can ever eat.
That is chemically no different from any other fructose in natural fruit. The concentration of fructose is the thing that they deliberately misnomer, as in orange juice from concentrate. One could simply dilute or use less of the high concentration fructose corn syrup. But, maple syrup is basically similar in chemistry and viscosity. Another one is the dubious ban on trans fats. A trans bond indicates a point of unsaturation, a carbon-carbon double bond, with cis and trans components, named dependent if the substituents are identical and somewhat symmetrical atoms or parts of the molecule or not. However, in the old days they told us that unsaturated fats were preferred over disgustingly weight gaining, heart disease causing saturated fats such as palm and coconut oils. The 1970s University of Minnesota study that was not published due to politics found the opposite conclusion. So while we all ate unsaturated artificial margarine, they knew that the recommendations were not only false but based on no empirical data whatsoever. Fat contains 9 kcal per gram (i.e. big C Calories or 1000 cal), whereas carbohydrates have only 4 kcal per gram. Fat also is harder to digest, so it keeps you full longer and gives you the calories or Calories (x 1000 conversion) that you need to maintain your weight. But since the 1970s the now finally proven bogus recommendations were for a low fat, high fiber diet. But, folks skipped the fiber for too much makes your gut uncomfortable, and the lowest common denominator took over as always, and people replaced the fat calories with carbs (sugars) to the tune of at least 2.25 to 1 in order to keep up calorie counts. The resultant outcomes have been predictably poor healthwise with type B diabetes going from virtually non-existent to endemic in more modern times. Eating a reasonably moderate amount of food to sustain oneself is a challenge and does take a fair amount of discipline, since at the grocery store advertising can take over one’s mindset, and choices are generally lousy for healthy eating, especially the quantity or size of portions, even in “Whole Foods”, of which I despise how self-righteous and misleading that company has become.
Sugar is sugar
RFK Jr will fix it. MAHA! Yeah, right – ain’t gonna happen. You can’t defeat BIG SUGAR, BIG MED, and BIG PHARMA. They’re all in cahoots. “Profit Over People” is their secret motto.
Good points. But Big Tobacco was eventually brought down, a notch anyway. Bobby will give his best shot as a sophisticated ambulance chaser personal injury attorney.
They define overweight in a really weird way though. Through my 30s I was extremely active, working out up to 6x a week. I was classified as overweight the entire time. Outside of the military weight charts, although I was told even if I had missed weight on those I’d have easily passed the tape and choke as they called it, iirc. If you do any resistance training you’ll be overweight. Heck, I’m fairly certain you’ll be overweight if you just do pushups and a lot of cardio and play sports, because you’ll get muscle development especially in your legs naturally.
Outside of that, it’s probably the face that most people don’t have enough money to eat healthy, especially young people in the middle and lower classes or with parents who don’t want to feed them, or being stuck in school or at work in a chair behind a computer desk for half a day. There’s no way to make up for that even with workouts. Lack of adequate sleep is another issue. Long commute another. Lack of open spaces is another. People need to be able to walk around and be around green things.
Doesn’t help the media attacks everyone, even if you’re fit and a good person the media will just attack you relentlessly all the time, insisting you’re unattractive for a myriad of reasons you can’t even change, from your height to your skin color to your social class or whatever else. I bet if society just removed mass media and removed so much power from the billionaire class, that things would be better. If the billionaires weren’t sucking up all of society’s resources, everyone else would have more than enough to be happy and free and work way less, spending more time with friends and family and on things they like, instead of slaving away for corporate overlords.
The definition as in hypertension (i.e. high blood pressure) is intentionally broad and poorly defined so as much as possible many feel trapped into thinking we are all in a death spiral if we do not bow down to them and take their advice hook, line, and sinker. BMI does not account for body density whatsoever, as it is operationally a linear function only. It also presumes we are square volume people, which is preposterous, as a squaring function only accounts for area. This leaves it with up to a 55% error, dependent upon how muscular you are. Fat tissue is less dense than muscle tissue. So, hypothetically you could have a fit person have a higher BMI that a flabby individual. Even when accounting for a spherical shape it is still significantly inaccurate. The only way to do it is body density, which can subtract out fat tissue since it is buoyant, whereas muscle and bone are not. That and the fat pinch calipers are also much more accurate for determing % body fat content and possibly a better overall health indicator as well. BMI is cheap and easy, just step on the scales, without much thought or advice, and presto lose weight moron. Wrong, medical doctors are the morons sometimes. But the establishment has made them all lucrative careers, and those that argue with them, no matter how logically, are doomed as Battacharya and Kennedy almost were. Disclaimer: I taught college/university chemistry for over 20 years, and to many a pre-med major.
Several publishion claim being FAT is healthy!
Yes, agreed! Yet another astoundingly contradictory recommendation hostile to empirical evidence and logical, reasonable thought. Can anyone now whom can think independently be blamed for being flabbergasted at what passes for supposedly peer-reviewed published modern ‘science’
now if only medical science would stop keeping these fat f$%ks alive, the world would be a much better place.
There’s a pill for that now.
DIAF