By 2050, two-thirds of adults and one-third of adolescents in the United States could face obesity

A growing health concern calls for urgent action to address rising obesity rates.

study: National and state-level prevalence of overweight and obesity among U.S. children, adolescents, and adults from 1990 to 2021 and projections to 2050. Image credit: Cynthia A Jackson/Shutterstock.com

In a recent study published in lanceta group of researchers estimated and predicted trends in overweight and obesity among all age groups in the United States (USA) (1990-2050) to guide health policy and interventions.

background

The United States is facing a severe obesity epidemic, and the increasing trend poses significant health, economic, and environmental burdens. Obesity contributes to 335,000 deaths and 11.6 million disability-adjusted life years annually, with direct medical costs exceeding $260 billion.

Childhood obesity is a particularly worrying problem, affecting nearly 20% of young people and leading to early-onset diseases such as diabetes and cardiovascular disease. Geographic, socio-economic, and racial disparities exacerbate the problem, influenced by factors such as food deserts, lack of recreational space, and genetic predisposition.

Monitoring and predicting obesity trends is important for effective prevention and tailored interventions. Further research is needed to address disparities and improve policy responses.

About research

This study estimated the prevalence of overweight and obesity among U.S. children, adolescents, and adults from 1990 to 2021, with projections to 2050. Overweight and obesity were defined using body mass index (BMI) thresholds to classify children and adolescents. Based on the standards of the International Committee to Combat Obesity.

Data were systematically collected from 134 sources, including major U.S. national surveys such as the National Health and Nutrition Examination Survey (NHANES) and the Behavioral Risk Factor Surveillance System (BRFSS), and included self-reported and directly measured height and Includes weight.

Rigorous quality checks ensured consistency, and bias adjustment was applied to self-reported data using statistical models adjusted for age, gender, and time period.

Prevalence estimates were generated using a spatiotemporal Gaussian process regression model that incorporated covariates such as urbanization, education, and agricultural employment to capture socio-economic influences.

Forecasting integrated multiple submodels using a generalized ensemble modeling approach to leverage historical trends and socioeconomic indicators to predict overweight and obesity rates at the national and state levels. Age cohort analysis was also conducted to investigate age patterns and changes in onset over time.

Uncertainty was addressed through probabilistic modeling, providing robust 95% uncertainty intervals for all estimates. These analyzes were performed using R and Python.

Research results

In 2021, the prevalence of overweight and obesity in the United States was significantly higher across all age groups. Approximately 15.1 million children aged 5 to 14 years were affected (95% UI 13.5 to 16.8), with an age-standardized prevalence of 36.2% in males and 37.2% in females.

Among adolescents aged 15 to 24 years, 21.4 million (20.2 to 22.6) were overweight or obese, with a higher prevalence observed in women (50.8%) compared to men (46.7%). Of note, obesity affected 28.8% of female adolescents and 22.7% of male adolescents.

Among adults aged 25 and older, 172 million (169-174) were overweight or obese, with 75.9% of men and 72.6% of women obese. Obesity was more common in adult women (45.6%) than in men (41.5%).

State-level analysis revealed significant geographic disparities. Mississippi had the highest prevalence of overweight and obesity among female adolescents (63.0%), and Texas had the highest prevalence among adolescent males (52.4%).

Youth obesity rates are above 20% in all states and above 30% in some states, with Mississippi once again at the forefront. Adult obesity rates varied widely, from 30.4% in Washington, DC, to 50.5% in West Virginia for men, and from 36.0% in Hawaii to 55.9% in Mississippi, for women.

Age-specific trends highlight a sharp rise in obesity prevalence during adolescence, particularly among women, reaching 33.3% by age 20-24.

Among adults, obesity prevalence peaked at 48.7% in women aged 50 to 54 years and 46.8% in men aged 45 to 49 years, and then decreased in older age groups. However, peak age and prevalence vary by state and reflect regional differences.

From 1990 to 2021, the prevalence of obesity increased dramatically, especially among adolescents. Obesity rates among adolescent males increased by 158.4%, while among females it jumped by 185.9%. Obesity rates among adults increased by 123.6% for men and 99.9% for women. The sharpest increases at the state level were in Utah, New Mexico, and Alabama for men, and in Nebraska and Oklahoma for women.

Projections to 2050 suggest continued increases, with an additional 6.7 million children and adolescents and 41.4 million adults expected to be overweight or obese. The prevalence of obesity among adults is projected to exceed 55% nationwide and exceed 60% in some states.

conclusion

In summary, this analysis highlights an alarming increase in overweight and obesity in the United States from 1990 to 2021, with projections showing worsening trends through 2050. Almost three-quarters of adults will be overweight or obese in 2021, with obesity rates doubling in 30 years.

Projections suggest that by 2050, more than 80% of adults will be affected, with the rate of increase particularly faster among men. Adolescent women face the greatest burden, especially in southern states, where obesity rates are projected to exceed 50% by 2050 in some regions.