Over the past three decades, obesity rates in the United States have risen at an alarming pace. Since 1990, the prevalence of obesity has at least doubled among adults (aged 25 and older) and older adolescents (aged 15–24), reaching over 208 million people living with overweight or obesity by 2021.
A recent analysis published in The Lancet predicts that these numbers will only grow unless significant changes are made.
A Nationwide Challenge
By 2021, nearly three-quarters of U.S. adults (172 million people) were living with overweight or obesity. Obesity rates, in particular, saw dramatic increases, doubling in men from 18.6% in 1990 to 41.5% in 2021, and in women from 22.8% to 45.6% during the same period.
Some states have been hit harder than others. For example, 80% of men in North Dakota and women in Mississippi were classified as overweight or obese in 2021.
The problem is not limited to adults. Among adolescents aged 15–24, obesity rates have more than doubled since 1990.
In 2021, 50.8% of older adolescent females and 46.7% of older adolescent males were living with overweight or obesity. States like Mississippi and Texas report some of the highest rates in these groups.
Troubling Projections
If current trends continue, the number of adults with overweight or obesity in the U.S. is expected to rise from 172 million in 2021 to 213 million by 2050. Of these, 146 million will likely have obesity.
Children and adolescents face a similarly bleak future, with the number of individuals in these age groups living with overweight or obesity projected to increase from 36.36 million in 2021 to 43.1 million by 2050.
Southern states are forecasted to remain hotspots for obesity. By 2050, nearly two-thirds of adult men in West Virginia and Kentucky and two-thirds of adult women in states like Mississippi and Arkansas are expected to be living with obesity.
Among adolescents, obesity rates are expected to climb even higher, with half of older adolescent females in several southern states affected by 2050.
The Cost of Inaction
The rise in obesity is already causing significant health and economic burdens. Obesity increases the risk of many serious conditions, including diabetes, heart disease, strokes, certain cancers, and mental health issues.
These health problems are appearing at younger ages, further straining the healthcare system. If current trends persist, over 260 million Americans, including more than half of all children and adolescents, will be living with overweight or obesity by 2050, driving up medical costs and reducing quality of life.
Lead author Professor Emmanuela Gakidou from the University of Washington points out that the consequences of this epidemic are far-reaching.
“Addressing the structural drivers of obesity, such as food deserts, the marketing of unhealthy products, and sedentary lifestyles, is essential,” she said.
Moving Toward Solutions
Although medications like GLP-1 receptor agonists offer promise in managing obesity, experts warn they are not a cure-all.
High costs, limited accessibility, and potential side effects make these treatments unsuitable as the sole solution to the obesity epidemic. Instead, prevention needs to take center stage.
Preventive strategies must address the root causes of obesity, including unhealthy diets, limited access to nutritious food, and insufficient physical activity. Federal and state governments need to prioritize policies that encourage healthier lifestyles.
For instance, ensuring access to affordable, nutritious school meals and regulating junk food advertising could play a critical role. Investing in safe, walkable neighborhoods and promoting active living are also key steps.
Addressing obesity must begin early, even before birth. Interventions focused on maternal health and early childhood nutrition could prevent obesity from taking hold in future generations.
Researchers also emphasize the need for tailored solutions to tackle obesity-related disparities between states, genders, and age groups.
A Call for Unified Action
Experts agree that reversing the obesity epidemic requires a whole-system approach. This means coordinated efforts across healthcare, education, food industries, and local communities.
Professor Marie Ng, a co-author of the study, stresses the importance of long-term policies that prioritize prevention over treatment.
Without decisive action, the U.S. obesity epidemic will continue to escalate, threatening public health and overwhelming the healthcare system.
As Professor Sylvain Sebert from the University of Oulu aptly noted, prevention efforts must remain the cornerstone of any effective strategy, supported by new treatments where necessary.
Reversing these trends will require a unified commitment from policymakers, healthcare providers, and communities alike to ensure a healthier future for generations to come.
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The research findings can be found in The Lancet.
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