National-level and state-level prevalence of overweight and obesity among children, adolescents, and adults in the USA, 1990–2021, and forecasts up to 2050
Authors' conclusion
Existing policies have failed to address overweight and obesity. Without major reform, the forecasted trends will be devastating at the individual and population level, and the associated disease burden and economic costs will continue to escalate. Stronger governance is needed to support and implement a multifaceted whole-system approach to disrupt the structural drivers of overweight and obesity at both national and local levels. Although clinical innovations should be leveraged to treat and manage existing obesity equitably, population-level prevention remains central to any intervention strategies, particularly for children and adolescents.
Study context
- Population
- Children and adolescents (5–24 years) and adults (≥25 years) in the USA, national level; older adolescents (15–24 years) and adults for 50 states and Washington, DC; 1990–2021, forecasts to 2050134 unique sources
- Outcome
- Prevalence of overweight (BMI 25 to <30 kg/m²) and obesity (BMI ≥30 kg/m²; International Obesity Task Force criteria if <18 years)
- Follow-up
- 1990–2021, forecasts to 2050
Methodological detailsGBD analysis of prevalence with forecasts, spatiotemporal Gaussian process regression, generalised ensemble modelling forecasts, national and state-level estimates
- GBD analysis of prevalence with forecasts
- Spatiotemporal Gaussian process regression
- Generalised ensemble modelling forecasts
- National and state-level estimates
Main finding
As reported in the abstract
Children and young adolescents (5-14 years)
15.1 million
95% UI 13.5–16.8
Older adolescents (15-24 years)
21.4 million
20.2–22.6
Adults (≥25 years)
172 million
169–174
Further findings
Highest state age-standardised prevalence of overweight or obesity · 2021
- Male adolescents (15-24 years), Texas
- 52.4% (47.4-57.6)
- Female adolescents (15-24 years), Mississippi
- 63.0% (57.0-68.5)
- Adult males, North Dakota
- 80.6% (78.5-82.6)
- Adult females, Mississippi
- 79.9% (77.8-81.8)
Percentage change in age-standardised prevalence of obesity · 1990–2021
- Male adolescents (15-24 years)
- 158.4% (123.9-197.4)
- Female adolescents (15-24 years)
- 185.9% (139.4-237.1)
- Adult males
- 123.6% (112.4-136.4)
- Adult females
- 99.9% (88.8-111.1)
- Obesity prevalence has outpaced the increase in overweight, especially among adolescents
Forecast overweight or obesity if past trends continue · up to 2050
- Additional children and young adolescents (5-14 years)
- 3.33 million
- Additional older adolescents (15-24 years)
- 3.41 million
- Additional adults (≥25 years)
- 41.4 million
- Total children and adolescents
- 43.1 million (37.2-47.4)
- Total adults
- 213 million (202-221)
- In most states, adolescents (15-24 years) with obesity
- one in three
- In most states, adults (≥25 years) with obesity
- two in three
Original publication
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