Trends in the Prevalence of Clinical and Preclinical Obesity Among US Adults by Social Determinants of Health
Authors' conclusion
Clinical obesity increased dramatically, showing a strong dose-response relationship with social disadvantage and widening SDOH-based disparities, underscoring the need for targeted interventions addressing structural determinants among vulnerable populations.
Study context
- Population
- US adults aged ≥ 20 years, NHANES 1999–202311 NHANES cycles
- Participants
- 60,506 adults
- Outcome
- Age-standardized prevalence of clinical and preclinical obesity (Lancet Diabetes & Endocrinology Commission definition) and association with SDOH
- Follow-up
- 1999-2000 to 2021-2023
Methodological detailssurvey-weighted regression, age-standardized prevalence, 11 NHANES cycles
- Survey-weighted regression
- Age-standardized prevalence
- 11 NHANES cycles
Main finding
As reported in the abstract
Age-standardized prevalence of clinical obesity
Clinical obesity prevalence nearly doubled, driven by class III obesity (p < 0.001)
14.3% to 26.6%
Preclinical obesity increased modestly (p = 0.038)
17.1% to 20.6%
Observational data: associations, not effects.
Further findings
Disparities by cumulative social determinants of health (SDOH) burden
- Disparities widened significantly between highest (> 6) vs lowest (< 3) cumulative SDOH burden
Association with clinical vs preclinical obesity (multivariable-adjusted)
- Unemployment, OR
- 1.50
- Food insecurity, OR
- 1.38
- High cumulative SDOH burden, OR
- 1.48
- Strongly associated, particularly class II-III severity
- Multivariable-adjusted
Original publication
Trends in the Prevalence of Clinical and Preclinical Obesity Among US Adults by Social Determinants of Health. Obesity (Silver Spring). Published 24 February 2026. doi:10.
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