Massive: 208 million Americans are now obese or overweight 🍔

By Marie Ng - Affiliate Associate Professor of Global Health, University of Washington

In the United States, the overweight and obesity epidemic is rapidly growing. Children and teenagers are particularly affected. If no action is taken, by 2050, more than 80% of adults and nearly 60% of American teenagers will be affected.


In 2021, in the United States, nearly half of teenagers and three-quarters of adults were clinically considered overweight or obese, representing 208 million people. Back in 1990, these proportions were half as low. If no measures are taken, the trend will worsen: by 2025, more than 80% of adults and nearly 60% of American teenagers will be overweight or obese.

Published in the medical journal The Lancet, these figures are from a study we conducted with the Global Burden of Disease Study 2021 U.S. Obesity Forecasting Collaborator Group, which includes over 300 experts and researchers specializing in obesity.

A worsening situation

The goal of our work was to report on the evolution of obesity and overweight in the United States between 1990 and 2021 and to create projections to estimate their progression through 2050.

To achieve this, we synthesized and analyzed body mass index data from 132 different sources, including scientific studies, national surveys, and state-level surveys.

We determined that individuals aged 18 and above were considered "overweight" when their body mass index (BMI) ranged between 25 kilograms per square meter (kg/m²) and 30 kg/m². Beyond that, they were classified as obese. For those under 18, we relied on the criteria of the International Obesity Task Force.

Our findings are significant, as the United States already has one of the highest rates of obesity and overweight in the world. Furthermore, it is known that the life expectancy of affected individuals is reduced. This situation also limits the impact of medical advancements compared to the benefits seen by populations in other equally wealthy countries.

Prior research found that obesity accounted for 335,000 deaths in 2021 alone. It significantly increases the risks of diabetes, heart attacks, strokes, cancer, and mental health disorders. It is a major risk factor for poor health and early death. Furthermore, it is one of the fastest-growing risk factors.

The economic implications of obesity are also substantial. A 2024 report by Republican members of the United States Congress' Joint Economic Committee estimated that health costs related to obesity will reach $9.1 trillion (i.e., $9.1 thousand billion) over the coming decade.

Children and teenagers: a major concern

The rise of obesity among children and teenagers is particularly alarming, with the obesity rate more than doubling among adolescents aged 15 to 24 since 1990. Data from the National Health and Nutrition Examination Survey reveals that in the United States, nearly 20% of children and teenagers aged 2 to 19 years old are obese.

By 2050, our forecast results suggest that one in five children and one in three teenagers will be obese. It is known that in both these groups, obesity leads not only to the early development of chronic diseases but also to mental health issues, deteriorating social interactions, and declining physical abilities.

Geographical and social inequalities

Our research also highlighted significant geographical disparities in the prevalence of overweight and obesity from one state to another, with Southern states showing some of the highest rates.



Other studies on obesity in the United States have similarly pointed out large socio-economic and ethnic differences, suggesting, for instance, that Black and Hispanic populations have higher obesity rates than White populations.

These disparities are further exacerbated by so-called "systemic" barriers: discrimination, unequal access to education, healthcare, or economic opportunities, among others.

What are the solutions?

Among the interventions proven effective against obesity, the taxation of sugary drinks stands out. Recent research conducted in Seattle demonstrated that such measures reduce the average body mass index among children. Various studies have also examined the outcomes of initiatives aimed at improving access to physical activity and healthy foods, especially in underprivileged areas.

Additionally, a growing number of studies are being conducted to evaluate the potential of technology-driven behavioral interventions, such as mobile applications designed to help individuals better manage their weight. For now, questions remain about the effectiveness of these approaches and their scalability, which limits their adoption and potential large-scale impact.

Finally, clinical research is underway to develop new obesity medications (and to monitor the effectiveness and safety of current medications).

The advent of new medications could significantly change the management of obesity. However, their development alone is not enough to ensure they impact trends substantially in the decades to come. Many factors will need to be considered: the cost of these new drugs, accessibility, long-term effectiveness, variability in patient responses, etc. All these parameters will need thorough investigation by scientists in the future.