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A new analysis from the Global Burden of Disease Study Collaborator Network, published in The Lancet, paints a stark picture of the future of obesity in the U.S. According to the study, without immediate and decisive action, nearly 260 million people in the U.S.—including more than half of all children and adolescents—are projected to be living with overweight or obesity by 2050. This is a staggering increase from the 208 million people affected in 2021, underscoring the urgent need for comprehensive public health reforms.
The report reveals that the rise in obesity over the past three decades has been nothing short of alarming. Since 1990, the prevalence of obesity has doubled in both adult men and women, as well as in adolescents aged 15–24 years. By 2021, an estimated 172 million adults, or nearly three-quarters of the adult population, were living with overweight or obesity. In some states, the situation is even more dire, with regions such as Mississippi and Texas already seeing extremely high obesity rates among both adults and adolescents.
“Our analysis lays bare the decades-long failure to tackle the growing overweight and obesity epidemic in the U.S.,” said Professor Emmanuela Gakidou from the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, who led the study. “The catastrophic consequences of the surge in overweight and obesity among children are already evident in rising rates of childhood hypertension and type 2 diabetes.”
The study forecasts that the total number of children and adolescents with overweight or obesity will rise to 43.1 million by 2050, an increase of 6.74 million from 2021. Among adults, that figure is expected to climb to 213 million, a rise of 41.4 million. As obesity rates continue to rise, the public health impacts are expected to be severe, with escalating rates of chronic diseases such as diabetes, heart disease, stroke, and cancer.
Regional Disparities and Alarming Trends
Certain regions are projected to see even more dramatic increases in obesity rates, particularly in the southern U.S. In 2021, approximately 80% of adult men in North Dakota and 80% of adult women in Mississippi were already living with overweight or obesity. By 2050, this trend will worsen, with states like West Virginia and Kentucky seeing two-thirds of adults living with obesity.
The data also highlights a disturbing trend: the age at which individuals are developing obesity is getting younger. While approximately two out of five women born in the 1960s were living with obesity by the age of 45, women born in the 1980s reached that threshold by age 30, and women born in 2020 are expected to reach it by age 20.
“This is not just an issue for adults; the rising obesity rates among children and adolescents are especially concerning,” said co-author Marie Ng, an affiliate associate professor at IHME. “Existing interventions focusing on lifestyle changes have not been enough to reverse these trends, particularly in children and adolescents.”
The Economic and Health Impacts
The health consequences of this growing epidemic are vast and will put unprecedented strain on the U.S. healthcare system. In addition to chronic diseases, there are significant mental health risks associated with obesity, including increased rates of depression, anxiety, and low self-esteem. The economic burden is also expected to rise dramatically, with higher medical costs and lost productivity expected to escalate as obesity becomes more widespread.
Calls for Comprehensive Action
Experts stress that addressing the obesity epidemic will require a multi-faceted approach. While medications like GLP-1 receptor agonists (GLP-1 RAs) may have a role in treatment, they are not a panacea. The authors argue that prevention must be the primary focus, particularly through policies that address the root causes of obesity, such as food insecurity, sedentary lifestyles, and food marketing to children.
“We cannot tackle this crisis with a narrow focus on individual behavior alone,” said Professor Gakidou. “The structural drivers of obesity, including food environments, socioeconomic inequalities, and urban planning, need to be addressed at the national and local levels.”
The study calls for a cross-government strategy that includes measures to increase physical activity, improve access to healthy foods, and regulate the food industry, particularly in terms of marketing unhealthy products to children. Additionally, policymakers are urged to focus on early interventions, including promoting healthy eating and physical activity during pregnancy and early childhood, to break the intergenerational cycle of obesity.
A Global Issue
The findings from this study have far-reaching implications, not just for the U.S., but globally. Professor Sylvain Sebert from the University of Oulu, who was not involved in the study, wrote in a linked comment, “A multifaceted, whole-system approach is needed to address the overweight and obesity crisis. There is great hope in new therapeutic approaches, but these treatments should not be seen as a reason to abandon prevention efforts.”
As the U.S. faces the prospect of an obesity epidemic on an unprecedented scale, the clock is ticking for policymakers to take action. The time for a nationwide, coordinated response is now—before the human and economic costs become too great to manage.
For more information, visit The Lancet.
