A The Lancet study forecasts that over 80% of U.S. adults will have overweight or obesity by 2050 if trends persist, with substantial increases in children and adolescents with obesity. Using data from 134 sources from between 1990 and 2021, researchers predicted an additional 41.4 million adults and 6.73 million youths will develop overweight or obesity by mid-century.

In 2021, 172 million adults aged ≥25 years, 21.4 million adolescents aged 15–24 years, and 15.1 million children aged 5–14 years were overweight or obese. Projections indicate obesity prevalence among adults will surpass 50% in 45 states for men and 48 states for women by 2050. North Dakota and Mississippi reported the highest rates of male (80.6%) and female (79.9%) obesity, respectively, in 2021.

The study revealed earlier obesity onset across cohorts. Women born in 1960 reached 45% obesity prevalence by age 45, compared to age 30 for the 1980 cohort. The same level is projected at age 20 for 2020 cohorts. Similar trends are observed in men, with obesity prevalence accelerating most between ages 20 to 30 years.

Geographic disparities persist, with faster obesity growth in states including Colorado and New Mexico. Adolescents are particularly vulnerable, with forecasts of over 50% obesity prevalence in young women in states such as Mississippi and Alabama by 2050.

Obesity remains a critical driver of health care costs, projected to exceed $411 billion annually if half of adults with obesity are prescribed GLP-1 receptor agonists. Structural interventions targeting food environments, legislation, and prevention in early life stages are urgently needed to curb these trends.

Research funded by the Bill & Melinda Gates Foundation.

Conflict of interest disclosures can be found in the study.