Supersize US: Without ‘immediate action’ nearly 260 million Americans will be overweight or obese by 2050

Without immediate action, researchers have warned that nearly 260 million Americans, an increase of more than 41 million adults, will be considered overweight or obese by 2050.

That includes 213 million adults over 25 – nearly three-quarters of the adult population – and more than 43 million children and adolescents between the ages of five and 24.

Around one in five children, at least one in three adolescents, and two in three adults are expected to have obesity, with the highest levels concentrated in southern states.

“Our analysis lays bare the decades-long failure to tackle the growing overweight and obesity epidemic in the USA. The catastrophic consequences of the surge in overweight and obesity among children are already evident in the rising prevalence of childhood hypertension and type 2 diabetes,” University of Washington Professor Emmanuela Gakidou said in a statement.

She noted that being obese or overweight can trigger serious health conditions like diabetes, heart attacks, stroke, cancer, mental health disorders, and premature death.

“The soaring health system and economic costs will be equally pervasive, with over 260 million people in the USA, including over half of all children and adolescents, expected to be living with overweight or obesity by 2050,” said Gakidou. “United efforts and urgent investments are needed to alter these troubling trajectories and ensure a healthier future for current and upcoming generations.”

The findings come from a new, major analysis from the Global Burden of Disease Study Collaborator Network. Funded by the Bill & Melinda Gates Foundation, the peer-reviewed modeling study was published Thursday in the medical journal The Lancet. Gakidou was the lead author.

They used 134 unique data sources to reach these conclusions, including national surveillance data. They also used the definition of these conditions based on body mass index (BMI), noting it might not account for variations in body structure.

More those older than 18 years old, having a BMI of 25 kilograms per meters squared to less than 30 kilograms per meters squared were considered “overweight.” Obesity was defined as a BMI of 30 kilograms per meters squared or higher. For individuals younger than 18 years definitions were based on International Obesity Task Force criteria.

They did not examine racial and ethnic disparities in obesity.

The authors said this assessment of those who are overweight and considered obese, accounting for all age groups and states, estimates that obesity rates in adults and older adolescents have at least doubled over the past three decades, from 1990 to 2021.

This was especially noticeable in the South, including Oklahoma, Alabama, Arkansas, Mississippi, Texas, West Virginia, and Kentucky. These states had the highest levels of obesity and overweight people among older adolescents in 2021. More than half of Texas males ages 15 to 24 and nearly two-thirds of older adolescent females in Mississippi lived with these conditions.

Between 2021 and 2050, they project that the highest rise in obesity prevalence among men is expected in Colorado and New Mexico , and in Kansas and Colorado for adult women. The highest levels of obesity are expected to remain in the South.

In 2021, an estimated 15.1 million children and young adolescents and 21.4 million older adolescents were overweight or obese. By 2050, around one in five children and at least one in three adolescents are expected to be living with obesity.

While more people are using weight loss drugs like Ozempic and Wegovy, they alone will not be enough to solve the obesity epidemic. Although, past trends are not always indicative of what will happen in the future.

The authors called for legislative action that focuses on prevention and intervention, including programs to increase physical activity levels and guarantee the availability of healthy food.

“Obesity is at a crisis point throughout the USA, with every state challenged to some degree,” University of Washington Affiliate Associate Professor Marie Ng said. Ng is a co-author of the analysis.

“Over the past three decades, the country has experienced extensive economic, demographic, and technological transitions that have triggered profound changes to food and agricultural systems, urbanization, and wealth and educational inequalities together with underlying structural racism that all interact to drive population-wide obesity…”