The following are key points to remember from a review on national- and state-level prevalence of overweight and obesity among children, adolescents, and adults in the United States (US), 1990–2021, and forecasts up to 2050:

1. Overweight and obesity is epidemic in the US, resulting in significant health and economic burden. Understanding current trends and future trajectories is foundational for assessing the success of existing interventions, including health policy. This publication outlined the estimated prevalence of overweight and obesity from 1990 through 2021 and estimated future prevalences through 2050 for children and adolescents (aged 5–24 years) and adults (aged ≥25 years). The data used included 134 unique sources, including major national surveillance survey data. For individuals >18 years, overweight was defined as having a body mass index (BMI) of 25 kg/m² to <30 kg/m², and obesity was defined as a BMI of ≥30 kg/m², and for individuals <18 years, definitions were based on International Obesity Task Force criteria.
2. In 2021, an estimated 15.1 million children and young adolescents met the definition of overweight or obese in the US. An estimated 21.4 million older adolescents (aged 15–24 years) were overweight or obese, and 172 million adults (aged ≥25 years) were overweight or obese.
3. Texas had the highest age-standardized prevalence of overweight or obesity for male adolescents (aged 15–24 years) with 52.4%. Mississippi had the highest prevalence of female adolescents, at 63%.
4. Among adults, for males, the prevalence of overweight or obesity was highest in North Dakota at 80.6%, while for females, the highest prevalence was observed in Mississippi at 79.9%.
5. The prevalence of obesity has outpaced the increase in overweight, particularly among adolescents. Between 1990 and 2021, the percentage change in the age-standardized prevalence of obesity increased by 158.4% among male adolescents and 185.9% among female adolescents. For adults, the percentage change in the prevalence of obesity was 123.6% for males and 99.9% for females.
6. Forecast results suggest that if past trends continue, an additional 3.33 million children and young adolescents (aged ≤14 years) and 3.41 million older adolescents (aged 15–24 years) will meet the definition of overweight or obesity by the year 2050.
7. Forecasts for adults project that an additional 41.4 million adults (aged ≥25 years) will be overweight or obese by 2050.
8. By the year 2050, the total number of children and adolescents with overweight or obesity will reach an estimated 43.1 million, and the total number of adults with overweight or obesity will reach an estimated 213 million.
9. In 2050, most states project that one in three adolescents (aged 15–24) will be obese, and two in three adults (aged ≥25 years) will be obese. Southern states, such as Oklahoma, Mississippi, Alabama, Arkansas, West Virginia, and Kentucky, are forecast to continue to have a high prevalence of obesity. However, the highest percentage changes from 2021 are projected in states such as Utah for adolescents and Colorado for adults.
10. The authors of this report note that existing policies have failed to address overweight and obesity. Without major policy and interventional changes, these trends will result in significant increases in the health and economic burden for both individuals and populations. Multifaceted approaches to prevent and treat overweight and obesity are required at local and national levels. Although clinical innovations should be leveraged to treat and manage existing obesity equitably, population-level prevention remains central to any intervention strategies, particularly for children and adolescents.

Clinical Topics: Prevention, Cardiovascular Care Team

Keywords: Obesity, Overweight, Patient Care Team, Secondary Prevention

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