Obesity in the US Projected to Skyrocket by 2050

TOPLINE:

If the current pattern continues, more than 250 million people living in the United States, including nearly seven million children and adolescents, will have overweight or obesity by 2050.

METHODOLOGY:

• Self-reported and measured anthropometric data were extracted from 134 unique sources, which included all major national surveillance survey data, with adjustments to correct for self-reporting bias.
• For individuals aged > 18 years, overweight was defined as body mass index (BMI) of 25 kg/m² to International Obesity Task Force criteria.
• Trajectories up to 2050 were modeled assuming continuation of past trends and patterns.

TAKEAWAY:

• In 2021, an estimated 15.1 million children and young adolescents aged 5-14 years, 21.4 million adolescents aged 15-24 years, and 172 million adults aged ≥ 25 years had overweight or obesity in the United States.
• The age-standardized overweight/obesity prevalence among individuals aged ≥ 25 years was estimated at 75.9% in men and 72.6% in women.
• In 2021, for all 50 states and Washington, DC, the prevalence of overweight/obesity was > 40% in both sexes combined and was generally higher in female adolescents than in male adolescents aged 15-24 years.
• The highest prevalences were seen among adolescent girls in Mississippi (63.0%), Alabama (59.4%), and Oklahoma (59.0%); and for adolescent boys, Texas (52.4%), West Virginia (52.2%), and Oklahoma (51.4%).
• Among adults, prevalence in men ranged from 70.6% in Colorado to 80.6% in North Dakota, and was lowest in Washington, DC (65.3%), while in women, the range was from 63.7% in Hawaii to 79.9% in Mississippi.
• Nationally, among adults, the estimated percentage increase in prevalence of overweight/obesity from 1990 to 2021 was 25.6% for men and 47.9% for women.
• By 2050, the prevalence of overweight/obesity in children aged 5-14 years is projected to reach 45.1%; the prevalence of obesity alone is projected to reach 22.6%, and for adolescents, 57.3% and 34.2%, respectively.
• Forecast results suggest that by the time the 2000 birth cohort reaches age 50 years in 2050, the projected obesity prevalence will be 61.5%.

IN PRACTICE:

• New-generation clinical treatments, including antiobesity medications, will probably become a key option for obesity management. However, current access to these treatments is inequitable and their efficacy varies widely among individuals. Although they have a place within personalized comprehensive management plans, clinical treatments alone will not solve the current and future obesity epidemic.
• Existing policies have not shown adequate effectiveness. Future strategies must involve a multifaceted, whole-system approach, taking into consideration the complex drivers of obesity. Stronger governance is necessary to enact meaningful policy changes. Prevention remains the primary focus given the chronicity of the condition, with emphasis on children and adolescents.
• Regulations need to be put in place to eliminate barriers to accessing new generation obesity clinical treatments, ensuring the availability and affordability of these options to the broader population. To protect population health, avoid overwhelming the health-care system, and mitigate mounting health-care costs, deliberate concerted action is needed to disrupt the epidemic of overweight and obesity.

SOURCE:

The study was conducted by the GBD 2021 US Obesity Forecasting Collaborators and published online on November 14 in the Lancet.

LIMITATIONS:

Limitations included the definition of overweight and obesity is based on BMI, which might not account for variations in body structure across the population. Moreover, state-level obesity/overweight prevalence wasn’t reported for individuals aged 5-14 years due to scarce data. Besides, racial/ethnic disparities weren’t examined, the recommendations are US-specific, and the analysis didn’t differentiate between obesity severity categories. Data only extended through 2021, and didn’t capture more recent surges in GLP-1 drug use.

DISCLOSURES:

The study was funded by the Bill & Melinda Gates Foundation. Several authors listed disclosures, of which only some were pharmaceutical.