Overweight, Obesity to Affect 64% of Americans by 2050

The US is on course for a dramatic escalation in its obesity crisis, with a new study in The Lancet projecting that more than 250 million Americans will have overweight or obesity by 2050.¹

For reference, the total US population is 337 million at the time of publication.² This number is projected to climb between 371 and 392 million by 2050, with the US Census Bureau estimating a population size of 389 million.^3-5 With these new findings, this means approximately 64% of all Americans are projected to have overweight or obesity by 2050.

By 2050, researchers expect obesity to affect 1 in 3 adolescents and 2 in 3 adults in most states | Image credit: MP Studio – stock.adobe.com

This concerning forecast comes after researchers analyzed historical trends and future trajectories, highlighting the urgency for policy interventions.¹ In 2021, approximately 15.1 million children (aged 5-14 years), 21.4 million adolescents (aged 15-24 years), and 172 million adults (aged 25 years or older) had overweight or obesity. Projections suggest that without major changes, an additional 3.33 million children, 3.41 million adolescents, and 41.4 million adults will be affected by 2050.

“Existing policies have failed to address overweight and obesity,” the researchers said. “Without major reform, the forecasted trends will be devastating at the individual and population level, and the associated disease burden and economic costs will continue to escalate.”

Obesity Rates Highest Among Women

The prevalence of obesity alone is expected to be 22.6% among children, 34.2% among adolescents, 55.3% among adult men, and 58.8% among adult women. Zoomed out to include both overweight and obesity, prevalence increases to 45.1%, 57.3%, 81.1%, and 82.1%, respectively.

“Our forecasts suggest that without immediate action, by 2050, the prevalence of overweight and obesity in adults will exceed 80% nationwide,” researchers emphasized.

Despite current efforts—or a lack thereof—obesity rates have risen sharply, with adolescent obesity showing the fastest growth. Between 1990 and 2021, obesity prevalence jumped 158.4% among adolescent males and 185.9% among adolescent females, affecting about 22.7% and 28.8% of them in 2021, respectively. This sex-based gap persisted across age groups, with girls and women consistently facing higher obesity rates than boys and men.

Higher Rates in Southern States

State-level data showed significant geographic disparities as well. Mississippi had the highest obesity rates for adolescent females in 2021 at 63%, while Texas led for males at 52.4%. Among adults, North Dakota recorded the highest rates for men (80.6%) and Mississippi again topped the list for women (79.9%).

By 2050, researchers expect obesity to affect 1 in 3 adolescents and 2 in 3 adults in most states. Southern states like Oklahoma, Mississippi, Alabama, Arkansas, West Virginia, and Kentucky are projected to maintain particularly high rates. Meanwhile, rapid increases are expected among adolescents in Utah and adults in Colorado.

A Comprehensive Approach

The authors stressed that addressing the crisis requires a comprehensive approach, calling for a “whole-of-government, Health in All Policies approach” that focuses on structural drivers like urbanization, flawed food systems, and food insecurity. Suggested measures include legislative changes to increase access to healthy foods and stronger regulations on marketing and food industry practices.

While clinical treatments like antiobesity medications are promising, they are not a standalone solution, and there are still many unknowns about their long-term use. According to the researchers, population-level prevention measures are central to not just treating but mitigating the obesity epidemic, particularly among children and adolescents.

The study also highlights the financial strain of obesity treatments, pointing out the high costs of current medications like glucagon-like peptide 1 (GLP-1) receptor agonists. Earlier this year, Sen Bernie Sanders (I, Vermont), chairman of the Senate Health, Education, Labor, and Pensions Committee, cited that if half of American adults used GLP-1 agonists, health care expenses could skyrocket to $411 billion annually.⁶ In contrast, smart food strategies like taxing sugar-sweetened beverages are far more affordable, with estimated costs ranging from $430 million over a decade to $1.7 billion over a lifetime.¹

Urgent and coordinated action is necessary to prevent a worsening health and economic crisis, requiring investments in obesity prevention and policies that promote equitable access to care.

“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,” the researchers said. “The next administration must urgently focus on population-level prevention and intervention.”

References

1. GBD 2021 US Obesity Forecasting Collaborators. National-level and state-level prevalence of overweight and obesity among children, adolescents, and adults in the USA, 1990-2021, and forecasts up to 2050. Lancet. Published online November 12, 2024. doi:10.1016/S0140-6736(24)01548-4
2. U.S. and world population clock. United States Census Bureau. Accessed November 18, 2024. https://www.census.gov/popclock/
3. Sen S. National 50-state population projections: 2030, 2040, 2050. University of Virginia. July 22, 2024. Accessed November 18, 2024. https://www.coopercenter.org/research/national-50-state-population-projections-2030-2040-2050
4. Day JC. Population Projections of the United States, by Age, Sex, Race, and Hispanic Origin: 1992-2050. United States Census Bureau report P25-1092. November 1992. Accessed November 18, 2024. https://www.census.gov/library/publications/1992/demo/p25-1092.html
5. Vespa J, Medina L, Armstrong DM. Demographic Turning Points for the United States: Population Projections for 2020 to 2060. United States Census Bureau report P25-1144. February 2020. Accessed November 18, 2024. https://www.census.gov/content/dam/Census/library/publications/2020/demo/p25-1144.pdf
6. Sanders B. Breaking point: how weight loss drugs could bankrupt American health care. United States Senate; Health, Education, Labor, and Pensions Committee. May 15, 2024. Accessed November 18, 2024. https://www.sanders.senate.gov/wp-content/uploads/Wegovy-report-FINAL.pdf