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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

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Názov:	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
Autori:	Ng M., Dai X., Cogen R. M., Abdelmasseh M., Abdollahi A., Abdullahi A., Aboagye R. G., Abukhadijah H. J., Adeyeoluwa T. E., Afolabi A. A., Ahmad D., Ahmad N., Ahmed A., Ahmed S. A., Akkaif M. A., Akrami A. E., Al Hasan S. M., Al Ta'ani O., Alahdab F., Al-Aly Z., Aldhaleei W. A., Algammal A. M., Ali W., Al-Ibraheem A., Alqahatni S. A., Al-Rifai R. H., Alshahrani N. Z., Al-Wardat M., Aly H., Al-Zyoud W. A., Amiri S., Anil A., Arabloo J., Aravkin A. Y., Ardekani A., Areda D., Ashemo M. Y., Atreya A., Azadnajafabad S., Aziz S., Azzopardi P. S., Babu G. R., Baig A. A., Bako A. T., Bansal K., Barnighausen T. W., Bastan M. -M., Bemanalizadeh M., Beran A., Beyene H. B., Bhaskar S., Bilgin C., Bleyer A., Borhany H., Boyko E. J., Braithwaite D., Bryazka D., Bugiardini R., Bustanji Y., Butt Z. A., Barsbay M. C., Campos-Nonato I., Cembranel F., Cerin E., Chacon-Uscamaita P. R., Chandrasekar E. K., Chattu V. K., Chen A. -T., Chen G., Chi G., Ching P. R., Cho S. M. J., Choi D. -W., Chong B., Chung S. -C., Cindi Z., Cini K. I., Columbus A., Couto R. A. S., Criqui M. H., Cruz-Martins N., Da'ar O. B., Dadras O., Dai Z., Darcho S. D., Dash N. R., Desai H. D., Dharmaratne S. D., Diaz D., Diaz M. J., Do T. C., Dolatshahi M., D'Oria M., Doshi O. P., Doshi R. P., Dowou R. K., Dube J., Dumuid D., Dziedzic A. M., E'mar A. R., El Arab R. A., El Bayoumy I. F., Elhadi M., Eltaha C., Falzone L., Farrokhpour H., Fazeli P., Feigin V. L., Fekadu G., Ferreira N., Fischer F., Francis K. L., Gadanya M. A., Gebregergis M. W., Ghadimi D. J., Gholami E., Golechha M., Golinelli D., Gona P. N., Gouravani M., Grada A., Grover A., Guha A., Gupta R., Habibzadeh P., Haep N., Halimi A., Hasan M. K., Hasnain M. S., Hay S. I., He W. -Q., Hebert J. J., Hemmati M., Hiraike Y., Hoan N. Q., Hostiuc S., Hu C., Huang J., Huynh H. -H., Islam M. R., Islam S. M. S., Jacob L., Joseph A., Kamarajah S. K., Kanmodi K. K., Kantar R. S., Karimi Y., Kazemian S., Khan M. J., Khan M. S., Khanal P., Khanmohammadi S., Khatab K., Khatatbeh M. M., Khormali M., Khubchandani J., Kiconco S., Kim M. S., Kimokoti R. W., Kisa A., Kulimbet M., Kumar V., Kundu S., Kurmi O. P., Lai H., Le N. H. H., Lee M., Lee S. W., Lee W. -C., Li A., Li W., Lim S. S., Lin J., Lindstedt P. A., Liu X., Lo J., Lopez-Gil J. F., Lucchetti G., Luo L., Lusk J. B., Mahmoudi E., Rad E. M., Manla Y., Martinez-Piedra R., Mathangasinghe Y., Matozinhos F. P., McPhail S. M., Meles H. N., Mensah G. A., Meo S. A., Mestrovic T., Michalek I. M., Mini G. K., Mirza-Aghazadeh-Attari M., Mocciaro G., Mohamed J., Mohamed M. F. H., Mohamed N. S., Mohammad A. M., Mohammed S., Mokdad A. H., Momenzadeh K., Momtazmanesh S., Montazeri F., Moradi-Lakeh M., Morrison S. D., Motappa R., Mullany E. C., Murray C. J. L., Naghavi P., Najdaghi S., Davani D. N., Nascimento G. G., Natto Z. S., Nguyen D. H., Nguyen H. T. H., Nguyen P. T., Nguyen V. T., Nigatu Y. T., Nikravangolsefid N., Noor S. T. A., Nugen F., Nzoputam O. J., Oancea B., O'Connell E. M., Okeke S. R., Olagunju A. T., Olasupo O. O., Olorukooba A. A., Ostroff S. M., Oulhaj A., Owolabi M. O., Mahesh Padukudru P. A., Parikh R. R., Park S., Pashaei A., Pereira G., Pham H. N., Pham T., Philip A. K., Pradhan J., Pradhan P. M. S., Pronk N. P., Puvvula J., Alavi S. N. R., Raggi C., Rahman M. A., Rahmani B., Rahmanian M., Ramasamy S. K., Ranabhat C. L., Rao S. J., Rashedi S., Rashid A. M., Redwan E. M. M., Rhee T. G., Rodrigues M., Rodriguez J. A. B., Sabet C. J., Sabour S., Saeed U., Sagoe D., Saleh M. A., Samuel V. P., Samy A. M., Saravanan A., Sawhney M., Sawyer S. M. M., Scarmeas N., Schlaich M. P., Schuermans A., Sepanlou S. G., Seylani A., Shafie M., Shah N. S., Shamim M. A., Shamshirgaran M. A., Sharfaei S., Sharifan A., Sharma A., Sharma M., Sheikh A., Shenoy R. R., Shetty P. K., Shibuya K., Shittu A., Shuval K., Siddig E. E., Silva D. A. S., Singh J. A., Smith A. E., Solanki R., Soliman S. S. M., Song Y., Soraneh S., Straif K., Szarpak L., Tabatabaei S. M., Tabche C., Tanwar M., Tat N. Y., Temsah M. -H., Thavamani A., Tran T. H., Trico D., Truyen T. T. T. T., Tyrovolas S., Udoh A., Ullah S., Vahabi S. M., Vahdati S., Vaithinathan A. G., Vakilpour A., Van Den Eynde J., Vinayak M., Weerakoon K. G., Wickramasinghe N. D., Wolde A. A., Wonde T. E., Xu S., Yang L., Yano Y., Yigit A., Yon D. K., Yu C., Yuan C. -W., Zastrozhin M., Zeariya M. G., Zhong C. C., Zhu B., Zhumagaliuly A., Zielinska M., Zyoud S. H., Kerr J. A., Vollset S. E., Gakidou E.
Prispievatelia:	Ng, Marie, Dai, Xiaochen, Cogen, Rebecca M, Abdelmasseh, Michael, Abdollahi, Arash, Abdullahi, Auwal, Aboagye, Richard Gyan, Abukhadijah, Hana J, Adeyeoluwa, Temitayo Esther, Afolabi, Aanuoluwapo Adeyimika, Ahmad, Danish, Ahmad, Noah, Ahmed, Ayman, Ahmed, Syed Anee, Akkaif, Mohammed Ahmed, Akrami, Ashley E, Al Hasan, Syed Mahfuz, Al Ta'ani, Omar, Alahdab, Fare, Al-Aly, Ziyad, Aldhaleei, Wafa A, Algammal, Abdelazeem M, Ali, Waad, Al-Ibraheem, Akram, Alqahatni, Saleh A, Al-Rifai, Rami H, Alshahrani, Najim Z, Al-Wardat, Mohammad, Aly, Hany, Al-Zyoud, Walid A, Amiri, Sohrab, Anil, Abhishek, Arabloo, Jalal, Aravkin, Aleksandr Y, Ardekani, Ali, Areda, Demelash, Ashemo, Mubarek Yesse, Atreya, Alok, Azadnajafabad, Sina, Aziz, Shahkaar, Azzopardi, Peter S, Babu, Giridhara Rathnaiah, Baig, Atif Amin, Bako, Abdulaziz T, Bansal, Kannu, Bärnighausen, Till Winfried, Bastan, Mohammad-Mahdi, Bemanalizadeh, Maryam, Beran, Azizullah, Beyene, Habtamu B, Bhaskar, Sonu, Bilgin, Cem, Bleyer, Archie, Borhany, Hamed, Boyko, Edward J, Braithwaite, Dejana, Bryazka, Dana, Bugiardini, Raffaele, Bustanji, Yasser, Butt, Zahid A, Çakmak Barsbay, Mehtap, Campos-Nonato, Ismael, Cembranel, Francieli, Cerin, Ester, Chacón-Uscamaita, Pamela Roxana, Chandrasekar, Eeshwar K, Chattu, Vijay Kumar, Chen, An-Tian, Chen, Guangjin, Chi, Gerald, Ching, Patrick R, Cho, So Mi Jemma, Choi, Dong-Woo, Chong, Bryan, Chung, Sheng-Chia, Cindi, Zinhle, Cini, Karly I, Columbus, Alyssa, Couto, Rosa A S, Criqui, Michael H, Cruz-Martins, Natalia, Da'Ar, Omar B, Dadras, Omid, Dai, Zhaoli, Darcho, Samuel Demissie, Dash, Nihar Ranjan, Desai, Hardik Dineshbhai, Dharmaratne, Samath Dhamminda, Diaz, Daniel, Diaz, Michael J, Do, Thanh Chi, Dolatshahi, Mahsa, D'Oria, Mario, Doshi, Ojas Prakashbhai, Doshi, Rajkumar Prakashbhai, Dowou, Robert Kokou, Dube, John, Dumuid, Dorothea, Dziedzic, Arkadiusz Marian, E'Mar, Abdel Rahman, El Arab, Rabie Adel, El Bayoumy, Ibrahim Farahat, Elhadi, Muhammed, Eltaha, Chadi, Falzone, Luca, Farrokhpour, Hossein, Fazeli, Patrick, Feigin, Valery L, Fekadu, Ginenu, Ferreira, Nuno, Fischer, Florian, Francis, Kate Louise, Gadanya, Muktar A, Gebregergis, Miglas Welay, Ghadimi, Delaram J, Gholami, Ehsan, Golechha, Mahaveer, Golinelli, Davide, Gona, Philimon N, Gouravani, Mahdi, Grada, Ayman, Grover, Ashna, Guha, Avirup, Gupta, Rahul, Habibzadeh, Parham, Haep, Nil, Halimi, Aram, Hasan, Md. Kamrul, Hasnain, Md Saquib, Hay, Simon I, He, Wen-Qiang, Hebert, Jeffrey J, Hemmati, Mehdi, Hiraike, Yuta, Hoan, Nguyen Quoc, Hostiuc, Sorin, Hu, Chengxi, Huang, Junjie, Huynh, Hong-Han, Islam, Md. Rabiul, Islam, Sheikh Mohammed Shariful, Jacob, Loui, Joseph, Abel, Kamarajah, Sivesh Kathir, Kanmodi, Kehinde Kazeem, Kantar, Rami S, Karimi, Yeganeh, Kazemian, Sina, Khan, Mohammad Jobair, Khan, Muhammad Shahzeb, Khanal, Praval, Khanmohammadi, Shaghayegh, Khatab, Khaled, Khatatbeh, Moawiah Mohammad, Khormali, Moein, Khubchandani, Jagdish, Kiconco, Sylvia, Kim, Min Seo, Kimokoti, Ruth W, Kisa, Adnan, Kulimbet, Mukhtar, Kumar, Vijay, Kundu, Satyajit, Kurmi, Om P, Lai, Hanpeng, Le, Nhi Huu Hanh, Lee, Munjae, Lee, Seung Won, Lee, Wei-Chen, Li, An, Li, Wei, Lim, Stephen S, Lin, Jialing, Lindstedt, Paulina A, Liu, Xiaofeng, Lo, Justin, López-Gil, José Francisco, Lucchetti, Giancarlo, Luo, Lisha, Lusk, Jay B, Mahmoudi, Elham, Malakan Rad, Elaheh, Manla, Yosef, Martinez-Piedra, Ramon, Mathangasinghe, Yasith, Matozinhos, Fernanda Penido, Mcphail, Steven M, Meles, Hadush Negash, Mensah, George A, Meo, Sultan Ayoub, Mestrovic, Tomislav, Michalek, Irmina Maria, Mini, Gk, Mirza-Aghazadeh-Attari, Mohammad, Mocciaro, Gabriele, Mohamed, Jama, Mohamed, Mouhand F H, Mohamed, Nouh Saad, Mohammad, Ameen Mosa, Mohammed, Shafiu, Mokdad, Ali H, Momenzadeh, Kaveh, Momtazmanesh, Sara, Montazeri, Fateme, Moradi-Lakeh, Maziar, Morrison, Shane Dougla, Motappa, Rohith, Mullany, Erin C, Murray, Christopher J L, Naghavi, Pirouz, Najdaghi, Soroush, Narimani Davani, Delaram, Nascimento, Gustavo G, Natto, Zuhair S, Nguyen, Dang H, Nguyen, Hau Thi Hien, Nguyen, Phat Tuan, Nguyen, Van Thanh, Nigatu, Yeshambel T, Nikravangolsefid, Nasrin, Noor, Syed Toukir Ahmed, Nugen, Fred, Nzoputam, Ogochukwu Janet, Oancea, Bogdan, O'Connell, Erin M, Okeke, Sylvester Reuben, Olagunju, Andrew T, Olasupo, Omotola O, Olorukooba, Abdulhakeem Abayomi, Ostroff, Samuel M, Oulhaj, Abderrahim, Owolabi, Mayowa O, P A, Mahesh Padukudru, Parikh, Romil R, Park, Seoyeon, Park, Sungchul, Pashaei, Ava, Pereira, Gavin, Pham, Hoang Nhat, Pham, Tom, Philip, Anil K, Pradhan, Jalandhar, Pradhan, Pranil Man Singh, Pronk, Nicolaas P, Puvvula, Jagadeesh, Rafiei Alavi, Seyedeh Niloufar, Raggi, Catalina, Rahman, Muhammad Aziz, Rahmani, Bita, Rahmanian, Mohammad, Ramasamy, Shakthi Kumaran, Ranabhat, Chhabi Lal, Rao, Sowmya J, Rashedi, Sina, Rashid, Ahmed Mustafa, Redwan, Elrashdy Moustafa Mohamed, Rhee, Taeho Gregory, Rodrigues, Monica, Rodriguez, Jefferson Antonio Buendia, Sabet, Cameron John, Sabour, Siamak, Saeed, Umar, Sagoe, Dominic, Saleh, Mohamed A, Samuel, Vijaya Paul, Samy, Abdallah M, Saravanan, Aswini, Sawhney, Monika, Sawyer, Susan M M, Scarmeas, Nikolao, Schlaich, Markus P, Schuermans, Art, Sepanlou, Sadaf G, Seylani, Allen, Shafie, Mahan, Shah, Nilay S, Shamim, Muhammad Aaqib, Shamshirgaran, Mohammad Ali, Sharfaei, Sadaf, Sharifan, Amin, Sharma, Anupam, Sharma, Manoj, Sheikh, Aziz, Shenoy, Rekha Raghuveer, Shetty, Premalatha K, Shibuya, Kenji, Shittu, Aminu, Shuval, Kerem, Siddig, Emmanuel Edwar, Silva, Diego Augusto Santo, Singh, Jasvinder A, Smith, Amanda E, Solanki, Ranjan, Soliman, Sameh S M, Song, Yi, Soraneh, Soroush, Straif, Kurt, Szarpak, Lukasz, Tabatabaei, Seyyed Mohammad, Tabche, Celine, Tanwar, Manoj, Tat, Nathan Y, Temsah, Mohamad-Hani, Thavamani, Aravind, Tran, Thang Huu, Trico, Domenico, Truyen, Thien Tan Tri Tai, Tyrovolas, Stefano, Udoh, Arit, Ullah, Sana, Vahabi, Seyed Mohammad, Vahdati, Sanaz, Vaithinathan, Asokan Govindaraj, Vakilpour, Azin, Van den Eynde, Jef, Vinayak, Manish, Weerakoon, Kosala Gayan, Wickramasinghe, Nuwan Darshana, Wolde, Asrat Arja, Wonde, Tewodros Eshete, Xu, Suowen, Yang, Lin, Yano, Yuichiro, Yiğit, Arzu, Yon, Dong Keon, Yu, Chuanhua, Yuan, Chun-Wei, Zastrozhin, Michael, Zeariya, Mohammed G M, Zhong, Claire Chenwen, Zhu, Bin, Zhumagaliuly, Abzal, Zielińska, Magdalena, Zyoud, Sa'ed H, Kerr, Jessica A, Vollset, Stein Emil, Gakidou, Emmanuela
Zdroj:	Lancet
Informácie o vydavateľovi:	Elsevier BV, 2024.
Rok vydania:	2024
Predmety:	obesity among the younger population, Male, obesity among the population, Pediatric Obesity, Biomedical and clinical sciences, Epidemiology, 32 Biomedical and Clinical Sciences, Oral and gastrointestinal, anzsrc-for: 4206 Public Health, Global Burden of Disease, Body Mass Index, 0302 clinical medicine, Prevalence, Obesity, USA, Child, 11 Medical and Health Sciences, Pediatric, Public health, anzsrc-for: 42 Health Sciences, obesity among older adolescents and adults, Burden of disease, 3 Good Health and Well Being, Articles, Middle Aged, Child, Preschool, 3210 Nutrition and Dietetics, 4206 Public Health, Female, Adult, Adolescent, anzsrc-for: 3210 Nutrition and Dietetics, obesity burden, forecasting, obesity among children, obesity among female adolescents, Young Adult, 03 medical and health sciences, anzsrc-for: 32 Biomedical and Clinical Sciences, General & Internal Medicine, Humans, Preschool, gbd, GBD 2021 US Obesity Forecasting Collaborators, Health sciences, 42 Health Sciences, overweight, obesity children, adolescents, adults: global burden of diasese, Overweight, United States, obesity among males, Nutrition and dietetics, anzsrc-for: 11 Medical and Health Sciences, Forecasting
Popis:	Over the past several decades, the overweight and obesity epidemic in the USA has resulted in a significant health and economic burden. Understanding current trends and future trajectories at both national and state levels is crucial for assessing the success of existing interventions and informing future health policy changes. We estimated the prevalence of overweight and obesity from 1990 to 2021 with forecasts to 2050 for children and adolescents (aged 5-24 years) and adults (aged ≥25 years) at the national level. Additionally, we derived state-specific estimates and projections for older adolescents (aged 15-24 years) and adults for all 50 states and Washington, DC.In this analysis, self-reported and measured anthropometric data were extracted from 134 unique sources, which included all major national surveillance survey data. Adjustments were made to correct for self-reporting bias. For individuals older than 18 years, overweight was defined as having a BMI of 25 kg/m2 to less than 30 kg/m2 and obesity was defined as a BMI of 30 kg/m2 or higher, and for individuals younger than 18 years definitions were based on International Obesity Task Force criteria. Historical trends of overweight and obesity prevalence from 1990 to 2021 were estimated using spatiotemporal Gaussian process regression models. A generalised ensemble modelling approach was then used to derive projected estimates up to 2050, assuming continuation of past trends and patterns. All estimates were calculated by age and sex at the national level, with estimates for older adolescents (aged 15-24 years) and adults aged (≥25 years) also calculated for 50 states and Washington, DC. 95% uncertainty intervals (UIs) were derived from the 2·5th and 97·5th percentiles of the posterior distributions of the respective estimates.In 2021, an estimated 15·1 million (95% UI 13·5-16·8) children and young adolescents (aged 5-14 years), 21·4 million (20·2-22·6) older adolescents (aged 15-24 years), and 172 million (169-174) adults (aged ≥25 years) had overweight or obesity in the USA. Texas had the highest age-standardised prevalence of overweight or obesity for male adolescents (aged 15-24 years), at 52·4% (47·4-57·6), whereas Mississippi had the highest for female adolescents (aged 15-24 years), at 63·0% (57·0-68·5). Among adults, the prevalence of overweight or obesity was highest in North Dakota for males, estimated at 80·6% (78·5-82·6), and in Mississippi for females at 79·9% (77·8-81·8). The prevalence of obesity has outpaced the increase in overweight over time, especially among adolescents. Between 1990 and 2021, the percentage change in the age-standardised prevalence of obesity increased by 158·4% (123·9-197·4) among male adolescents and 185·9% (139·4-237·1) among female adolescents (15-24 years). For adults, the percentage change in prevalence of obesity was 123·6% (112·4-136·4) in males and 99·9% (88·8-111·1) in females. Forecast results suggest that if past trends and patterns continue, an additional 3·33 million children and young adolescents (aged 5-14 years), 3·41 million older adolescents (aged 15-24 years), and 41·4 million adults (aged ≥25 years) will have overweight or obesity by 2050. By 2050, the total number of children and adolescents with overweight and obesity will reach 43·1 million (37·2-47·4) and the total number of adults with overweight and obesity will reach 213 million (202-221). In 2050, in most states, a projected one in three adolescents (aged 15-24 years) and two in three adults (≥25 years) will have obesity. Although southern states, such as Oklahoma, Mississippi, Alabama, Arkansas, West Virginia, and Kentucky, are forecast to continue to have a high prevalence of obesity, the highest percentage changes from 2021 are projected in states such as Utah for adolescents and Colorado for adults.Existing policies have failed to address overweight and obesity. 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. Stronger governance is needed to support and implement a multifaceted whole-system approach to disrupt the structural drivers of overweight and obesity at both national and local 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.Bill & Melinda Gates Foundation.
Druh dokumentu:	Article Other literature type
Popis súboru:	application/pdf; application/zip
Jazyk:	English
ISSN:	0140-6736
DOI:	10.1016/s0140-6736(24)01548-4
Prístupová URL adresa:	https://pubmed.ncbi.nlm.nih.gov/39551059 https://hdl.handle.net/11368/3098324 https://www.sciencedirect.com/science/article/pii/S0140673624015484 https://pmc.ncbi.nlm.nih.gov/articles/pmid/39551059/ https://www.thelancet.com/action/showPdf?pii=S0140-6736(24)01548-4 https://doi.org/10.1016/S0140-6736(24)01548-4 https://www.sciencedirect.com/science/article/pii/S0140673624015484 https://hdl.handle.net/10576/61195 https://www.sciencedirect.com/science/article/pii/S0140673624015484 https://hdl.handle.net/10576/62006 https://pergamos.lib.uoa.gr/uoa/dl/object/3482172 https://acuresearchbank.acu.edu.au/item/91x96/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 https://www.sciencedirect.com/science/article/pii/S0140673624015484 https://hdl.handle.net/11368/3098324 https://doi.org/10.1016/s0140-6736(24)01548-4 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)01548-4/fulltext https://doi.org/10.1016/S0140-6736(24)01548-4 https://hdl.handle.net/11585/1010155
Rights:	CC BY
Prístupové číslo:	edsair.doi.dedup.....9ee0b0a519dfede46e2d04c556b7376e
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Abstrakt:	Over the past several decades, the overweight and obesity epidemic in the USA has resulted in a significant health and economic burden. Understanding current trends and future trajectories at both national and state levels is crucial for assessing the success of existing interventions and informing future health policy changes. We estimated the prevalence of overweight and obesity from 1990 to 2021 with forecasts to 2050 for children and adolescents (aged 5-24 years) and adults (aged ≥25 years) at the national level. Additionally, we derived state-specific estimates and projections for older adolescents (aged 15-24 years) and adults for all 50 states and Washington, DC.In this analysis, self-reported and measured anthropometric data were extracted from 134 unique sources, which included all major national surveillance survey data. Adjustments were made to correct for self-reporting bias. For individuals older than 18 years, overweight was defined as having a BMI of 25 kg/m2 to less than 30 kg/m2 and obesity was defined as a BMI of 30 kg/m2 or higher, and for individuals younger than 18 years definitions were based on International Obesity Task Force criteria. Historical trends of overweight and obesity prevalence from 1990 to 2021 were estimated using spatiotemporal Gaussian process regression models. A generalised ensemble modelling approach was then used to derive projected estimates up to 2050, assuming continuation of past trends and patterns. All estimates were calculated by age and sex at the national level, with estimates for older adolescents (aged 15-24 years) and adults aged (≥25 years) also calculated for 50 states and Washington, DC. 95% uncertainty intervals (UIs) were derived from the 2·5th and 97·5th percentiles of the posterior distributions of the respective estimates.In 2021, an estimated 15·1 million (95% UI 13·5-16·8) children and young adolescents (aged 5-14 years), 21·4 million (20·2-22·6) older adolescents (aged 15-24 years), and 172 million (169-174) adults (aged ≥25 years) had overweight or obesity in the USA. Texas had the highest age-standardised prevalence of overweight or obesity for male adolescents (aged 15-24 years), at 52·4% (47·4-57·6), whereas Mississippi had the highest for female adolescents (aged 15-24 years), at 63·0% (57·0-68·5). Among adults, the prevalence of overweight or obesity was highest in North Dakota for males, estimated at 80·6% (78·5-82·6), and in Mississippi for females at 79·9% (77·8-81·8). The prevalence of obesity has outpaced the increase in overweight over time, especially among adolescents. Between 1990 and 2021, the percentage change in the age-standardised prevalence of obesity increased by 158·4% (123·9-197·4) among male adolescents and 185·9% (139·4-237·1) among female adolescents (15-24 years). For adults, the percentage change in prevalence of obesity was 123·6% (112·4-136·4) in males and 99·9% (88·8-111·1) in females. Forecast results suggest that if past trends and patterns continue, an additional 3·33 million children and young adolescents (aged 5-14 years), 3·41 million older adolescents (aged 15-24 years), and 41·4 million adults (aged ≥25 years) will have overweight or obesity by 2050. By 2050, the total number of children and adolescents with overweight and obesity will reach 43·1 million (37·2-47·4) and the total number of adults with overweight and obesity will reach 213 million (202-221). In 2050, in most states, a projected one in three adolescents (aged 15-24 years) and two in three adults (≥25 years) will have obesity. Although southern states, such as Oklahoma, Mississippi, Alabama, Arkansas, West Virginia, and Kentucky, are forecast to continue to have a high prevalence of obesity, the highest percentage changes from 2021 are projected in states such as Utah for adolescents and Colorado for adults.Existing policies have failed to address overweight and obesity. 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. Stronger governance is needed to support and implement a multifaceted whole-system approach to disrupt the structural drivers of overweight and obesity at both national and local 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.Bill & Melinda Gates Foundation.
ISSN:	01406736
DOI:	10.1016/s0140-6736(24)01548-4