US obesity trends

For the report, TFAH analyzed data from CDC's National Health and Nutrition Examination Survey (NHANES) and the Behavioral Risk Factor Surveillance System (BRFSS).

Based on the latest NHANES, which covered data from 2021 to 2023, the obesity rate for adults in the United States was 40.3%, a 1.6 percentage point decrease from the rate between 2017 and 2020. Among children, the nationwide obesity rate was 21.1% from 2021 to 2023, a slight increase from 19.7% from 2017 to 2020. 

Overall obesity rates were largely similarly between men and women at 39.2% and 41.3%, respectively. However, adults ages 40 to 59 had higher obesity rates (46.4%) compared to adults ages 20 to 39 (35.5%) and adults ages 60 and older (38.9%).

In 2024, 19 states had adult obesity rates at or above 35%, a decrease from 23 states in 2023. According to the report, this is the first time since 2013 that there has been a decrease in states with a 35%+ obesity rate. However, it is also the first time since 2011 that there has been no state with an adult obesity rate below 25%.

Between 2019 and 2024, nearly all 50 states reported an increase in adult obesity rates, with Oregon seeing the highest increase at 15% or more. However, several states, including Pennsylvania, North Carolina, and Texas, reported increases of less than 5%. 

Commentary

Currently, it's not clear what may be contributing to the slight improvements in U.S. obesity rates, but Aviva Musicus, a science director at the Center for Science in the Public Interest, suggested that increased support for nutrition assistance programs during the COVID-19 pandemic, as well as increased use of GLP-1 weight-loss medications, may be potential factors.

According to a recent study, two common GLP-1 medications, semaglutide and tirzepatide, could help prevent 32,100 and 45,600 cases of obesity per 100,000 individuals, respectively, over a lifetime. The GLP-1 drugs could also prevent thousands of cardiovascular events and roughly 20,000 cases of diabetes.

J. Nadine Gracia, president and CEO of TFAH, said that while the decline in the number of states with a 35% or higher obesity rate was positive, "it's too soon to call it a trend."

Gracia also noted that recent cuts to federal funding, healthy agency staff, and public health programs could put the current potential progress at risk.

The One Big Beautiful Bill Act includes over $900 billion in cuts to Medicaid, as well as $186 billion in cuts to the Supplemental Nutrition Assistance Program. Thousands of HHS workers have also been laid off in recent months, including during the current government shutdown. Some obesity-related programs that have been negatively impacted by these changes or are at risk include CDC's Division of Population Health, CDC's Racial and Ethnic Approaches to Community Health Program, and NIH's National Diabetes Prevention Program Outcomes Study.

"Structural barriers to healthy eating and physical activity need continued policy attention and investment," Gracia said. "It is vital that government and other sectors invest in – not cut – proven programs that support good nutrition and physical activity and ensure they reach all communities."

Advisory Board's weight-related resources

To help you address the growing use of weight management drugs, Advisory Board offers several resources:

This expert insight outlines the five biggest questions about weight management drugs and their answers. Similarly, this expert insight addresses what headlines get wrong about weight management drugs and what healthcare leaders should know instead.

Radio Advisory's Rachel Woods has also covered GLP-1 drugs on the podcast, discussing the potential future of these drugs and how they could help — or hurt — health systems' finances. Other useful resources include this expert insight on the five catalysts that will impact the future of obesity care and this research on four key elements of comprehensive obesity care.

Our weight management and obesity care resource library can also help leaders understand the current care landscape, manage innovations, and prepare for transformations in care.