Are US obesity rates increasing or decreasing?

In 1990, fewer than 20% of U.S. adults had obesity. Since then, this number has grown significantly, reaching roughly 40% or more depending on the data source. However, whether obesity rates will continue to grow is less clear.

According to a 2025 Gallup survey, the U.S. adult obesity rate declined to 37% in 2025 after reaching a record high of 39.9% in 2022. This is equal to roughly 7.6 million fewer adults with obesity in 2025 compared to 2022. The largest decrease in obesity rates was among adults ages 40 to 49 (4.3 percentage point decrease) and those ages 50 to 64 (5.0 percentage point decrease).

Similarly, a recent report from Trust for America's Health found that U.S. adult obesity rates decreased from 41.9% between 2017 and 2020 to 40.3% between 2021 and 2023. The number of states reporting adult obesity rates at or above 35% also declined. In 2024, 19 states had adult obesity rates at or above 35%, a decrease from 23 states in 2023.

Although almost all 50 states reported an increase in adult obesity rates between 2019 and 2024, several states, including Pennsylvania, North Carolina, and Texas, reported increases of less than 5%.

While these two studies suggest that U.S. obesity rates may be decreasing, other research predicts that rates will continue to increase.

In a new cross-sectional study published in JAMA, researchers found that the U.S. obesity rate increased from 19.3% in 1990 to 42.5% in 2022. Adult obesity rates were also projected to increase to 46.9% by 2035. This would mean that roughly 126 million U.S. adults ages 20 and older would have obesity by 2035.

In addition, no states were expected to have a decrease in obesity prevalence over the next 10 years. However, states with some of the highest obesity prevalence in certain groups were projected to see smaller increases, suggesting that obesity prevalence may be plateauing in some areas.

How will GLP-1s impact obesity?

As use of GLP-1 drugs for weight loss continues to grow, some research suggests that the medication could help decrease obesity rates going forward.

In the Gallup survey, researchers found that GLP-1 use for weight loss has increased significantly over the last few years. In Feb. 2024, 5.8% of adults said they were taking GLP-1s specifically for weight loss. This later increased to 12.4% in October 2025. Women continue to use GLP-1s for weight loss at a higher rate than men, which aligned with the obesity rate in women decreasing slightly more than in men (3.5 percentage points vs. 2.3 percentage points, respectively).

By age group, increased use of GLP-1s for weight loss was also associated with a greater decrease in the obesity rate. Adults ages 40 to 49 and those ages 50 to 64 used GLP-1s for weight loss the most and had the greatest decrease in obesity rate since 2022. 

However, it's not clear how impactful GLP-1 drugs will be in the long term, especially as many patients discontinue use of the medication over time, whether due to side effects, high costs, or other reasons.

In a study of over 120,000 people who were overweight or obese, 47% of those with Type 2 diabetes and almost 65% without diabetes stopped taking GLP-1s within a year. Older patients were also 20% to 30% more likely to discontinue the drugs than younger ones.

In another study published in The BMJ, researchers found that people who stopped taking weight management drugs, including GLP-1s, typically regained the weight they lost and reversed their cardiometabolic improvements within two years.

In general, patients were projected to return to their baseline weight by 1.5 to 1.7 years, with those who previously took semaglutide (Ozempic and Wegovy) and tirzepatide (Mounjaro and Zepbound) projected to gain back the weight fastest. This projected weight regain was roughly four times faster than someone who stopped behavioral programs, such as a diet.

Overall, Catherine Johnson, an author of the JAMA study from the Hans Rosling Center for Population Health, said obesity continues to be a major public health threat and that "[w]e will need public health strategies as well as increased access to clinical interventions to make a difference."

"Treatment needs to be multifactorial, addressing all of the many drivers of the development of obesity, along with medications or other clinical therapies that can act to reduce body weight," she recommended.

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, how they could help (or hurt) health systems' finances, and what doctors really think about the medication. 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.