A new large-scale study has projected a troubling future for public health in the United States: by 2035, nearly half of all American adults, about 126 million people, could be living with obesity.
Published in the medical journal JAMA, the research underscores a steady rise in obesity rates over the past three decades and points to widening disparities across states, age groups, and racial and ethnic communities.
Using data from more than 11 million participants collected through nationally representative surveys, including federal health surveillance systems and independent polling, researchers traced obesity trends from 1990 to 2022 and developed projections through 2035.
In 1990, approximately 19.3% of U.S. adults were classified as obese.
That figure more than doubled to 42.5% by 2022 and is expected to reach 46.9% within the next decade.
The studyβs authors describe the trend as a reflection of complex social and economic forces rather than individual behavior alone.
Obesity prevalence is projected to increase in every state, with the steepest rises expected in parts of the Midwest and South.
These regional patterns mirror long-standing differences in access to healthcare, nutritious food, and safe spaces for physical activity.
Racial and ethnic disparities remain particularly stark. By 2035, the study estimates that about 60% of Black women and more than half of Latino women nationwide could be living with obesity, compared with roughly 47% of white women.
Among men, projections suggest nearly half of Latino men could be affected, compared with about 45% of white men and just over 40% of Black men.
Researchers say these differences are closely tied to structural inequalities, including food insecurity, economic instability, and unequal access to preventive healthcare.
California offers a revealing case study. While the state is projected to see slower overall growth in obesity rates than the national average, disparities within its population are expected to persist.
By 2035, obesity prevalence among Black and Latino women in California could approach 60%, compared with around 40% among white women.
Latino men in the state may exceed a 50% obesity rate, far higher than their white counterparts.
Health experts attribute these gaps to a combination of environmental and policy factors. Urban design that prioritizes car travel over walking, limited availability of affordable healthy foods in some neighborhoods, and uneven access to obesity treatment all play a role.
Recent changes to public insurance programs have further complicated the issue, with some low-income residents losing coverage for obesity-related medications and care.
Despite these challenges, Californiaβs relatively slower growth in obesity rates suggests that public policy can make a difference.
Over the past two decades, the state has implemented nutrition standards for school meals, required calorie labeling on restaurant menus, and supported local soda taxes in cities such as Berkeley and Oakland.
Public health researchers credit these measures with helping to curb excessive consumption of sugar-sweetened beverages and improving nutritional awareness.
Looking ahead, experts say sustained investment is critical.
Proposed strategies include strengthening school nutrition programs, expanding transportation infrastructure that encourages walking and cycling, increasing economic disincentives for unhealthy food products, and addressing βfood desertsβ by incentivizing grocery stores and farmersβ markets in underserved areas.
Targeted interventions aimed at Black and Latino communities, identified as the most affected groups, are also seen as essential.
At the same time, some health professionals caution against overreliance on body mass index (BMI), the measurement used in the study to define obesity.
BMI is calculated using height and weight and does not directly measure body fat or account for differences in body composition.
Critics argue that this method may not accurately reflect individual health status and can vary in accuracy across demographic groups.
The studyβs authors acknowledged this limitation, along with potential biases stemming from self-reported data and limited information in certain geographic areas.
Even with these caveats, the overall trajectory is clear: obesity rates in the United States are continuing to rise, with serious implications for healthcare costs, chronic disease prevalence, and overall quality of life.
Public health advocates stress that reversing this trend will require coordinated action across healthcare systems, government agencies, and communities.
As the nation faces the prospect of nearly half its adult population living with obesity by 2035, the study serves as a stark reminder that the issue extends beyond individual choices.
It reflects broader social structures, and addressing it will demand equally broad, systemic solutions.
