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US child, teen obesity rates reach record high while adult trends appear to slow, CDC report finds

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Person on scale (bymuratdeniz/Getty Images)

(NEW YORK) — U.S. childhood and teen obesity rates have reached record-highs while adult obesity rates may be slowing, according to two new reports published early Wednesday by the Centers for Disease Control and Prevention (CDC).

Researchers used measured heights and weights from the National Health and Nutrition Examination Survey (NHANES) — run by the CDC’s National Center for Health Statistics — to track trends over more than six decades.

In the first report, the team found that, in the most recent survey conducted between August 2021 and August 2023, 40.3% of adults aged 20 and older were found to be obese, including 9.7% with severe obesity and another 31.7% classified as overweight. 

By comparison, for the survey conducted between 1988 and 1994, 22.9% adults aged 20 and older were found to be obese including 2.8% with severe obesity and 33.1% classified as overweight.

However, some of the newest estimates suggest the rapid rise seen in earlier decades may be slowing slightly.

In the 2017-2018 survey, 42.4% of adults were classified as obese, which is the highest figure ever recorded. The decrease between the two most recent surveys could be indicative of a downward trend. Dr. John Brownstein, an epidemiologist and chief innovation officer at Boston Children’s Hospital and an ABC News contributor, noted that it aligns with observations of electronic medical record data.

“So, we’re seeing, for the first time in decades, that there’s like a leveling off and even maybe a slight decrease and I think this is like challenging a major shift from the long-held expectation that obesity would just be climbing year after year,” he said.

According to Brownstein, the decrease is likely due to many factors including public health policies and education about healthier lifestyles as well as medications such as GLP-1s.

GLP-1s, or glucagon-like peptide-1 receptor agonists, mimic the GLP-1 hormone that is produced in the gut after eating.

It can help produce more insulin, which reduces blood sugar and therefore helps control Type 2 diabetes. It can also interact with the brain and signal a person to feel full, which — when coupled with diet and exercise — can help reduce weight in those who are overweight or obese.

Many GLP-1s have become household names, including Ozempic, Wegovy, Mounjaro, Zepbound and Trulicity.

“I do think the advent of the GLP-1s are absolutely playing a role,” Brownstein said. “At that point in 2023, they weren’t as widespread as they are today. So, we expect that these factors could play even more significant role in more recent times.”

Dr. Justin Ryder, an associate professor of surgery and pediatrics at Northwestern Feinberg School of Medicine, said he’s cautiously optimistic about the slight decrease.

However, he added that it remains to be seen whether this is a blip or if the decrease is indicative of a longer-term trend.

“We’ve seen dips in the past and typically, when they do, in the next reporting period it goes right back up,” Ryder told ABC News. “And that’s because of how the sampling is done. This is a random sample of U.S. adults.”

He noted that the random sampling makes it difficult to draw firm conclusions.

“Could it just be the people who were sampled, or is it real?” he said. “And I think we won’t know that until we have another set or a larger set of data over either the same sampling period or a couple more years from now.”

Meanwhile, a second report found that more than one in five U.S. children and teenagers have obesity, which is the highest figure ever recorded.

The survey conducted between August 2021 and August 2023 found 21.1% of U.S. children and teenagers between ages 2 and 19 have obesity, up from 5.2% during the 1971-1974 survey.

Additionally, 7% of children live with severe obesity, an increase from the 1% seen 50 years ago, according to the report.

“This is exceptionally concerning,” Dr. David Ludwig, co-director of the New Balance Foundation Obesity Prevention Center at Boston Children’s Hospital and professor of nutrition at Harvard School of Public Health, told ABC News.

He added that in the 1970s, “children were certainly recognized [as obese] but it was the rare child, one in 20. And now we’re looking at one in five children with obesity.”

Ludwig said it had seemed for a short period of time that the prevalence of obesity was decreasing at least among 2-to-5-year-olds when rates declined from 12.1% in 2009-2010 to 9.4% in 2013-2014.

At the time, he viewed it as a “glimmer of hope” — but rates increased again and now sit at 14.9% for this age group.

“We saw that dip and we all got excited thinking that we were beginning to turn the tide,” Ludwig said. “In retrospect, that was more of a statistical aberration, more of mirage than a true glimmer of hope because the trend overall has continued upward.”

To reverse the trends among children, Ryder said the 2-to-5-year-old group will need lifestyle modifications such as healthier eating. The 6-to-11-year-old group will need similar methods although some medications are available, he said.

For children above age 12, Ryder said medications and bariatric surgery are options.

Nearly 23% of children ages 12 to 19 were considered obese in the most recent survey. Ryder said that means they meet the guidelines for intensive treatment, whether that’s lifestyle adjustments or in combination with medications or surgery.

“I think the only way that we’re going to see a downward trend in that number is if we take that adolescent group of 12- to 19-year-olds and actually start to apply the clinical practice guidelines and treat those kids seriously, offering them medications,” he said.

Ishani D. Premaratne, MD, is an integrated plastic & reconstructive surgery resident and member of the ABC News Medical Unit.

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