Overweight describes adolescents above a healthy weight for their height, while obesity denotes a greater excess. Credit: Florida Atlantic University.

Researchers have found a concerning rise in US teen obesity over a decade, where one in five is putting their long-term health at serious risk.

Obesity in adolescence leads to many deleterious medical conditions including diabetes, high blood pressure, sleep apnoea, and mental health struggles with low self-esteem and depression.  

Understanding patterns of obesity and weight-loss efforts in US adolescents is critical for shaping effective clinical and public health interventions. Yet, data remain sparse on whether and how adolescents attempt to lose weight.

To explore these issues, researchers from Florida Atlantic University’s Charles E Schmidt College of Medicine analysed obesity trends among 85,588 US high school students (grades nine to 12) from 2013 to 2023 using the Youth Risk Behavior Survey, the most recent data available from the US Centers for Disease Control and Prevention.

They examined patterns of overweight, obesity and weight-loss attempts, both overall as well as in subgroups of gender, grade level, race and ethnicity.

Overweight describes adolescents above a healthy weight for their height, while obesity denotes a greater excess. Both adolescent overweight and obesity have been linked to higher health risks in the short and long term.

Results of the study reveal a concerning rise in adolescent obesity over the past decade.

Climbing

Overall obesity among US high school students climbed from 13.7% in 2013 to 15.9% in 2023, peaking at 16.3% in 2021.

Black and Hispanic adolescents consistently had the highest rates, with peaks of 21.2% and 20.2%, respectively, while Asian teens had the lowest, though their prevalence nearly doubled from 5.6% to 11%.

In contrast, the proportion of students classified as overweight declined from 16.6% to 14.7%, driven largely by decreases among male students.

Female students were more likely than their male counterparts to attempt weight loss, but overall, fewer adolescents reported trying to lose weight in 2023 (44.5%) than in 2013 (47.7%).

Weight-loss efforts dropped most sharply among tenth and 12th graders, signalling a troubling gap in healthy behaviours as teens get older.

Male obesity rates rose steadily to a peak of 18.9% in 2019 before slightly declining to 18.2% in 2023, while female rates fluctuated, with lows of 10.8% and highs of 13.7%.

Among grades, 11th graders had the highest obesity prevalence in 2023 at 17.3%, followed by ninth graders, whereas ninth and 12th graders had the lowest rates of overweight.

Charles H Hennekens, MD, DrPH, FACPM, co-author and the First Sir Richard Doll Professor of Medicine and Preventive Medicine and senior academic advisor in FAU’s College of Medicine, said: “In the US today, adolescent obesity rates continue to rise while weight-loss attempts have steadily declined.

“These findings highlight increasing clinical and public health challenges and illustrate the urgent need for targeted interventions.”

Striking decline

Taken together, the data depict a generation where higher body weights are becoming more common, even as motivation to manage weight – particularly among female adolescents – is declining.

While female adolescents still report weight-loss attempts at higher rates than their male counterparts, these efforts have dropped compared with previous years.

This decline is striking given that adolescent girls often experience greater body dissatisfaction and a desire to be thinner, pressures likely amplified by social comparisons on platforms like social media.

Hennekens said: “While more research is needed, these data have implications for clinicians and public health practitioners.

“These patterns underscore the need for clinical and public health strategies to address the challenges in US adolescents to prevent future morbidity and mortality.”

The researchers emphasise school programmes that boost nutrition knowledge, body image and mental health to help teens build lasting healthy habits.

Public health policies should also target motivation, with initiatives like the CDC’s State Physical Activity and Nutrition programme tailored to males’ higher obesity rates and females’ declining weight-loss efforts.

The study is published in the Ochsner Journal.