Understanding patterns of obesity and weight-loss efforts in U.S. 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 analyzed obesity trends among 85,588 U.S. high school students (grades nine to 12) from 2013 to 2023 using the Youth Risk Behavior Survey, the most recent data available from the U.S. 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, published in the Ochsner Journal, reveal a concerning rise in adolescent obesity over the past decade. Overall obesity among U.S. 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 10th and 12th graders, signaling a troubling gap in healthy behaviors 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.
“In the U.S. today, adolescent obesity rates continue to rise while weight-loss attempts have steadily declined,” said Charles H. Hennekens, M.D., Dr.PH, 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. “These findings highlight increasing clinical and public health challenges and illustrate the urgent need for targeted interventions.”
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.
“While more research is needed, these data have implications for clinicians and public health practitioners,” said Hennekens. “These patterns underscore the need for clinical and public health strategies to address the challenges in U.S. adolescents to prevent future morbidity and mortality.”
The researchers emphasize school programs 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 program tailored to males’ higher obesity rates and females’ declining weight-loss efforts.
Study co-authors are Jack Yang, first author; Emily Krill and Cheila Llorens, FAU College of Medicine medical students; Alan Kunz-Lomelin, Ph.D., an assistant professor in the Phyllis and Harvey Sandler School of Social Work within FAU’s College of Social Work and Criminal Justice; and Panagiota Kitsantas, Ph.D., professor of epidemiology and biostatistics at George Mason University, and former professor and chair of population health at FAU’s College of Medicine.
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About the Charles E. Schmidt College of Medicine:
Florida Atlantic University’s Charles E. Schmidt College of Medicine is one of approximately 159 accredited medical schools in the U.S. The college was launched in 2010, when the Florida Board of Governors made a landmark decision authorizing FAU to award the M.D. degree. After receiving approval from the Florida legislature and the governor, it became the 134th allopathic medical school in North America. With more than 170 full and part-time faculty and more than 1,400 affiliate faculty, the college matriculates 80 medical students each year and has been nationally recognized for its innovative curriculum. The college offers M.S. (thesis and non-thesis) and Ph.D. programs in biomedical science, along with a certificate in genomics and precision medicine. Taught by top researchers, the curriculum combines innovative coursework with hands-on learning, preparing graduates for careers in medicine, research, industry, and academia. To further Florida Atlantic’s commitment to increase much needed medical residency positions in Palm Beach County and to ensure that the region will continue to have an adequate and well-trained physician workforce, the FAU Charles E. Schmidt College of Medicine Consortium for Graduate Medical Education (GME) was formed in fall 2011 with five leading hospitals in Palm Beach County. The consortium currently has five Accreditation Council for Graduate Medical Education (ACGME) accredited residencies including internal medicine, surgery, emergency medicine, psychiatry, and neurology, and five fellowships in cardiology, hospice and palliative care, geriatrics, vascular surgery, and pulmonary disease and critical care medicine. The college also manages the Florida Atlantic University Medical Group, offering comprehensive primary care, and the Marcus Institute of Integrative Health specializes in integrative pain management, precision therapies, and mental health.
About Florida Atlantic University:
Florida Atlantic University serves more than 32,000 undergraduate and graduate students across six campuses along Florida’s Southeast coast. Recognized as one of only 13 institutions nationwide to achieve three Carnegie Foundation designations - R1: Very High Research Spending and Doctorate Production,” “Opportunity College and University,” and Carnegie Community Engagement Classification - FAU stands at the intersection of academic excellence and social mobility. Ranked among the Top 100 Public Universities by U.S. News & World Report, FAU is also nationally recognized as a Top 25 Best-In-Class College and cited by Washington Monthly as “one of the country’s most effective engines of upward mobility.” To learn more, visit www.fau.edu.
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