Burden of Obesity Among Adults in the United States: A Population Health Study

Background. As a growing public health concern, obesity places a significant burden on both healthcare systems and society. While its association with chronic diseases is well documented, less is known about its broader impact on health-related quality of life (HRQoL) in the general population. This study investigated the clinical and humanistic burden of obesity among U.S. adults using nationally representative data. Methods. This cross-sectional study utilized data from the 2019-2022 Medical Expenditure Panel Survey (MEPS). Adults aged ≥18 years with complete BMI and HRQoL information were eligible for inclusion. Based on the World Health Organization BMI criteria, participants were categorized as underweight, normal weight, overweight, or obese. Associations between obesity, sociodemographic factors, chronic diseases, and HRQoL were examined using descriptive analyses, chi-square tests, one-way ANOVA, and multinomial logistic regression. Results. The study included 9311 adults, of whom 35.0% had obesity, 31.0% were overweight, 31.9% had normal weight, and 1.8% were underweight. Health-related quality of life differed significantly across BMI categories. Participants with obesity had the lowest mean Physical Component Summary (PCS) score (48.84 ± 0.23) compared with those with normal weight (54.28 ± 0.19; p < 0.0001), as well as lower mean Mental Component Summary (MCS) scores (49.77 ± 0.23 vs. 51.37 ± 0.23; p < 0.0001). After adjustment for potential confounders, higher PCS scores were associated with reduced odds of obesity (adjusted odds ratio [AOR] = 0.96, 95% confidence interval [CI]: 0.95-0.97). A higher odds of obesity was observed among those with diabetes (AOR = 3.43, 95% CI = 2.48-4.77), hypertension (AOR = 2.52, 95% CI = 2.07-3.06), osteoarthritis (AOR = 1.43, 95% CI = 1.01-2.02), depression (AOR = 1.45, 95% CI = 1.11-1.88), and anxiety (AOR = 1.40, 95% CI = 1.11-1.76). Conclusions. More than one-third of participants had obesity, which was associated with substantial clinical and humanistic burden. Individuals with obesity experienced significantly poorer physical-health-related quality of life and a greater burden of chronic physical and mental health conditions. These results underscore the need for integrated interventions aimed at preventing and managing obesity while improving health-related quality of life.