Nationwide epidemic

Individuals gain excess weight when they consume more energy each day than their bodies need to support their physical activity and basic bodily functions. Adults and children in the U.S. currently consume, on average, more calories each day than they actually need to maintain a healthy weight.1 Consuming small amounts of extra calories on a daily level promotes weight gain over time. The obesity and severe obesity epidemics are continuing to grow, unless we do something to make a difference.2

See where obesity is headed in the U.S. & in each state

Among children

The current childhood obesity epidemic has been well-documented, but more research is needed on the long-term risks for children. The CHOICES team predicts that, if nothing is done to change current trends, 57% of today’s children will have obesity at age 35. In addition, we found that excess weight in childhood is highly predictive of adult obesity. This is especially true for children with severe obesity, even at very young ages. We also estimated that 79% of two year-olds with severe obesity will still have obesity by the time they are 35 years old, as will 94% of 19 year-olds with severe obesity. Racial and ethnic disparities in obesity are already present by the age of two and persist into adulthood.3

A framework for action

Translating the obesity epidemic into age-specific energy gaps makes it possible to work with a range of key partners across multiple settings where children spend their lives, in order to identify policy and program changes that can cumulatively close the energy gap. The CHOICES team is working to identify the most cost-effective policy and programmatic strategies that can contribute to eliminating the energy gap and reversing the childhood obesity epidemic. Our methods include:

Key partner consultation

Working with key partners & researchers to identify the most promising programs & policies for evaluation

U.S. population model

Building a computer model of the U.S. population & projecting Body Mass Index (BMI) changes & health outcomes over time

See details about the model parameters

Systematic reviews & meta-analyses

Synthesizing scientific literature to estimate the likely effects of promising obesity prevention interventions on BMI & physical activity

Cost-effectiveness analysis

Integrating information on the economic costs & health effects of interventions, utilizing a structured & transparent process

Learn more about our modeled outcomes here

Health equity lens

Projecting the impact of effective intervention strategies on population health and health equity

Learn more about our methods for projecting health equity impacts


      1. Hall KD, Sacks G, Chandramohan D, Chow CC, Wang YC, Gortmaker SL, Swinburn BA. Quantification of the effect of energy imbalance on bodyweight. Lancet. 2011 Aug 27;378(9793):826-37. doi: 10.1016/S0140-6736(11)60812-X
      2. Ward ZJ, Bleich SN, Cradock AL, Barrett JL, Giles CM, Flax CN, Long MW, Gortmaker SL. Projected U.S. State-Level Prevalence of Adult Obesity and Severe Obesity. N Engl J Med. 2019;381:2440-50. doi: 10.1056/NEJMsa1909301
      3. Ward Z, Long M, Resch S, Giles C, Cradock A, Gortmaker S. Simulation of Growth Trajectories of Childhood Obesity into Adulthood. N Engl J Med. 2017 Nov 30;377(22):2145-2153. doi: 10.1056/NEJMoa1703860

Last updated:  March 2, 2023