State‐level prevalence of chronic conditions co‐occurring with obesity among US adults

Aims Recent estimates of chronic conditions (CCs) among adults with obesity are lacking. This study analysed state‐representative data to assess the prevalence of CCs that co‐occur with obesity. Materials and Methods We used 2021–2022 Behavioural Risk Factor Surveillance System data to assess the age‐standardised prevalence of nine CCs among adults with obesity (body mass index ≥30 kg/m 2 ) based on self‐reported weight and height. We examined prevalence overall and by key sociodemographic factors, obesity class, and states and territories, using t ‐tests for subgroup comparisons. Results The most prevalent CCs with obesity were hypertension (42.2%), high cholesterol (37.4%), arthritis (30.2%), and depression (26.4%), followed by diabetes (16.7%), asthma (13.4%), heart disease/stroke (9.2%), cancer (6.9%), and kidney disease (3.9%). Prevalence generally increased with age except for depression and asthma, which were lower among those 65 and older compared to those aged 18–44 ( p < 0.001). There was an inverse relationship between CCs prevalence and household income. Significant differences were observed across sex, race/ethnicity, education, employment status, healthcare access, and obesity class. Across states and territories, hypertension was the most prevalent CC, ranging from 31.8% in the Virgin Islands (VI) to 51.6% in Alabama, followed by high cholesterol (28.1% in VI to 44.9% in Guam). Other CCs also showed significant variation by state and territory. Conclusions Among US adults with obesity, the age‐standardised prevalence of CCs varies significantly across population subgroups and states. Awareness of these differences can help clinicians, public health officials, and decision‐makers address chronic disease prevention and obesity management for populations at higher risk.