Obesity and severe obesity prevalence among youth aged 2-17 in Minnesota, 2020-2025.

Objective: Existing sources for monitoring pediatric obesity prevalence are limited by delayed data availability and insufficient granularity for small-area estimates. We used data from the Minnesota Electronic Health Record Consortium's Health Trends Across Communities (HTAC) project to estimate obesity and severe obesity prevalence among Minnesota youth. Methods: In serial cross-sectional analyses, HTAC data were obtained from 11 health systems in Minnesota. Patients aged 2-17 years with a valid body mass index (BMI) measurement at a participating health system from 2020 to 2025 were included. Obesity was defined as BMI ≥95th percentile for age and sex, and severe obesity as BMI ≥120% of the 95th percentile. Results are reported as prevalence estimates stratified by sociodemographic characteristics. Results: Among 486,744 youth with BMI measured in 2025, 80,360 (16.5%, 95% CI: 16.4, 16.6) had obesity and 25,776 (5.3%, 95% CI: 5.2, 5.4) had severe obesity. Prevalence was higher among youth 12-17 years, males, and youth who were American Indian, Black, or Hispanic, and among those living in small towns or rural communities and in areas of high social vulnerability. Conclusions: HTAC data provide timely pediatric obesity and severe obesity prevalence estimates in Minnesota and may serve as a model for other regions.