Every year, during the third week of January, communities observe National Healthy Weight Week, an initiative that, since 1994, invites reflection on lifestyle habits.

This 2026, from January 18-24, this commemoration takes on special relevance in Puerto Rico, where figures on overweight and obesity confront us with a reality we cannot ignore.

When we discuss overweight and obesity, we refer to conditions characterized by an increase in the size and number of fat cells. Body Mass Index, or BMI, is the tool we use to assess body fat based on a person’s weight and height. But beyond technical definitions, what these figures really tell us is that approximately 7 out of 10 Puerto Rican adults live with overweight or obesity.

Data from the Puerto Rico Behavioral Risk Factor Surveillance System 2024 are conclusive: 72.4% of adults 18 years and older on our island are overweight or obese. We are talking about nearly 1,866,525 people. This prevalence ranks us among the highest in the Americas and underscores the urgent need for coordinated prevention, care, and community-based health initiatives.

But these numbers do not affect everyone in the same way.

People aged 45-54 have the highest prevalence, at 82.9%. Those who have suffered a stroke have a prevalence of 84.6%, while people with asthma reach 77.7%, and those with hypertension 76.6%. Disparities are also observed by educational and economic status: 73.0% of individuals with education at or below high school, and 78.6% of those with incomes between $15,000 and $24,999 annually, live with this condition.

Obesity does not exist in isolation. Like a domino effect, it triggers a cycle of diseases that affects the entire body. In Puerto Rico, 17.8% of the population live with diabetes and 7.9% with heart disease. Hypertension has reached epidemic proportions, affecting 44.2% of adults, while high cholesterol impacts 43.2%. People who are overweight or obese have a higher risk of suffering strokes, and obesity has been identified as one of the main modifiable risk factors for cancer.

Beyond obesity itself, there are factors that increase and perpetuate it. Physical inactivity is the most concerning factor: 42.8% of our population does not engage in the recommended level of physical activity. Tobacco use affects 8.5% of the population, with higher prevalence among people 45 to 54 years old and men. Excessive alcohol use represents 9.4% prevalence, being more common in adults between 35 and 44 years.

Faced with this reality, Puerto Rico has developed multisectoral strategies through complementary initiatives. The Chronic Disease Action Plan 2026-2030 establishes the epidemiological framework for the next decade. This plan identifies at-risk populations, quantifies comorbidities, analyzes modifiable risk factors, and establishes a baseline to monitor our progress. The Puerto Rico Food and Nutrition Commission, in collaboration with the Pan American Health Organization, developed the Obesity Prevention Action Plan 2023-2025. This plan articulates five strategic lines: strengthens primary care and promotes breastfeeding from the early stages of life; seeks 90% of schools to comply with the Local Wellness Policy, increasing participation in school food programs; promotes fiscal policies on sugary drinks and regulates advertising of unhealthy foods aimed at minors; expands family farmer markets and bike path projects; and develops the Food, Nutrition, and Physical Activity Surveillance System of Puerto Rico.

In December 2025, Puerto Rico Health Insurance Administration (ASES, for its Spanish acronym) announced the launch of the Obesity Prevention and Control Program, which took effect in January 2026. This program replaces the special coverage that allowed limited access to GLP-1 medications for obesity management in the Vital Plan. The program integrates education and promotion of healthy lifestyles, early detection and clinical follow-up, provider guidelines, community resources, and cost-effective initiatives aligned with federal recommendations. It is important to note that GLP-1 medications remain available for the management of type 2 diabetes on the Vital Plan medication list.

New Year’s Resolutions

Is improving your health among your resolutions for 2026?

The American Heart Association’s Life’s Essential 8 can help you turn those goals into reality. Although developed for cardiovascular health, these steps also benefit overall health, including weight management, diabetes, and lung health.

1. 1. Eat Better: Healthy eating means consuming more vegetables, fruits, whole grains, and lean proteins, while reducing consumption of processed foods and sugary drinks. The MyPlate model offers a simple visual guide for balanced portions.
   2. Be More Active: Children and adolescents need at least 60 minutes of daily physical activity. Adults benefit from 150 to 300 minutes of weekly moderate-intensity activity, complemented by muscle-strengthening exercises twice per week.
   3. Quit Tobacco: 8.5% of our population uses tobacco. Quitting smoking is one of the most important decisions you can make for your health.
   4. Get Healthy Sleep: Healthy sleep is essential for body recovery and weight control. Establish a regular sleep routine.
   5. Manage Weight: With 72.4% of adults living with overweight or obesity, weight management is essential. Small sustainable changes generate great results.
   6. Control Cholesterol: 43.2% of the population has high cholesterol. Monitoring and controlling these levels can protect your heart.
   7. Manage Blood Sugar: With 17.8% diabetes prevalence, controlling blood sugar prevents serious complications.
   8. Control Blood Pressure: Hypertension affects 44.2% of our population. Regular control is essential to prevent cardiovascular diseases.

Health professionals have a fundamental role. Integrating BMI assessment, waist circumference measurement, and nutritional counseling into routine consultations should be the norm. Screening should include hypertension, diabetes, high cholesterol, physical inactivity, tobacco, and alcohol use. Promoting exclusive breastfeeding during the first six months and referring to community programs when appropriate are essential actions. The Guide to Healthy Eating and Physical Activity for Puerto Rico 2021-2026 is available as a practical resource.

The Alliance's Contribution to Healthy Weight Research to Improve Health and Well-Being

For researchers, the field is open. Translational research should focus on culturally appropriate interventions, on studying the drivers of obesity, and on developing strategies to reduce physical inactivity. Comorbidity studies should investigate the relationship between obesity and prevalent chronic diseases, assess the economic impact on the health system, and examine disparities across groups with higher prevalence.

The beginning of a new year is the perfect time to make decisions that transform life. With 7 out of 10 adults living with overweight or obesity and 42.8% physically inactive, Puerto Rico needs an urgent response. The Alliance for Clinical and Translational Research is committed to strengthening research to improve health outcomes on our Island. During National Healthy Weight Week and throughout 2026, let us prioritize health. We call on individuals and families to adopt healthy eating habits and increase physical activity. We call on health professionals to integrate weight assessment and counseling in their clinical practice. We invite researchers to contribute studies that inform the development of effective policies. And we encourage community and government leaders to create environments that facilitate healthy choices.

Together we can achieve a healthier Puerto Rico, one family at a time, one community at a time, one resolution at a time.

References

American Heart Association. (n.d.). Life’s Essential 8. https://www.heart.org/en/healthy-living/healthy-lifestyle/lifes-essential-8

Puerto Rico Department of Health. (2025). Chronic Disease Action Plan in Puerto Rico 2026-2030.

Puerto Rico Food and Nutrition Commission. (2021). Guide to Healthy Eating and Physical Activity for Puerto Rico 2021-2026. Puerto Rico Department of Health. https://alimentacionynutricionpr.org

Puerto Rico Food and Nutrition Commission. (2023). Obesity Prevention Action Plan in Puerto Rico 2023-2025. Puerto Rico Department of Health. https://www.salud.pr.gov/CMS/DOWNLOAD/2826