In a new public health study, researchers have forecast that 42% of the US population could be obese by 2030. The findings suggest the US health care system could be burdened with 32 million more obese people within two decades. Action is needed to keep rates from increasing further, according to the research from Duke University, RTI International, and the Centers for Disease Control and Prevention (CDC).

The study, based on data from the Behavioral Risk Factor Surveillance System and state-level data from the Bureau of Labor Statistics and other organizations, was published in the American Journal of Preventive Medicine on May 7.

The study also forecasts an increase in the number of individuals with severe obesity, with rates rising to 11% by 2030. Severe obesity is defined as a body mass index over 40 or roughly 100 pounds overweight.

Severely obese individuals are at highest risk for the health conditions caused by excess weight, resulting in substantially greater medical expenditures and rates of absenteeism.