We aim to examine mortality trends and disparities associated with obesity and diseases of the nervous system among adults aged ≥ 25 years in the US (1999-2023).

We analyzed CDC WONDER mortality data (1999–2023) by calculating crude and age-adjusted mortality rates (CMRs and AAMRs per 100,000) associated with Obesity (ICD-10 code: E66) and Diseases of the Nervous System (ICD-10 code: G00–G99). Employing Joinpoint Regression (v5.4.0), we calculated annual percent changes (APCs) with 95% confidence intervals (p ≤ 0.05), categorized by demographic and geographical subgroups.

A total of 122,976 deaths were attributed to Obesity and Diseases of the Nervous System (1999-2023). Overall, the AAMRs increased from 0.7 in 1999 to 3.6 in 2023 [AAPC: 6.29; p<0.05], especially between the age 75 to 84 years (CMR: 4.73). The AAMR showed a notable spike between 1999 to 2015 [APC: 7.07; p<0.05] and 2018 and 2021 [APC: 21.1; p<0.05], followed by a notable decline until 2023 [APC: -10.9; p<0.05]. Males had higher AAMRs compared to females (2.44 vs 1.79). Non-Hispanic (NH) Blacks (2.96) dominated in racial AAMRs stratification, followed by NH American Indians (2.63), NH Whites (2.08), Hispanics (1.33), and the NH Asians (0.455) being the last. The Western region had the highest AAMRs (28.44), with non-metropolitan areas exhibiting higher AAMRs compared to Metropolitan areas (2.29 vs 1.75). State-wise AAMRs ranged between Connecticut and Oregon (1.1 to 3.9).