Introduction: Data from the Brazilian surveillance system (Vigitel 2022) show that cardiovascular diseases account for about 28% of annual deaths in Brazil, while obesity (OB) impacts over 22% of the adult population. The relationship between atherosclerosis (AS) and OB is complex and bidirectional, with each condition exacerbating the other. Therefore, understanding their distribution and interaction in Brazil over time is essential to developing effective prevention strategies.

Methods: A time series analysis was performed based on public and secondary data obtained from the Datasus platform. The analysis examined hospital admissions for OB and AS and their distribution across Brazilian macroregions. Data were analyzed in ten-year intervals to compare the decades 2004–2013 and 2014–2023, aiming to identify temporal and regional trends.

Results: Between 2004 and 2013, Brazil recorded 62,511 hospitalizations for OB and 96,935 for AS. From 2014 to 2023, OB admissions rose to 107,272, reflecting a 71.60% increase compared to the previous decade. For AS, 232,524 hospitalizations were reported, indicating a 139.9% increase. Geographically, the South and Southeast regions accounted for most of these admissions in the earlier period, representing 81.88% of OB and 72.76% of AS cases. This pattern persisted in the subsequent decade, with these regions comprising 87.14% of OB and 68.20% of AS hospitalizations.

Conclusions: The increase in hospitalizations related to OB and AS over the past 20 years reflects not only a shift in the health profile of the Brazilian population but also the influence of socioeconomic and behavioral factors, such as greater consumption of ultra-processed foods and a sedentary lifestyle. The concentration of cases in highly industrialized regions, such as the South and Southeast, underscores the need for public policies to promote healthy habits and address regional health disparities.