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Background Overweight, obesity, and central obesity have become significant public health issues globally, affecting the well-being of residents. Analyzing the prevalence trends of overweight, obesity, and central obesity among residents in Shanxi Province can provide valuable scientific insights for the prevention and control of related diseases. Objective To analyze the prevalence and trends of overweight, obesity, and central obesity among adults aged 20 and above in Shanxi Province between 2010 and 2018. Methods The survey data of adults aged 20 and above in Shanxi Province were collected during four rounds of the China Chronic Disease Surveillance project from August 2010 to November 2018 (in 2010, 2013, 2015, and 2018) to calculate the rates of overweight, obesity, and central obesity among adults aged 20 and above in different years, and analyze the prevalence trends of overweight, obesity and central obesity for different characteristics of the study subjects. Results From 2010 to 2018, the overall crude rates and age- and gender-standardized rates of overweight among adults aged 20 and above in Shanxi Province ranged from 37.7% to 40.1% and 36.1% to 39.6%, respectively, with no significant upward trend (Z=0.005, 2.413; P=0.942, 0.120). The overall standardized obesity rate, overall crude rate of central obesity and the standardized rate central of obesity increased from 17.2%, 53.8%, and 52.4% in 2010 to 20.0%, 61.6%, and 60.2% in 2018, respectively (Z=8.100, 10.994, 12.218; P0.05) ; the standardized overweight rate for males was higher than that for females (χ2=4.259, P0.05) ; the overall obesity rate, male obesity rate, and both male and female central obesity rates in the age group of 20-39 years old showed an upward trend during the 8-year period (P0.05). There was also no significant difference in the trends of these rates between different genders and regions (P>0.05) . Conclusion From 2010 to 2018, the overweight rate among residents aged 20 and above in Shanxi Province remained stable, while the overall trends for obesity and central obesity rates showed an increasing trend. The prevention and control of obesity and central obesity should focus on the population aged 20-39 years to slow down the growth rate. For residents aged 40 and above, as well as urban residents, targeted prevention strategies should be implemented, so as to control the prevalence of overweight, obesity, and central obesity.