Obesity Affects More Than 1 Billion Around the World

TOPLINE:

More than a billion children, adolescents, and adults are living with obesity, globally, with rates of obesity among children and adolescents quadrupling between 1990 and 2022.

Obesity rates nearly tripled among adult men and more than doubled among women during the time period, according to results from a collaboration between the NCD Risk Factor Collaboration and the World Health Organization (WHO).

The rates of being underweight have meanwhile declined, making obesity now the most common form of malnutrition in most regions.

METHODOLOGY:

• In this global analysis, the authors evaluated 3663 population-based studies conducted in 200 countries and territories, with data on 222 million participants in the general population, including height and weight.
• Trends were established according to categories of body mass index (BMI) in groups of adults aged 20 years or older, representing 150 million individuals, and 63 million school-aged children and adolescents aged 5-19 years, spanning from 1990 to 2022.
• Assessments of adults focus on the individual and combined prevalence of underweight (BMI 2) and obesity (BMI ≥ 30 kg/m²).
• For school-aged children and adolescents, assessments were for thinness (BMI 2 SD above the median).

TAKEAWAY:

• The combined prevalence of obesity as well as underweight increased over the study period in most countries for women (162 countries, 81%) and men (140 countries, 70%), with increases driven by increases in obesity in nearly all countries, while underweight or thinness rates decreased.
• In 2022, obesity rates were higher than underweight in 177 countries (89%) for women and 145 countries (73%) for men.
• Likewise, among school-aged children and adolescents, obesity in 2022 was more prevalent than thinness among girls in 130 countries (67%) and boys in 125 countries (63%), while thinness was more prevalent in only 18% and 21% of the countries, respectively.
• In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, as well as in countries in the Middle East and north Africa.
• Among school-aged children, the countries with the highest combined prevalence of underweight and obesity were Polynesia and Micronesia and the Caribbean for both sexes and Chile and Qatar for boys.
• The prevalence of obesity surpassed 60% among women in eight countries (4%) and men in six countries (3%), all in Polynesia and Micronesia.
• In the United States, the obesity rate increased from 21.2% in 1990 to 43.8% in 2022 for women and from 16.9% to 41.6% in 2022 for men.
• As of 2022, the prevalence of obesity in the United States ranked 36th highest in the world for women and 10th highest in the world for men.

IN PRACTICE:

“It is very concerning that the epidemic of obesity that was evident among adults in much of the world in 1990 is now mirrored in school-aged children and adolescents,” said senior author Majid Ezzati, PhD, of the Imperial College of London, London, England, in a press statement.

“At the same time, hundreds of millions are still affected by undernutrition, particularly in some of the poorest parts of the world,” he said. “To successfully tackle both forms of malnutrition, it is vital we significantly improve the availability and affordability of healthy, nutritious foods.”

Tedros Adhanom Ghebreyesus, PhD, WHO Director-General, adds in the press statement that “this new study highlights the importance of preventing and managing obesity from early life to adulthood, through diet, physical activity, and adequate care, as needed.”

“Getting back on track to meet the global targets for curbing obesity will take the work of governments and communities, supported by evidence-based policies from WHO and national public health agencies,” he said.

“Importantly, it requires the cooperation of the private sector, which must be accountable for the health impacts of their products.”

SOURCE:

The study was published on February 29, 2024, in The Lancet. The study was conducted by the NCD Risk Factor Collaboration and the WHO.

LIMITATIONS:

Data differences in countries included that some had limited data and three had none, requiring some estimates to be formed using data from other countries. Data availability was also lower among the youngest and oldest patients, increasing uncertainty of data in those age groups. In addition, data from health surveys can be subject to error, and BMI can be an imperfect measure of the extent or distribution of body fat.

DISCLOSURES:

The study was funded by UK Medical Research Council, UK Research and Innovation, and the European Commission.