Action Needed as Obesity, Overweight Expected to Increase- Study
By Sharon Atieno
More than half of adults (3.8 billion) and one in three children and adolescents (about 746 million) worldwide will be obese or overweight by 2050 without urgent policy reform and action, a new study shows.
The analysis from the Global Burden of Disease Study BMI Collaborators, published in The Lancet, shows that the current increase is due to massive global failures in responding to the growing obesity crisis.
The number of adults (aged 25 and older) and children and adolescents (aged 5-24 years) with overweight and obesity worldwide rose from 731 million and 198 million, respectively, in 1990 to 2.11 billion and 493 million in 2021.
The number of adults (aged 25 and older) and children and adolescents (aged 5-24 years) with overweight and obesity worldwide rose from 731 million and 198 million, respectively, in 1990 to 2.11 billion and 493 million in 2021.
“The unprecedented global epidemic of overweight and obesity is a profound tragedy and a monumental societal failure,” said lead author Professor Emmanuela Gakidou from the Institute for Health Metrics and Evaluation (IHME), University of Washington, USA.
“Governments and the public health community can use our country-specific estimates on the stage, timing, and speed of current and forecasted transitions in weight to identify priority populations experiencing the greatest burdens of obesity who require immediate intervention and treatment, and those that remain predominantly overweight and should be primarily targeted with prevention strategies.”
According to the study, covering 204 countries and territories, overweight and obesity among adults are estimated to rise from 43.4% in 2021 to around 57.4% for men in 2050 and from 46.7% to 60.3% for women. Driven by growing populations, the largest increases are projected in Asia and sub-Saharan Africa.
While the largest number of adults with overweight and obesity are still expected in China (627 million), India (450 million) and the USA (214 million) in 2050, the number in sub-Saharan Africa is forecast to rise by over 250% to 522 million, driven by population growth.
While the largest number of adults with overweight and obesity are still expected in China (627 million), India (450 million) and the USA (214 million) in 2050, the number in sub-Saharan Africa is forecast to rise by over 250% to 522 million, driven by population growth.
Worldwide, Nigeria stands out for its predicted rise in adults who are overweight and obese, with the number projected to more than triple from 36.6 million in 2021 to 141 million in 2050—making it the country with the fourth-largest population of adults with overweight and obesity.
Further, around one in three adults worldwide are expected to be affected by obesity in 2050, of whom around one in four are forecast to be 65 years or older. The highest levels are expected in the United Arab Emirates and Nauru (more than 80% of males expected to have obesity in 2050) and in Tonga and Egypt (at least 87% of females).
“Obesity rates are skyrocketing across sub-Saharan Africa, with 522 million adults and more than 200 million young people expected to be living with overweight or obesity by 2050,” said co-author Awoke Temesgen, clinical Associate Professor at IHME.
“This has added a double burden to the already overstretched healthcare systems that are ill-equipped to handle the extraordinary rise in obesity-related disease. Action is urgently needed to implement preventative initiatives such as policies on marketing of unhealthy foods and planning to include facilities for exercise and playing fields in schools.”
Notably, the authors observe that more recent generations are gaining weight faster than previous ones and obesity is occurring earlier, increasing the risk of complications such as type 2 diabetes, high blood pressure, cardiovascular diseases, and multiple cancers occurring at younger ages.
In high-income countries, for instance, approximately 7% of men born in the 1960s were living with obesity at the age of 25, but this increased to around 16% for men born in the 1990s and is forecast to reach 25% for men born in 2015.
According to the new analysis, globally, more 5–14-year-old males are forecast to be living with obesity compared to overweight by 2050 (16.5% vs 12.9%), whereas in females (5-24 years) and older males (15-24 years), overweight is still expected to remain more prevalent than obesity.
The most rapid accelerations in obesity are forecast in North Africa and the Middle East and Latin America and the Caribbean, where one-third of all the world’s children and adolescents with obesity (130 million) are expected to live in 2050.
The most rapid accelerations in obesity are forecast in North Africa and the Middle East and Latin America and the Caribbean, where one-third of all the world’s children and adolescents with obesity (130 million) are expected to live in 2050.
The transition to obesity predominance (versus overweight) is also expected to be overwhelming for several Oceanic countries such as Cook Islands, Nauru and Tonga where levels of obesity are expected to reach 60-70% by 2050, as well as for heavily populated countries such as Nigeria (18.1 million), India (26.4 million), Brazil (17.8 million), China (35.2 million), and the USA (22.1 million) where the numbers of young people with obesity are forecast to soar.
“But if we act now, preventing a complete transition to global obesity for children and adolescents is still possible,” said co-lead author Dr Jessica Kerr from Murdoch Children’s Research Institute in Australia.
“Our estimates identify children and adolescents in much of Europe and south Asia living with overweight who should be targeted with obesity prevention strategies. We have also identified large populations, particularly adolescent girls, in North America, Australasia, Oceania, North Africa and the Middle East, and Latin America that are expected to tip over to obesity predominance and require urgent, multifaceted intervention and treatment. This is essential to avoid intergenerational transmission of obesity and to prevent a wave of serious health conditions and dire financial and societal costs for future generations.”
A new roadmap for obesity prevention
The authors stress that five-year action plans (2025-2030) are urgently required to curb the rise in obesity and help inform new goals and targets for the post-2030 Sustainable Development Goal-era.
They call for more concerted efforts to deliver comprehensive, transdisciplinary interventions tailored to each county’s unique socio-demographic, economic, environmental, and commercial situation.
“Preventing obesity must be at the forefront of policies in low- and middle-income countries,” said Dr Kerr. “Policy action in these regions must balance the challenges of overnutrition with undernutrition and stunting, with interventions ranging from support for nutritional diets and regulating ultra-processed foods to promoting maternal and child health programmes that encourage pregnant women to follow a healthy diet and breastfeed. This is no time for business as usual. Many countries only have a short window of opportunity to stop much greater numbers shifting from overweight to obesity.”
She added, “Ultimately, as global obesity rates continue to soar, much stronger political commitment is needed to transform diets within sustainable global food systems and to support comprehensive strategies that improve people’s nutrition, physical activity and living environments, whether it’s too much processed food or not enough parks.”
The study used body mass index (BMI) for adults, which is widely used to track current global trends. For individuals older than 18 years, overweight was defined as having a BMI of 25 kg/m² to less than 30 kg/m² and obesity was defined as a BMI of 30 kg/m² or higher. For individuals younger than 18 years, definitions were based on International Obesity Task Force criteria.