Global Obesity Rates Top One Billion, Quadrupling Among Youth from 1999-2022

The global burden of obesity now affects more than 1 billion individuals, according to a new analysis that found a 4-fold increase in the disease among children and adolescents between 1990 and 2022 and a more than doubling of rates among adults during that time.

The findings, published online in The Lancet February 29, were compiled by the NCD Risk Factor Collaboration (NCD-RisC), in collaboration with the World Health Organization (WHO).

“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,” senior study author Majid Ezzati, PhD, a professor of global environmental health at Imperial College London, said in a press release. “At the same time, hundreds of millions are still affected by undernutrition, particularly in some of the poorest parts of the world. To successfully tackle both forms of malnutrition, it is vital we significantly improve the availability and affordability of healthy, nutritious foods.”

In total, 159 million children and adolescents and 879 million adults were living with obesity in 2022.

Ezzati and colleagues evaluated 3,663 population-based studies that measured height and weight for atotal of 222 million children, adolescents, and adults globally.

They used a Bayesian hierarchical model to determine obesity and underweight trends, based on BMI, between 1990 to 2022 among adults aged 20 years and older and youth aged 5 to 19 years. Two hundred countries and territories were represented, according to the study. For adults obesity was defined as BMI ≥30 kg/m² and for youth, BMI >2 SD above the median of the WHO growth reference.

Between 1990 and 2022, Ezzati and colleagues found that the rates of global obesity rose from:

• 4.8% to 14% among men
• 8.8% to 18.5% among women
• 1.7% to 6.9% among girls
• 2.1% to 9.3% among boys

In the United States, obesity rates during the study period increased from:

• 11.5% to 21.7 among boys
• 11.6% to 19.4% among girls
• 21.2% to 43.8% among women
• 16.9% to 41.6% among men

In 2022, the prevalence of obesity in the US, ranked globally, was:

• 10th highest for men
• 22nd highest for girls
• 26th highest for boys
• 36th highest for women

The global proportion of girls and boys who were underweight, meanwhile, fell from 10.3% to 8.2% and from 16.7% to 10.8%, respectively.

Ezzati and the research team highlight implications of their research including its exposure of the “urgent need for obesity prevention, supporting weight loss, and reducing disease risk in those with obesity.” They add that “Prevention and management are especially important because the age of onset of obesity has decreased, which increases the duration of exposure.”

There were an estimated 880 million adults — 504 million women and 374 million men — with obesity in 2022, up from 195 million in 1990.

Among the study’s limitations the authors note that some countries had fewer data than others and that availability of data by age group also differed. Ezzati et al also said that while BMI “is an imperfect measure of the extent and distribution of body fat,” it is “widely available in population-based surveys and used in clinical practice.”

And yet, the research may be a form of wake-up call. “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,” WHO Director-General Tedros Adhanom Ghebreyesus, PhD, MSc, said in the release. “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. Importantly, it requires the cooperation of the private sector, which must be accountable for the health impacts of their products,” he concluded.

References:

1. More than one billion people in the world are now living with obesity, global analysis suggests. News release. https://www.eurekalert.org/news-releases/1035924. Published Feb. 29, 2024. Accessed March 1, 2024.
2. Phelps N, Singleton RK, Zhou B, et al, for the NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population representative studies with 222 million children, adolescents, and adults. Lancet. Published online February 29, 2024. doi:10.1016/S0140-6736(23)02750-2