Abstract:
Background: Overweight and obesity weight classifications, calculated using body-mass index (BMI, kg/m2), continue to be major contributors to negative health outcomes, even resulting in disability and death. Comprehensive estimates of the prevalence of overweight and obesity are essential to inform and guide global health strategies.
Methods: In the Global Burden of Disease, Injuries, and Risk Factors (GBD) Study 2023, we used spatiotemporal Gaussian progress regression to estimate the prevalence of overweight and obese across 204 countries and territories, stratified by age and sex, from 1990 to 2023. Estimates were based on measured and bias-adjusted self-reported data from 2,729 nationally or sub-nationally representative surveys. Adults (≥20 years) were considered overweight if their calculated BMI was greater than or equal to 25 kg/m2 and obese if their BMI was calculated as greater than or equal to 30 kg/m2. Definitions for children (2-19 years) overweight and obesity were based on International Obesity Task Force (IOTF) standards.
Findings: In 2023, 42.6% (95% confidence interval 38.2, 47.5) of adults and 12.6% (10.3, 15.2) of children were estimated to have overweight and obesity globally. For adults, island nations and territories in Oceania have the highest rates of overweight and obesity (Tokelau [96.2% (94.0, 97.8))] and Nauru [92.4% (88.5, 95.5)]), while Sub-Saharan African and Southeast Asian nations have the lowest rates (Ethiopia [10.5% (6.9, 15.5)] and Timor-Leste [11.9% (8.3,16.5)]). For children, the highest rates of overweight and obesity were found in New Zealand (34.0% [30.3, 38.4]) and Tonga (33.7% [29.9, 38.1]), while the lowest rates were observed in Viet Nam (2.8% [2.1, 3.6]) and Madagascar (3.4% [2.6, 4.4]). Between 2022 and 2023, every country experienced an increase in prevalence of overweight and obesity for adults, while children showed an increase in all countries except for the USA and India.
Interpretation: The prevalence of overweight and obesity continues to increase globally, despite many active initiatives aimed at its reduction. Even among countries with high prevalence of underweight, populations of overweight and obesity are increasing, resulting in a double burden of weight-related health conditions. Additional programs targeting the epidemic of overweight and obesity need to be implemented urgently to lessen the contribution of overweight and obesity to health outcomes.
