Geneva: The total number of children, adolescents and adults worldwide living with obesity has surpassed one billion, according to a global analysis released today by The Lancet.
The study also shows that even though the rates of undernutrition have dropped, it is still a public health challenge in many places, particularly in South-East Asia and sub-Saharan Africa.
These trends, together with the declining prevalence of people who are underweight since 1990, make obesity the most common form of malnutrition in most countries.
Malnutrition, in all its forms, includes undernutrition (wasting, stunting, underweight), inadequate vitamins or minerals, overweight and obesity. Undernutrition is responsible for half of the deaths of children under 5 and obesity can cause noncommunicable diseases such as cardiovascular diseases, diabetes and some cancers.
Countries with the highest prevalence of obesity for adults in 2022 were the island nations of Tonga and American Samoa for women and American Samoa and Nauru for men in Polynesia and Micronesia, where more than 60% of the adult population were living with obesity. These countries now have higher obesity rates than many high-income industrialised countries, especially those in Europe.
Countries with the highest prevalence of obesity for children and adolescents in 2022 were Niue and Cook Islands for both girls and boys, where more than 30% of the child and adolescent population were living with obesity.
In India, the obesity rate increased from 1.2% in 1990 to 9.8% in 2022 for women and 0.5% to 5.4% in 2022 for men. The prevalence of obesity in India ranked 19th lowest (182nd highest) in the world for women and 21st lowest (180th highest) in the world for men in 2022.
Moreover in India, the obesity rate increased from 0.1% in 1990 to 3.1% in 2022 for girls and 0.1% to 3.9% in 2022 for boys. The prevalence of obesity in India ranked 27th lowest (174th highest) in the world for both girls and boys in 2022.
In India, the underweight rate decreased from 41.7% in 1990 to 13.7% in 2022 for women and 39.8% to 12.5% in 2022 for men. The prevalence of underweight in India ranked 13th highest in the world for women and 26th highest in the world for men in 2022.
Countries with the highest prevalence of underweight in 2022 were Eritrea and Timor-Leste for women and Eritrea and Ethiopia for men, where more than 20% of the adult population were affected by underweight.
Dr Guha Pradeepa, study co-author from the Madras Diabetes Research Foundation, warned that major global issues risk worsening both forms of malnutrition, saying: “The impact of issues such as climate change, disruptions caused by the COVID-19 pandemic, and the war in Ukraine risk worsening both rates of obesity and underweight, by increasing poverty and the cost of nutrient-rich foods. The knock-on effects of this are insufficient food in some countries and households and shifts to less healthy foods in others. To create a healthier world, we need comprehensive policies to address these challenges.”
The analysis of global data estimates that among the world’s children and adolescents, the rate of obesity in 2022 was four times the rate in 1990. Among adults, the obesity rate more than doubled in women (8.8% to 18.5%) and nearly tripled in men (4.8% to 14.0%) between 1990 and 2022. In total, 159 million children and adolescents and 879 million adults were living with obesity in 2022.
From 1990 to 2022, global obesity rates more than quadrupled in girls (1.7% to 6.9%) and boys (2.1% to 9.3%), with increases seen in almost all countries. The proportion of girls who were underweight fell from 10.3% in 1990 to 8.2% in 2022, and for boys it fell from 16.7% to 10.8%. Among girls, a decrease in the rates of underweight was detected in 44 countries, whilst among boys, a decrease was noted in 80 countries.
In total, an estimated nearly 880 million adults were living with obesity in 2022 (504 million women and 374 million men), four and a half times the 195 million recorded in 1990 (128 million women and 67 million men). Combined with the 159 million children living with obesity in 2022, this is a total of over one billion people affected by obesity in 2022. Despite global population growth, 183 million women and 164 million men were affected by underweight in 2022, 45 million and 48 million fewer, respectively, than in 1990.
Between 1990 and 2022, the proportion of the world’s children and adolescents who were affected by underweight fell by around one-fifth in girls and more than one-third in boys. 77 million girls and 108 million boys were underweight in 2022, decreasing from 81 million for girls and 138 million for boys in 1990.
The proportion of the world’s adults who were affected by underweight more than halved over the same period (14.5% to 7.0% in women; 13.7% to 6.2% in men).
The study highlights an urgent need for major changes to measures aimed at tackling obesity, as well as policies to further reduce the number of people who are underweight, especially in the poorest parts of the world.
Obesity and underweight are both forms of malnutrition and are detrimental to people’s health in many ways. This latest study provides a highly detailed picture of global trends in both forms of malnutrition over the last 33 years.
Senior author Professor Majid Ezzati, of Imperial College London, said: “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. 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.”
“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,” said Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization which contributed to the data collection and analysis of this study. “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 said.
Obesity is a complex chronic disease. The causes are well understood, as are the interventions needed to contain the crisis, which are backed by strong evidence. However, they are not implemented. At the World Health Assembly in 2022 Member States adopted the WHO Acceleration Plan to stop obesity, which supports country-level action through 2030. To date, 31 governments are now leading the way to curb the obesity epidemic by implementing the plan.
The core interventions are:
- actions to support healthy practices from day 1, including breastfeeding promotion, protection and support;
- regulations on the harmful marketing of food and beverages to children;
- school food and nutrition policies, including initiatives to regulate the sales of products high in fats, sugars and salt in the proximity of schools;
- fiscal and pricing policies to promote healthy diets;
- nutrition labelling policies;
- public education and awareness campaigns for healthy diets and exercise;
- standards for physical activity in schools; and
- integration of obesity prevention and management services into primary health care.
“There are significant challenges in implementing policies aimed at ensuring affordable access to healthy diets for all and creating environments that promote physical activity and overall healthy lifestyles for everyone,” stated Dr Francesco Branca, Director of WHO’s Nutrition and Food Safety Department and one of the co-authors of the study. “Countries should also ensure that health systems integrate the prevention and management of obesity into the basic package of services.”
The new study was conducted by the NCD Risk Factor Collaboration (NCD-RisC), in collaboration with the World Health Organization (WHO). Researchers analysed weight and height measurements from over 220 million people aged five years or older (63 million people aged five to 19 years, and 158 million aged 20 years or older), representing more than 190 countries. More than 1,500 researchers contributed to the study, which looked at body mass index (BMI) to understand how obesity and underweight have changed worldwide from 1990 to 2022.
– global bihari bureau
