Study details

For the study, researchers tracked the body mass index (BMI) rates of people in 204 countries and territories from 1990 to 2021. The researchers then used those trends to project obesity rates to 2050.

Researchers found that 2.1 billion adults and 493 million children and teens are either overweight or obese, and if current trends continue, around 60% of all adults and a third of children and teens will be overweight or obese by 2050.

The projected surge in obesity among children and teens is expected to outpace the increase in overweight children and teens. Boys are expected to fare worse, with obesity rates of boys between the ages of five and 14 expected to outpace those of overweight boys the same age 17% to 13% by 2050.

Among high-income countries, the United States had the highest rates of obesity, the researchers found, with around 42% of men and 46% of women obese in the United States in 2021.

More than half of adults who are overweight or obese live in eight countries, the researchers found, including:

• China (402 million)
• India (180 million)
• United States (172 million)
• Brazil (88 million)
• Russia (71 million)
• Mexico (58 million)
• Indonesia (52 million)
• Egypt (41 million)

Discussion

In the study, the researchers wrote that the increase in obese and overweight people worldwide "will cause more avertable adverse health outcomes in the coming decades than any other modifiable risk at an individual level."

"Urgent, bold, and comprehensive initiatives are imperative to enable multisectoral collaboration and propel structural reforms to address drivers of overweight and obesity at individual and population levels," they wrote. "Although new-generation antiobesity medications appear promising, tactful, whole-system, public health strategies will continue to be crucial to achieving widespread and sustainable impact."

"The unprecedented global epidemic of overweight and obesity is a profound tragedy and a monumental societal failure," said Emmanuela Gakidou, lead author on the study and a professor of health metrics sciences at the Institute for Health Metrics and Evaluation at the University of Washington.

"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," Gakidou said.

In an accompanying editorial, Thorkild Sørensen from the University of Copenhagen noted that "in view of the devastating subsequent rise in a variety of serious, potentially fatal, comorbidities -- with type 2 diabetes, hypertension, and cardiovascular diseases being the most prominent — the results of both the historical and forecasted trends are concerning and urgent challenges to global public health."

Sørensen added that "recent improvements in individual clinical management of obesity are likely to be suitable for only small subsets of the global population for whom healthcare services can offer them. The scale of the epidemic is such that solutions will have to be public health interventions, also considering the profound macro-level and micro-level heterogeneity of the development of the epidemic."

Jessica Kerr from Murdoch Children's Research Institute in Australia said that "if we act now, preventing a complete transition to global obesity for children and adolescents is still possible."

"Our estimates identify children and adolescents in much of Europe and south Asia living with overweight who should be targeted with obesity prevention strategies," Kerr said. "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," Kerr added.

Advisory Board's weight-related resources

Advisory Board offers several weight-related resources.

This expert insight outlines the five biggest questions about weight management drugs and their answers. Similarly, this expert insight addresses what headlines get wrong about weight management drugs and what healthcare leaders should know instead.

Radio Advisory's Rachel Woods has also covered GLP-1 drugs on the podcast, discussing the potential future of these drugs and how they could help — or hurt — health systems' finances. Other useful resources include this expert insight on the five catalysts that will impact the future of obesity care and this research on four key elements of comprehensive obesity care.

This emerging idea outlines how three health systems reinvented their weight management programs in order to provide comprehensive, high-quality obesity services. And this research can show you how stakeholder actions could shape three potential futures for obesity care and the strategies leaders can implement to ensure optimal outcomes.

Our weight management and obesity care resource library can also help leaders understand the current care landscape, manage innovations, and prepare for transformations in care.