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
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| Available date | 2024-09-29T07:41:44Z |
| Publication Date | 2024-03-22 |
| Publication Name | The Lancet |
| Identifier | http://dx.doi.org/10.1016/S0140-6736(23)02750-2 |
| Citation | Phelps, N. H., Singleton, R. K., Zhou, B., Heap, R. A., Mishra, A., Bennett, J. E., ... & Barbagallo, C. M. (2024). 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. The Lancet, 403(10431), 1027-1050. |
| ISSN | 01406736 |
| Abstract | BackgroundUnderweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. MethodsWe used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI <18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For school-aged children and adolescents, we report thinness (BMI <2 SD below the median of the WHO growth reference) and obesity (BMI >2 SD above the median). FindingsFrom 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. InterpretationThe combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesity. FundingUK Medical Research Council, UK Research and Innovation (Research England), UK Research and Innovation (Innovate UK), and European Union. |
| Sponsor | This study was funded by the UK Medical Research Council (grant number MR/V034057/1), the UK Research and Innovation (Research England Policy Support Fund), UK Research and Innovation (Innovate UK grant number 10103595, for participation in the OBCT consortium funded by the European Union grant agreement 101080250), and European Union (STOP Project grant agreement 774548). BZ is supported by a fellowship from the Abdul Latif Jameel Institute for Disease and Emergency Analytics at Imperial College London, funded by a donation from Community Jameel. For the purpose of open access, the author has applied a Creative Commons Attribution (CC BY) licence to the Author Accepted Manuscript version arising from this submission. The authors alone are responsible for the views expressed in this Article and they do not necessarily represent the views, decisions, or policies of the institutions with which they are affiliated. |
| Language | en |
| Publisher | Elsevier B.V. |
| Subject | obesity |
| Type | Article |
| Pagination | 1027-1050 |
| Issue Number | 10431 |
| Volume Number | 403 |
| Open Access user License | http://creativecommons.org/licenses/by/4.0/ |
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