‘Epidemic of obesity’ blights children as global rates soar

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Obesity rates in adults have more than doubled in the past three decades and increased at almost twice that pace for children and adolescents, according to new research.

The alarming trend, based on a study of more than 220mn people in almost 200 countries, means more than 1bn people are now defined as obese. This is creating an “urgent need” for policies to promote prevention, encourage weight loss and cut disease risks, says the paper published on Thursday in The Lancet.

Soaring obesity rates also threaten to undermine a rise in longevity and expected years of healthy life — with health systems and employers bearing the increased financial burden. Experts blame the rise on an abundance of unhealthy foods and drinks, the unaffordability of nutritious products and a lack of opportunities to exercise.

“It’s a population that’s living longer but — possibly — living sicker,” said Majid Ezzati, professor at Imperial College London’s school of public health and the paper’s senior author. “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.”

A wide-ranging collaboration of more than 1,500 researchers and the World Health Organization, the study analysed changes between 1990 and 2022. It looked at height and weight measurements for people aged five and older, using it to calculate body mass index and estimate obesity and underweight rates.

Rates of obesity, which increases the risk of chronic and fatal conditions including type 2 diabetes, heart disease and some cancers, were found to have risen in countries across geographic regions, cultures and income levels.

The prevalence of obesity more than doubled for women from 8.8 per cent to 18.5 per cent and almost tripled for men from 4.8 per cent to 14 per cent.

“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 Tedros Adhanom Ghebreyesus, WHO director-general.

This would require a wide-ranging effort including co-operation with the private sector, which “must be accountable for the health impacts of their products”, Tedros added.

Despite the overall rise across the globe, the study revealed significant regional differences.

Some of the biggest rises were in countries in the Middle East and north Africa, with high increases also observed in island nations in the Caribbean, Micronesia and Polynesia, such as American Samoa.

In the US, 43.8 per cent of women and 41.6 per cent of men were classified as obese in 2022, with the male prevalence being the tenth highest in the world. In the UK, 28.3 per cent of women and 26.9 per cent of men were obese.

In India and China, the world’s most populous countries, obesity rates were relatively low but still showed sharp rises over the 32-year period covered in the study. Almost 10 per cent of women in India were obese in 2022 and 8.9 per cent of men in China.

The increased obesity rates in children and adolescents were particularly troubling, experts said. Global prevalence of obesity more than quadrupled in girls between 1990 and 2022, rising from 1.7 per cent to 6.9 per cent, and going up from 2.1 per cent to 9.3 per cent among boys.

This suggests a greater number of people will be obese for a large portion of their lives, exacerbating risks of chronic disease.

“That means a longer time to develop these conditions that increase your mortality and reduce your life expectancy,” said Nita Gandhi Forouhi, professor of the MRC Epidemiology Unit at Cambridge university.

Louise Foley, an epidemiologist at Cambridge university’s Centre for Diet and Activity Research, said the rise in child obesity reflected urban planning trends that do not prioritise walking or sporting activities.

“We have set up our societies in such a way that they don’t support good health,” she said.

“We haven’t really designed our cities to make activity an easy things to do. In a lot of places in the world, it’s not a safe thing to do.”

New weight-loss drugs could boost treatment for obesity but they remain expensive and inaccessible, experts said, with clinical guidelines yet to be developed. Demand in the US and Europe is surging for treatments such as Wegovy, the weight-loss drug from Danish company Novo Nordisk, which was shown in a trial to reduce the risk of death by 18 per cent.

Rollout of Wegovy has been limited to the US, several European countries and the United Arab Emirates. The US list price of the drug is about $1,350 for a month’s supply, while Zepbound, a competing product from Eli Lilly, costs $1,060.

Other potential initiatives include measures to make a nutritious diet more affordable and unhealthy food more expensive. A separate report published by the British Medical Journal on Wednesday showed that ultra-processed foods were directly linked to 32 harmful effects to health, including a higher risk of type 2 diabetes and heart disease.

Taxes on high-sugar drinks in countries such as the US, Mexico and Chile had been shown to be effective, said Sara Bleich, professor of public health policy at Harvard university.

But an effective international response would require “enormous political will” to tackle corporate interests, Bleich said. Increasing obesity was a “phenomenon that has huge implications for healthcare systems, associated economic costs and mental health”, she added.