Global, regional, and national prevalence of child and adolescent overweight and obesity, 1990–2021, with forecasts to 2050: a forecasting study for the Global Burden of Disease Study 2021
Authors: Jessica A Kerr, George C Patton, Karly I Cini, Yohannes Habtegiorgis Abate, Nasir Abbas, Abdallah H A Abd Al Magied, Samar Abd ElHafeez, Sherief Abd-Elsalam, Arash Abdollahi, Meriem Abdoun, Deldar Morad Abdulah, Rizwan Suliankatchi Abdulkader, Auwal Abdullahi, Hansani Madushika Abeywickrama, Alemwork Abie, Olumide Abiodun, Shady Abohashem, Dariush Abtahi, Hasan Abualruz, Bilyaminu Abubakar, Eman Abu-Gharbieh, Hana J Abukhadijah, Niveen ME Abu-Rmeileh, Salahdein Aburuz, Ahmed Abu-Zaid, Lisa C. Adams, Mesafint Molla Adane, Isaac Yeboah Addo, Kamoru Ademola Adedokun, Nurudeen A Adegoke, Ridwan Olamilekan Adesola, Juliana Bunmi Adetunji, Temitayo Esther Adeyeoluwa, Usha Adiga, Qorinah Estiningtyas Sakilah Adnani, Abdelrahman Yousry Afify, Aanuoluwapo Adeyimika Afolabi, Muhammad Sohail Afzal, Saira Afzal, Suneth Buddhika Agampodi, Shahin Aghamiri, César Agostinis Sobrinho, Williams Agyemang-Duah, Bright Opoku Ahinkorah, Austin J Ahlstrom, Aqeel Ahmad, Danish Ahmad, Fuzail Ahmad, Muayyad M Ahmad, Noah Ahmad, Sajjad Ahmad, Ayman Ahmed, Haroon Ahmed, Luai A Ahmed, Mehrunnisha Sharif Ahmed, Meqdad Saleh Ahmed, Syed Anees Ahmed, Marjan Ajami, Mohammed Ahmed Akkaif, Ashley E Akrami, Hanadi Al Hamad, Syed Mahfuz Al Hasan, Zain Al Ta'ani, Yazan Al Thaher, Tariq A Alalwan, Ziyad Al-Aly, Khurshid Alam, Rasmieh Mustafa Al-amer, Amani Alansari, Fahmi Y. Al-Ashwal, Mohammed Albashtawy, Bezawit Abeje Alemayehu, Abdelazeem M Algammal, Khalid F Alhabib, Dari Alhuwail, Abid Ali, Endale Alemayehu Ali, Mohammad Daud Ali, Mohammed Usman Ali, Rafat Ali, Waad Ali, Sheikh Mohammad Alif, Yousef Alimohamadi, Samah W Al-Jabi, Mohamad Aljofan, Syed Mohamed Aljunid, Ahmad Alkhatib, Wael Almahmeed, Sabah Al-Marwani, Mahmoud A Alomari, Saleh A Alqahtani, Abdullah A Alqarni, Ahmad Alrawashdeh, Intima Alrimawi, Sahel Majed Alrousan, Najim Z Alshahrani, Zaid Altaany, Awais Altaf, Farrukh Jawad Alvi, Nelson Alvis-Guzman, Mohammad Al-Wardat, Yaser Mohammed Al-Worafi, Hany Aly, Safwat Aly, Karem H Alzoubi, Masoud Aman Mohammadi, Tewodros Getnet Amera, Sohrab Amiri, Hubert Amu, Dickson A Amugsi, Ganiyu Adeniyi Amusa, Roshan A Ananda, Robert Ancuceanu, Mohammed Tahir Ansari, Sumbul Ansari, Boluwatife Stephen Anuoluwa, Iyadunni Adesola Anuoluwa, Saeid Anvari, Sumadi Lukman Anwar, Anayochukwu Edward Anyasodor, Juan Pablo Arab, Jalal Arabloo, Mosab Arafat, Aleksandr Y Aravkin, Demelash Areda, Brhane Berhe Aregawi, Hidayat Arifin, Benedetta Armocida, Johan Ärnlöv, Mahwish Arooj, Amit Arora, Anton A Artamonov, Kurnia Dwi Artanti, Ashokan Arumugam, Mohammad Asghari-Jafarabadi, Tahira Ashraf, Bernard Kwadwo Yeboah Asiamah-Asare, Thomas Astell-Burt, Seyyed Shamsadin Athari, Prince Atorkey, Alok Atreya, Zaure Maratovna Aumoldaeva, Mamaru Ayenew Awoke, Adedapo Wasiu Awotidebe, Setognal Birara Aychiluhm, Amirali Azimi, Sadat Abdulla Aziz, Shahkaar Aziz, Ahmed Y. Azzam, Domenico Azzolino, Mina Babashahi, Giridhara Rathnaiah Babu, Alaa Aboelnour Badran, Nasser Bagheri, Ruhai Bai, Atif Amin Baig, Shankar M Bakkannavar, Senthilkumar Balakrishnan, Ovidiu Constantin Baltatu, Kiran Bam, Rajon Banik, Shirin Barati, Mainak Bardhan, Hiba Jawdat Barqawi, Simon Barquera, Amadou Barrow, Lingkan Barua, Mohammad-Mahdi Bastan, Saurav Basu, Reza Bayat, Mulat Tirfie Bayih, Nebiyou Simegnew Bayleyegn, Narasimha M Beeraka, Priyamadhaba Behera, Diana Fernanda Bejarano Ramirez, Umar Muhammad Bello, Luis Belo, Derrick A Bennett, Maria Bergami, Kidanemaryam Berhe, Abiye Assefa Berihun, Ajeet Singh Bhadoria, Neeraj Bhala, Ravi Bharadwaj, Nikha Bhardwaj, Pankaj Bhardwaj, Sonu Bhaskar, Ajay Nagesh Bhat, Priyadarshini Bhattacharjee, Gurjit Kaur Bhatti, Jasvinder Singh Bhatti, Cem Bilgin, Catherine Bisignano, Bijit Biswas, Bruno Bizzozero Peroni, Espen Bjertness, Tone Bjørge, Archith Boloor, Sri Harsha Boppana, Samuel Adolf Bosoka, Souad Bouaoud, Edward J Boyko, Dejana Braithwaite, Javier Brazo-Sayavera, Hermann Brenner, Dana Bryazka, Raffaele Bugiardini, Linh Phuong Bui, Yasser Bustanji, Nadeem Shafique Butt, Zahid A Butt, Mehtap Çakmak Barsbay, Daniela Calina, Luis Alberto Cámera, Luciana Aparecida Campos, Si Cao, Angelo Capodici, Claudia Carletti, Andre F Carvalho, Márcia Carvalho, Monica Cattafesta, Maria Sofia Cattaruzza, Luca Cegolon, Francieli Cembranel, Ester Cerin, Achille Cernigliaro, Joshua Chadwick, Chiranjib Chakraborty, Eeshwar K Chandrasekar, Jung-Chen Chang, Vijay Kumar Chattu, Anis Ahmad Chaudhary, Akhilanand Chaurasia, An-Tian Chen, Haowei Chen, Nicholas WS Chew, Gerald Chi, Ritesh Chimoriya, Patrick R Ching, Abdulaal Chitheer, Dong-Woo Choi, Bryan Chong, Chean Lin Chong, Hitesh Chopra, Shivani Chopra, Hou In Chou, Sonali Gajanan Choudhari, Sheng-Chia Chung, Sunghyun Chung, Muhammad Chutiyami, Rebecca M Cogen, Alyssa Columbus, Nathalie Conrad, Michael H Criqui, Natalia Cruz-Martins, Alanna Gomes da Silva, Omid Dadras, Xiaochen Dai, Mayank Dalakoti, Emanuele D'Amico, Lalit Dandona, Rakhi Dandona, Lucio D'Anna, Pojsakorn Danpanichkul, Samuel Demissie Darcho, Reza Darvishi Cheshmeh Soltani, Nihar Ranjan Dash, Kairat Davletov, Azizallah Dehghan, Edgar Denova-Gutiérrez, Meseret Derbew Molla, Ismail Dergaa, Aragaw Tesfaw Desale, Vinoth Gnana Chellaiyan Devanbu, Devananda Devegowda, Arkadeep Dhali, Bibha Dhungel, Daniel Diaz, Monica Dinu, Thanh Chi Do, Camila Bruneli do Prado, Milad Dodangeh, Phidelia Theresa Doegah, Sushil Dohare, Klara Georgieva Dokova, Paul Narh Doku, Neda Dolatkhah, Mario D'Oria, Fariba - Dorostkar, Ojas Prakashbhai Doshi, Rajkumar Prakashbhai Doshi, Robert Kokou Dowou, Mi Du, Samuel C Dumith, Dorothea Dumuid, Bruce B Duncan, Sulagna Dutta, Alireza Ebrahimi, Kristina Edvardsson, Ashkan Eighaei Sedeh, Michael Ekholuenetale, Rabie Adel El Arab, Ibrahim Farahat El Bayoumy, Mohamed Ahmed Eladl, Said El-Ashker, Iffat Elbarazi, Islam Y Elgendy, Muhammed Elhadi, Ashraf A El-Metwally, Mohamed A Elmonem, Mohamed Hassan Elnaem, Randa Elsheikh, Chadi Eltaha, Theophilus I Emeto, Maysa Eslami, Natalia Fabin, Heidar Fadavian, Adeniyi Francis Fagbamigbe, Ildar Ravisovich Fakhradiyev, Seyed Nooreddin Faraji, Carla Sofia e Sá Farinha, MoezAlIslam Ezzat Mahmoud Faris, Pawan Sirwan Faris, Mohsen Farjoud Kouhanjani, Umar Farooque, Hossein Farrokhpour, Samuel Aanuoluwapo Fasusi, Patrick Fazeli, Timur Fazylov, Alireza Feizkhah, Ginenus Fekadu, Xiaoqi Feng, Rodrigo Fernandez-Jimenez, Nuno Ferreira, Nataliya A Foigt, Morenike Oluwatoyin Folayan, Artem Alekseevich Fomenkov, Roham Foroumadi, Celia Fortuna Rodrigues, Matteo Foschi, Kate Louise Francis, Richard Charles Franklin, Aleš Gába, Muktar A Gadanya, Abhay Motiramji Gaidhane, Yaseen Galali, Silvano Gallus, Balasankar Ganesan, Shivaprakash Gangachannaiah, Miglas Welay Gebregergis, Mesfin Gebrehiwot, Lemma Getacher, Molla Getie, Fataneh Ghadirian, Ramy Mohamed Ghazy, Artyom Urievich Gil, Tiffany K Gill, Richard F Gillum, Alem Abera Girmay, Mahaveer Golechha, Pouya Goleij, Alessandra C Goulart, Ayman Grada, Michal Grivna, Ashna Grover, Zhongyang Guan, Giovanni Guarducci, Mohammed Ibrahim Mohialdeen Gubari, Avirup Guha, Snigdha Gulati, Damitha Asanga Gunawardane, Zheng Guo, Bhawna Gupta, Rahul Gupta, Rajeev Gupta, Vipin Gupta, Roberth Steven Gutiérrez-Murillo, Jose Guzman-Esquivel, Najah R Hadi, Zahra Hadian, Nadia M Hamdy, Samer Hamidi, Asif Hanif, Nasrin Hanifi, Graeme J Hankey, Allie Haq, Josep Maria Haro, Faizul Hasan, Reza Hashempour, Mohammad Hashem Hashempur, Md Saquib Hasnain, Amr Hassan, Nageeb Hassan, Soheil Hassanipour, Afagh Hassanzade Rad, Rasmus J Havmoeller, Simon I Hay, Jeffrey J Hebert, Kamal Hezam, Yuta Hiraike, Mai Hoang, Ramesh Holla, Alamgir Hossain, Hassan Hosseinzadeh, Mihaela Hostiuc, Sorin Hostiuc, Zin Wai Htay, Mengsi Hu, Yifei Hu, Ayesha Humayun, Tsegaye Gebreyes Hundie, Mohamed Ibrahim Husseiny, Foziya Mohammed Hussien, Hong-Han Huynh, Bing-Fang Hwang, Ramzi Ibrahim, Anel Ibrayeva, Nayu Ikeda, Olayinka Stephen Ilesanmi, Irena M Ilic, Milena D Ilic, Leeberk Raja Inbaraj, Arit Inok, Khalid Iqbal, Md Sahidul Islam, Md. 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Journal: The Lancet (2025)

Despite the well documented consequences of obesity during childhood and adolescence and future risks of excess body mass on non-communicable diseases in adulthood, coordinated global action on excess body mass in early life is still insufficient. Inconsistent measurement and reporting are a barrier to specific targets, resource allocation, and interventions. In this Article we report current estimates of overweight and obesity across childhood and adolescence, progress over time, and forecasts to inform specific actions. Using established methodology from the Global Burden of Diseases, Injuries, and Risk Factors Study 2021, we modelled overweight and obesity across childhood and adolescence from 1990 to 2021, and then forecasted to 2050. Primary data for our models included 1321 unique measured and self-reported anthropometric data sources from 180 countries and territories from survey microdata, reports, and published literature. These data were used to estimate age-standardised global, regional, and national overweight prevalence and obesity prevalence (separately) for children and young adolescents (aged 5-14 years, typically in school and cared for by child health services) and older adolescents (aged 15-24 years, increasingly out of school and cared for by adult services) by sex for 204 countries and territories from 1990 to 2021. Prevalence estimates from 1990 to 2021 were generated using spatiotemporal Gaussian process regression models, which leveraged temporal and spatial correlation in epidemiological trends to ensure comparability of results across time and geography. Prevalence forecasts from 2022 to 2050 were generated using a generalised ensemble modelling approach assuming continuation of current trends. For every age-sex-location population across time (1990-2050), we estimated obesity (vs overweight) predominance using the log ratio of obesity percentage to overweight percentage. Between 1990 and 2021, the combined prevalence of overweight and obesity in children and adolescents doubled, and that of obesity alone tripled. By 2021, 93·1 million (95% uncertainty interval 89·6-96·6) individuals aged 5-14 years and 80·6 million (78·2-83·3) aged 15-24 years had obesity. At the super-region level in 2021, the prevalence of overweight and of obesity was highest in north Africa and the Middle East (eg, United Arab Emirates and Kuwait), and the greatest increase from 1990 to 2021 was seen in southeast Asia, east Asia, and Oceania (eg, Taiwan [province of China], Maldives, and China). By 2021, for females in both age groups, many countries in Australasia (eg, Australia) and in high-income North America (eg, Canada) had already transitioned to obesity predominance, as had males and females in a number of countries in north Africa and the Middle East (eg, United Arab Emirates and Qatar) and Oceania (eg, Cook Islands and American Samoa). From 2022 to 2050, global increases in overweight (not obesity) prevalence are forecasted to stabilise, yet the increase in the absolute proportion of the global population with obesity is forecasted to be greater than between 1990 and 2021, with substantial increases forecast between 2022 and 2030, which continue between 2031 and 2050. By 2050, super-region obesity prevalence is forecasted to remain highest in north Africa and the Middle East (eg, United Arab Emirates and Kuwait), and forecasted increases in obesity are still expected to be largest across southeast Asia, east Asia, and Oceania (eg, Timor-Leste and North Korea), but also in south Asia (eg, Nepal and Bangladesh). Compared with those aged 15-24 years, in most super-regions (except Latin America and the Caribbean and the high-income super-region) a greater proportion of those aged 5-14 years are forecasted to have obesity than overweight by 2050. Globally, 15·6% (12·7-17·2) of those aged 5-14 years are forecasted to have obesity by 2050 (186 million [141-221]), compared with 14·2% (11·4-15·7) of those aged 15-24 years (175 million [136-203]). We forecasted that by 2050, there will be more young males (aged 5-14 years) living with obesity (16·5% [13·3-18·3]) than overweight (12·9% [12·2-13·6]); while for females (aged 5-24 years) and older males (aged 15-24 years), overweight will remain more prevalent than obesity. At a regional level, the following populations are forecast to have transitioned to obesity (vs overweight) predominance before 2041-50: children and adolescents (males and females aged 5-24 years) in north Africa and the Middle East and Tropical Latin America; males aged 5-14 years in east Asia, central and southern sub-Saharan Africa, and central Latin America; females aged 5-14 years in Australasia; females aged 15-24 years in Australasia, high-income North America, and southern sub-Saharan Africa; and males aged 15-24 years in high-income North America. Both overweight and obesity increased substantially in every world region between 1990 and 2021, suggesting that current approaches to curbing increases in overweight and obesity have failed a generation of children and adolescents. Beyond 2021, overweight during childhood and adolescence is forecast to stabilise due to further increases in the population who have obesity. Increases in obesity are expected to continue for all populations in all world regions. Because substantial change is forecasted to occur between 2022 and 2030, immediate actions are needed to address this public health crisis. Bill & Melinda Gates Foundation and Australian National Health and Medical Research Council.