Over Half of Adults, a Third of Kids Globally Will Have Overweight, Obesity by 2050

Over half of adults and a third of kids and teens around the world will have overweight or obesity by 2050, according to two reports using data on 204 countries and territories.

If observed trends over the past 30 years continue, the total number of adults ages 25 and older living with overweight (body mass index [BMI] 25 to <30) or obesity (BMI ≥30) will reach 3.8 billion by 2050 — more than half of the likely global adult population at that time.

Meanwhile, 356 million young people ages 5 to 14 years and 390 million young people ages 15 to 24 years are projected to have overweight or obesity by 2050, reported the Global Burden of Disease (GBD) Study 2021 Adult and Adolescent BMI Collaborators in The Lancet.

“This polycrisis will cause more avertable adverse health outcomes in the coming decades than any other modifiable risk at an individual level,” the researchers wrote. “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. Although new-generation antiobesity medications appear promising, tactful, whole-system, public health strategies will continue to be crucial to achieving widespread and sustainable impact.”

In an accompanying commentary, Thorkild I. A. Sørensen, MD, of the University of Copenhagen in Denmark, 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.”

Historical Trends and Projections

In 2021, an estimated 1 billion men, 1.11 billion women, and 493 million youths ages 5 to 24 worldwide had overweight or obesity. Since 1990, rates of obesity increased by 155.1% in men, 104.9% in women, and 244% in children and adolescents.

“Adult obesity is closely tied to childhood obesity,” the GBD Study Collaborators pointed out. “With the global prevalence of obesity in children and adolescents having increased by 244% in the past 30 years and having a forecasted increase of 121% in the next 30 years, trends in adult obesity prevalence are unlikely to abate.”

Eight countries — China, India, the U.S., Brazil, Russia, Mexico, Indonesia, and Egypt — accounted for over half of the global adult population living with overweight and obesity in 2021. China had the largest population of adults with overweight and obesity (402 million people), followed by India (180 million people), and the U.S. (172 million people).

These three countries are expected to continue to have the largest numbers of people with overweight or obesity by 2050, with China to have an estimated 627 million affected individuals, India with 450 million, and the U.S. with 214 million.

However, the prevalence of obesity alone was relatively low in China and India in 2021. On the other hand, the U.S. had a relatively high prevalence of obesity, estimated at 41.5% for men and 45.6% for women — the highest among all high-income countries.

Looking at the U.S., 49.1% of women and 60.5% of men had overweight or obesity in 1990. By 2021, this increased to 72.6% and 75.9%, respectively. Using this historical data to forecast prevalence rates in 2050, an estimated 82.1% of women and 81.1% of men are expected to have overweight or obesity.

Historically, the sharpest increase in adult obesity prevalence was concentrated in the North Africa and Middle East super-region, where prevalence rates in men more than tripled and rates in women more than doubled since 1990. Through 2050, sub-Saharan Africa is forecasted to have the largest increase in overweight and obesity prevalence, at 254.8%, “driven by population growth.”

As for children and adolescents, increases in overweight and obesity between 1990 and 2021 were fastest in North Africa and the Middle East, Latin America, and the Caribbean. By 2021, many countries in Australasia (e.g., Australia) and in high-income North America (e.g., Canada) had already transitioned to obesity predominance for females in both age groups, as had males and females in a number of countries in North Africa and the Middle East and Oceania.

Looking to 2050, global overweight prevalence among kids and adolescents is expected to plateau in some areas, but this is mostly attributed to more youth transitioning to obesity. That being said, there is “no indication” that the increase in youth obesity prevalence will stabilize in any region across the globe by 2050, the researchers said.

These projections among youth “will impact future societal and economic developments if the forthcoming workforce carries this large disease burden,” they wrote. “At the individual level, child and adolescent obesity will immediately affect young lives. There will be even greater effects on their future lives, and on their offspring, as children and adolescents with obesity are highly likely to become adults with obesity.”

Sørensen noted 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.”

“In particular, the consistent and unexplained tendency towards a higher prevalence among socially deprived groups enhances the challenges,” he added. “The most pressing question concerns which interventions will be both feasible and effective.”

Co-author Emmanuela Gakidou, PhD, MSc, of the Institute for Health Metrics and Evaluation (IHME) at the University of Washington in Seattle, said in a statement that “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 should be primarily targeted with prevention strategies.”

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