Global, Regional, and National Prevalence of Overweight and Obesity in Children and Adults During 1980–2013: A Systematic Analysis for the Global Burden of Disease Study 2013

Study Questions:

What is the estimated global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013?

Methods:

A systematic review identified surveys, reports, and published studies (n = 1,769) that included data for height and weight, both through physical measurements and self-reports. Several strategies were used to identify data sources including data from major multi-country survey programs, large databases (the WHO Global Infobase, the International Association for the Study of Obesity Data Portal, and the Global Health Data Exchange). In addition, nation health ministry websites were used to identify national multiyear surveys. Of the 2,270 sources identified, 501 were excluded because the samples were not representative. All articles reporting prevalence of overweight and obesity based on body mass index (BMI) from 1980 to 2012 were reviewed. Estimates were reported for 188 countries, 21 regions, and development status (developed or developing). Estimated prevalence was also reported by sex and age groups (from age 2–4 years to ≥80 years). In adults over the age of 18 years, overweight was defined as a BMI ≥25 to <30 kg/m2 and obesity as BMI ≥30 kg/m2. In children, classification was based on the International Obesity Task Force definition. Mixed-effects linear regression models were used to correct for bias in self-reports.

Results:

Over the time period examined, the number of overweight and obese individuals increased from 857 million in 1980, to 2.1 billion in 2013. The proportion of adults with a BMI of ≥25 kg/m2 increased between 1980 and 2013 from 28.8% (95% uncertainty intervals [UI], 28.4–29.3) to 36.9% (36.3–37.4) in men, and from 29.8% (29.3–30.2) to 38.0% (37.5–38.5) in women. Prevalence increased substantially in children and adolescents in developed countries; 23.8% (22.9–24.7) of boys and 22.6% (21.7–23.6) of girls were overweight or obese in 2013. The prevalence of overweight and obesity also increased in children and adolescents in developing countries, from 8.1% (7.7–8.6) to 12.9% (12.3–13.5) in 2013 for boys and from 8.4% (8.1–8.8) to 13.4% (13.0–13.9) in girls. In adults, estimated prevalence of obesity exceeded 50% in men in Tonga and in women in Kuwait, Kiribati, Federated States of Micronesia, Libya, Qatar, Tonga, and Samoa. More than 50% of the 671 million obese individuals in the world live in 10 countries (listed in order of number of obese individuals): USA, China, India, Russia, Brazil, Mexico, Egypt, Germany, Pakistan, and Indonesia. The USA accounted for 13% of obese people worldwide in 2013, with China and India jointly accounting for 15%. Although age-standardized rates were lower in developing than in developed countries overall, 62% of the world’s obese individuals live in developing countries. Since 2006, the increase in adult obesity in developed countries has slowed down; however, no countries have observed significant decreases in obesity in the past 33 years.

Conclusions:

The authors concluded that obesity has become a major global health challenge. Not only is obesity increasing, but no national success stories have been reported in the past 33 years. Urgent global action and leadership is needed to help countries to more effectively intervene.

Perspective:

This comprehensive review emphasizes the significant increases in obesity worldwide. As the authors suggest, addressing overweight and obesity in both developing and developed countries should be a high priority for the multiple stakeholders involved in health care.

Clinical Topics: Congenital Heart Disease and Pediatric Cardiology, CHD & Pediatrics and Prevention, CHD & Pediatrics and Quality Improvement

Keywords: Global Health, Overweight, Body Weight, Developing Countries, Child, Prevalence, Body Mass Index, Brazil, Developed Countries, Obesity, Linear Models


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