GBD 2021成人BMI协作组分析了1990-2021年全球、地区和国家成人超重和肥胖流行率，并预测至2050年。相关论文于2025年3月3日发表在《柳叶刀》杂志上。

超重和肥胖是一种全球性流行病。预测该流行病的未来轨迹对于为政策变化提供证据基础至关重要。研究组分析了1990年至2021年全球、地区和国家成人超重和肥胖患病率的历史趋势，并预测了到2050年的未来轨迹。

利用全球疾病、伤害和风险因素负担研究的既定方法，研究组估计了1990年至2050年204个国家和地区按年龄和性别分列的25岁及以上人群超重和肥胖的患病率。回顾性和当前的流行趋势是基于从1350个独特来源提取的自我报告和测量的人体测量数据得出的，其中包括调查微观数据和报告，以及已发表的文献。对自我报告偏差进行了具体调整。时空高斯过程回归模型用于综合数据，利用流行病学趋势中的空间和时间相关性，优化结果在时间和地理上的可比性。为了生成预测估计，研究组使用了社会人口指数的预测和时间相关性模式，以年化变化率表示，以告知未来的轨迹。并考虑了一个假设历史趋势延续的参考情景。

1990年至2021年间，全球和地区以及所有国家的超重和肥胖率都有所上升。2021年，估计有1000亿（95%不确定性区间[UI]0.989-1.01）成年男性和11.1亿（1.10-1.12）成年女性超重和肥胖。中国的超重和肥胖成年人人数最多（4.02亿[397-407]人），其次是印度（1.8亿[167-194]人）和美国（1.72亿[169-174]人）。大洋洲、北非和中东国家超重和肥胖的年龄标准化患病率最高，其中许多国家报告的成年人患病率超过80%。与1990年相比，全球肥胖患病率在男性中增加了155.1%（149.8-160.3），在女性中增加了104.9%（95%UI 100.9-108.8）。北非和中东超级地区的肥胖率上升最快，男性的年龄标准化患病率增加了两倍多，女性增加了一倍多。

假设历史趋势持续下去，到2050年，研究组预测超重和肥胖的成年人总数将达到380亿（95%UI 3.39-4.04），占当时全球成年人口的一半以上。虽然中国、印度和美国将继续在全球超重和肥胖人口中占很大比例，但撒哈拉以南非洲超级地区的这一数字预计将增长254.8%（234.4-269.5）。特别是在尼日利亚，到2050年，超重和肥胖的成年人人数预计将增至1.41亿（1.21-1.62亿），使其成为超重和肥胖人口第四大的国家。

研究结果表明，迄今为止，还没有一个国家成功遏制了成年人超重和肥胖率的上升。如果不立即采取有效的干预措施，超重和肥胖将在全球范围内继续增加。特别是在亚洲和非洲，受人口增长的推动，超重和肥胖的人数预计将大幅增加。这些地区将面临肥胖相关疾病负担的大幅增加。仅仅承认肥胖是一个全球健康问题，是全球卫生和公共卫生从业者的疏忽；需要采取更积极和更有针对性的措施来应对这场危机，因为肥胖是现在和未来对健康最重要的可避免风险之一，并在地方、国家和全球层面构成前所未有的过早疾病和死亡威胁。

附：英文原文

Title: Global, regional, and national prevalence of adult overweight and obesity, 1990–2021, with forecasts to 2050: a forecasting study for the Global Burden of Disease Study 2021

Author: Marie Ng, Emmanuela Gakidou, Justin Lo, Yohannes Habtegiorgis Abate, Cristiana Abbafati, Nasir Abbas, Mohammadreza Abbasian, Samar Abd ElHafeez, Wael M Abdel-Rahman, Sherief Abd-Elsalam, Arash Abdollahi, Meriem Abdoun, Deldar Morad Abdulah, Rizwan Suliankatchi Abdulkader, Auwal Abdullahi, Armita Abedi, Hansani Madushika Abeywickrama, Alemwork Abie, Richard Gyan Aboagye, Shady Abohashem, Dariush Abtahi, Hasan Abualruz, Bilyaminu Abubakar, Rana Kamal Abu Farha, 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, Abiola Victor Victor Adepoju, Ridwan Olamilekan Adesola, Temitayo Esther Adeyeoluwa, Usha Adiga, Qorinah Estiningtyas Sakilah Adnani, Siamak Afaghi, Saira Afzal, Muhammad Sohail Afzal, Thilini Chanchala Agampodi, Shahin Aghamiri, César Agostinis Sobrinho, Williams Agyemang-Duah, Austin J Ahlstrom, Danish Ahmad, Sajjad Ahmad, Aqeel Ahmad, Muayyad M Ahmad, Fuzail Ahmad, Noah Ahmad, Haroon Ahmed, Muktar Beshir Ahmed, Ayman Ahmed, Meqdad Saleh Ahmed, Mehrunnisha Sharif Ahmed, Syed Anees Ahmed, Marjan Ajami, Samina Akhtar, Mohammed Ahmed Akkaif, Ashley E Akrami, Tariq A Alalwan, Ziyad Al-Aly, Khurshid Alam, Rasmieh Mustafa Al-amer, Amani Alansari, Fahmi Y Al-Ashwal, Mohammed Albashtawy, Wafa A Aldhaleei, Bezawit Abeje Alemayehu, Abdelazeem M Algammal, Khalid F Alhabib, Hanadi Al Hamad, Syed Mahfuz Al Hasan, Dari Alhuwail, Rafat Ali, Abid Ali, Waad Ali, Mohammed Usman Ali, Sheikh Mohammad Alif, Samah W Al-Jabi, Syed Mohamed Aljunid, Ahmad Alkhatib, Sabah Al-Marwani, Mahmoud A Alomari, Saleh A Alqahtani, Rajaa M Mohammad Al-Raddadi, Ahmad Alrawashdeh, Intima Alrimawi, Sahel Majed Alrousan, Najim Z Alshahrani, Omar Al Taani, Zain Al Taani, Zaid Altaany, Awais Altaf, Yazan Al Thaher, Nelson Alvis-Guzman, Mohammad Al-Wardat, Yaser Mohammed Al-Worafi, Safwat Aly, Hany Aly, Hosam Alzahrani, Abdallah Alzoubi, Karem H Alzoubi, Md. Akib Al-Zubayer, Sohrab Amiri, Hubert Amu, Dickson A Amugsi, Ganiyu Adeniyi Amusa, Roshan A Ananda, Robert Ancuceanu, Catalina Liliana Andrei, Ranjit Mohan Anjana, Sumbul Ansari, Mohammed Tahir Ansari, Catherine M Antony, Iyadunni Adesola Anuoluwa, Boluwatife Stephen Anuoluwa, Saeid Anvari, Saleha Anwar, Anayochukwu Edward Anyasodor, Geminn Louis Carace Apostol, Juan Pablo Arab, Jalal Arabloo, Mosab Arafat, Aleksandr Y Aravkin, Demelash Areda, Hidayat Arifin, Mesay Arkew, Benedetta Armocida, Johan rnlv, Mahwish Arooj, Anton A Artamonov, Kurnia Dwi Artanti, Ashokan Arumugam, Mohammad Asghari-Jafarabadi, Tahira Ashraf, Bernard Kwadwo Yeboah Asiamah-Asare, Anemaw A Asrat, Thomas Astell-Burt, Seyyed Shamsadin Athari, Prince Atorkey, Alok Atreya, Zaure Maratovna Aumoldaeva, Hamzeh Awad, Mamaru Ayenew Awoke, Adedapo Wasiu Awotidebe, Setognal Birara Aychiluhm, Ali Azargoonjahromi

Issue&Volume: 2025-03-03

Abstract:

ackground

Overweight and obesity is a global epidemic. Forecasting future trajectories of the epidemic is crucial for providing an evidence base for policy change. In this study, we examine the historical trends of the global, regional, and national prevalence of adult overweight and obesity from 1990 to 2021 and forecast the future trajectories to 2050.

Methods

Leveraging established methodology from the Global Burden of Diseases, Injuries, and Risk Factors Study, we estimated the prevalence of overweight and obesity among individuals aged 25 years and older by age and sex for 204 countries and territories from 1990 to 2050. Retrospective and current prevalence trends were derived based on both self-reported and measured anthropometric data extracted from 1350 unique sources, which include survey microdata and reports, as well as published literature. Specific adjustment was applied to correct for self-report bias. Spatiotemporal Gaussian process regression models were used to synthesise data, leveraging both spatial and temporal correlation in epidemiological trends, to optimise the comparability of results across time and geographies. To generate forecast estimates, we used forecasts of the Socio-demographic Index and temporal correlation patterns presented as annualised rate of change to inform future trajectories. We considered a reference scenario assuming the continuation of historical trends.

Findings

Rates of overweight and obesity increased at the global and regional levels, and in all nations, between 1990 and 2021. In 2021, an estimated 1·00 billion (95% uncertainty interval [UI] 0·989–1·01) adult males and 1·11 billion (1·10–1·12) adult females had overweight and obesity. China had the largest population of adults with overweight and obesity (402 million [397–407] individuals), followed by India (180 million [167–194]) and the USA (172 million [169–174]). The highest age-standardised prevalence of overweight and obesity was observed in countries in Oceania and north Africa and the Middle East, with many of these countries reporting prevalence of more than 80% in adults. Compared with 1990, the global prevalence of obesity had increased by 155·1% (149·8–160·3) in males and 104·9% (95% UI 100·9–108·8) in females. The most rapid rise in obesity prevalence was observed in the north Africa and the Middle East super-region, where age-standardised prevalence rates in males more than tripled and in females more than doubled. Assuming the continuation of historical trends, by 2050, we forecast that the total number of adults living with overweight and obesity will reach 3·80 billion (95% UI 3·39–4·04), over half of the likely global adult population at that time. While China, India, and the USA will continue to constitute a large proportion of the global population with overweight and obesity, the number in the sub-Saharan Africa super-region is forecasted to increase by 254·8% (234·4–269·5). In Nigeria specifically, the number of adults with overweight and obesity is forecasted to rise to 141 million (121–162) by 2050, making it the country with the fourth-largest population with overweight and obesity.

Interpretation

No country to date has successfully curbed the rising rates of adult overweight and obesity. Without immediate and effective intervention, overweight and obesity will continue to increase globally. Particularly in Asia and Africa, driven by growing populations, the number of individuals with overweight and obesity is forecast to rise substantially. These regions will face a considerable increase in obesity-related disease burden. Merely acknowledging obesity as a global health issue would be negligent on the part of global health and public health practitioners; more aggressive and targeted measures are required to address this crisis, as obesity is one of the foremost avertible risks to health now and in the future and poses an unparalleled threat of premature disease and death at local, national, and global levels.

DOI: 10.1016/S0140-6736(25)00355-1

Source: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)00355-1/abstract