GBD 2021青少年BMI协作组研究了1990-2021年全球、区域和国家儿童和青少年超重和肥胖流行率，并预测至2050年。这一研究成果发表在2025年3月3日出版的《柳叶刀》杂志上。

尽管儿童和青少年肥胖的后果以及成年后体重超标对非传染性疾病的未来风险有据可查，但针对早期体重超标的全球协调行动仍然不足。不一致的衡量和报告是实现具体目标、资源分配和干预措施的障碍。研究组报告了目前对儿童和青少年超重和肥胖的估计、随时间推移的进展以及为具体行动提供信息的预测。

研究组使用2021年全球疾病、伤害和风险因素负担研究的既定方法，对1990年至2021年儿童和青少年的超重和肥胖进行了建模，然后预测到2050年。该模型的主要数据包括来自180个国家和地区的1321个独特的测量和自我报告的人体测量数据来源，这些数据来源于调查微观数据、报告和已发表的文献。这些数据用于估计1990年至2021年204个国家和地区按性别分列的儿童和青少年（5-14岁，通常在学校，由儿童卫生服务机构照顾）和年长青少年（15-24岁，越来越多地失学，由成人服务机构照顾。

1990年至2021年的患病率估计是使用时空高斯过程回归模型生成的，该模型利用流行病学趋势中的时间和空间相关性来确保结果在时间和地理上的可比性。2022年至2050年的患病率预测是使用通用集成建模方法生成的，假设当前趋势持续。对于整个时间段（1990-2050年）的每个年龄段、性别位置的人口，研究组使用肥胖百分比与超重百分比的对数比来估计肥胖（与超重）的主导地位。

1990年至2021年间，儿童和青少年超重和肥胖的总患病率翻了一番，仅肥胖的患病率就翻了两番。到2021年，9310万（95%不确定性区间896-96.6）5-14岁的人和8060万（782-83.3）15-24岁的人患有肥胖症。在2021年的超区域层面上，超重和肥胖的患病率在北非和中东（如阿拉伯联合酋长国和科威特）最高，从1990年到2021年，增幅最大的是东南亚、东亚和大洋洲（如马尔代夫和中国）。到2021年，对于这两个年龄段的女性来说，澳大拉西亚（如澳大利亚）和高收入北美（如加拿大）的许多国家已经转变为肥胖占主导地位，北非和中东（如阿拉伯联合酋长国和卡塔尔）以及大洋洲（如库克群岛和美属萨摩亚）的一些国家的男性和女性也是如此。从2022年到2050年，预计全球超重（非肥胖）患病率的增长将趋于稳定，但预计全球肥胖人口绝对比例的增长将大于1990年至2021年，预计2022年至2030年将大幅增长，2031年至2050年将继续增长。

到2050年，预计北非和中东（如阿拉伯联合酋长国）的超区域肥胖率将保持最高水平。预计东南亚、东亚和大洋洲（如东帝汶和朝鲜）以及南亚（如尼泊尔和孟加拉国）的肥胖率增幅仍然最大。与15-24岁的人群相比，到2050年，在大多数超级地区（拉丁美洲和加勒比地区以及高收入超级地区除外），预计5-14岁人群中肥胖的比例将高于超重的比例。在全球范围内，预计到2050年，5-14岁人群中有15.6%（12.7-17.2）的人会肥胖（1.86亿[141-221]），而15-24岁人群中只有14.2%（11.4-15.7）的人（1.75亿[136-203]）会肥胖。

研究组预测，到2050年，肥胖的年轻男性（5-14岁）（16.5%[13.3-18.3]）将超过超重的年轻男性的（12.9%[12.2-13.6]）；而对于女性（5-24岁）和年龄较大的男性（15-24年）来说，超重仍将比肥胖更普遍。在区域层面，预计在2041-50年之前，以下人群将转变为肥胖（与超重相比）占主导地位：北非、中东和热带拉丁美洲的儿童和青少年（5-24岁的男性和女性）；东亚、撒哈拉以南非洲中部和南部以及拉丁美洲中部5-14岁的男性；澳大利亚5-14岁的女性；澳大利亚、高收入北美和撒哈拉以南非洲地区15-24岁的女性；以及北美高收入地区15-24岁的男性。

研究结果表明，1990年至2021年间，世界各地区的超重和肥胖人数都大幅增加，这表明目前遏制超重和肥胖增加的方法已经失败了一代儿童和青少年。2021年以后，由于肥胖人口的进一步增加，预计儿童和青少年的超重情况将趋于稳定。预计世界各地区所有人口的肥胖率都将继续上升。由于预计2022年至2030年间将发生重大变化，因此需要立即采取行动应对这场公共卫生危机。

附：英文原文

Title: 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

Author: 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 Taani, 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 rnlv, 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

Issue&Volume: 2025-03-03

Abstract:

Background

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.

Methods

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.

Findings

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 Emiratesand 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.

Interpretation

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.

DOI: 10.1016/S0140-6736(25)00397-6

Source: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)00397-6/abstract