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
- PMID: 40049185
- PMCID: PMC11920006
- DOI: 10.1016/S0140-6736(25)00397-6
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
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 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.
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.
Funding: Bill & Melinda Gates Foundation and Australian National Health and Medical Research Council.
Copyright © 2025 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.
Conflict of interest statement
Declaration of interests S Afzal reports support for the present manuscript from King Edward Medical University; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from King Edward Medical University and collaborative partners including University of Johns Hopkins, University of California, University of Massachusetts, KEMCAANA, KEMCA_UK international scientific conferences, webinars and meetings; support for attending meetings and/or travel from King Edward Medical University; participation on a data safety monitoring board or advisory board with the National Bioethics Committee Pakistan, King Edward Medical University Ethical Review Board, and Ethical Review Board Fatima Jinnah Medical University and Sir Ganga Ram Hospital; leadership or fiduciary role in other board, society, committee or advocacy group (paid or unpaid) as a member of the Pakistan Association of Medical Editors, Fellow of Faculty of Public Health Royal Colleges UK (FFPH), Society of Prevention, Advocacy And Research, King Edward Medical University (SPARK), Member Pakistan Society of Infectious Diseases, and Member of the Technical Expert Advisory Group of the Government to formulate guidelines on the prevention, surveillance and research on infectious diseases; other financial or non-financial interests as Dean of Public Health and Preventive Medicine at King Edward Medical University, Chief Editor of Annals of King Edward Medical University since 2014, Director Quality Enhancement Cell King Edward Medical University, At International level, Fellow of Faculty of Public Health United Kingdom, Advisory Board Member and Chair Scientific Session, KEMCA-UK, Chairperson International Scientific Conference, KEMCAANA, At National level, Member Research and Publications Higher Education Commission, HEC (Pakistan), Member Research and Journals Committee Pakistan Medical and Dental Council (Pakistan), Member National Bioethics Committee (Pakistan), At Punjab Level Member Corona Experts Advisory Group, Member Technical Working Group for Infectious Diseases, Member Dengue Experts Advisory Group, and Chair, Punjab Residency Program Research Committee; outside the submitted work. S M Alif reports payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Victoria University Online; support for attending meetings and/or travel from University of Melbourne; leadership or fiduciary role in other board, society, committee or advocacy group (paid or unpaid) with the Thoracic Society of Australia and New Zealand; outside the submitted work. R Ancuceanu reports consulting fees from AbbVie and Merck Romania; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from AbbVie, Laropharm, Reckitt, and Merck Romania; support for attending meetings and/or travel from Merck Romania and Reckitt; outside the submitted work. J Ärnlöv reports payment or honoraria for lectures from AstraZeneca and Boehringer Ingelheim; participation on a data safety monitoring board or advisory board from AstraZeneca and Astella; outside the submitted work. O C Baltatu reports support for the present manuscript from the National Council for Scientific and Technological Development Fellowship (CNPq, 304224/2022-7), Anima Institute (AI) Research Professor Fellowship, and Alfaisal University; leadership or fiduciary role in other board, society, committee or advocacy group (paid or unpaid) with VividiWise Analytics as Managing Partner and the São José dos Campos Tech Park – CITE as Biotech Advisory Board Member; outside the submitted work. L Belo reports support from FCT in the scope of the project UIDP/04378/2020 and UIDB/04378/2020 of UCIBIO and the project LA/P/0140/2020 of i4HB; outside the submitted work. S Bhaskar reports grants or contracts from the Japan Society for the Promotion of Science (JSPS), Japanese Ministry of Education, Culture, Sports, Science and Technology (MEXT) and from The Australian Academy of Science; leadership or fiduciary roles in board, society, committee or advocacy groups (paid or unpaid) as the visiting director in the department of neurology at the National Cerebral and Cardiovascular Center, Suita (Osaka, Japan), district chair of diversity, equity and inclusion at the Rotary District 9675, chair and manager of the Global Health and Migration Hub Community (Berlin, Germany), an editorial member of PLOS One, BMC Neurology, Frontiers in Neurology, Frontiers in Stroke, Frontiers in Aging, Frontiers in Public Health, and BMC Medical Research Methodology, a member of the College of Reviewers (Canadian Institutes of Health Research, Government of Canada), a member of the scientific review committee at Cardiff University Biobank (UK), an export advisor and reviewer with the Cariplo Foundation (Milan, Italy), a Visiting Director at the National Cerebral and Cardiovascular Center, Department of Neurology, Division of Cerebrovascular Medicine and Neurology (Suita, Osaka, Japan); outside the submitted work. E J Boyko reports payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from the Korean Diabetes Association, Diabetes Association of the R.O.C (Taiwan), The American Diabetes Association, and the International Society for the Diabetic Foot; support for attending meetings/travel from the Korean Diabetes Association, Diabetes Association of the R.O.C. (Taiwan), and the International Society for the Diabetic Foot; outside the submitted work. M Carvalho reports support from FCT/MCTES under the scope of the project UIDP/50006/2020 (DOI 10.54499/UIDP/50006/2020), LAQV/REQUIMTE, University of Porto (Porto, Portugal); outside the submitted work. N Conrad reports grants or contracts from Research Foundation Flanders (grant number 12ZU922N); outside the submitted work. A A Fomenkov reports support for the present manuscript from the Ministry of Science and Higher Education of the Russian Federation (themes number 122042600086-7). R C Franklin reports support for attending meetings and/or travel from the ACTM Conference (2022-2024); leadership or fiduciary role in other board, society, committee or advocacy group (paid or unpaid) as the President of the Australasian College of Tropical Medicine; outside the submitted work. Z Guan reports grants or contracts from Dementia Centre of Excellence, Curtin enAble Institute, Curtin University; outside the submitted work. A Guha reports grants or contracts from the Department of Defense and American Heart Association; leadership or fiduciary role in other board, society, committee or advocacy group (paid or unpaid) with ZERO Cancer health disparities advisory group; outside the submitted work. A Hassan reports consulting fees from Novartis, Sanofi Genzyme, Biologix, Merck, Hikma Pharma, Janssen, Inspire Pharma, Future Pharma, Elixir pharma; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Novartis, Allergan, Merck, Biologix, Janssen, Roche, Sanofi Genzyme, Bayer, Hikma Pharma, Al Andalus, Chemipharm, Lundbeck, Inspire Pharma, Future Pharma and Habib Scientific Office, and Everpharma; support for attending meetings and/or travel from Novartis, Allergan, Merck, Biologix, Roche, Sanofi Genzyme, Bayer, Hikma Pharma, Chemipharm, and Al Andalus and Clavita pharm; leadership or fiduciary role in other board, society, committee or advocacy group (paid or unpaid) as Vice president of MENA headache society, Board member of Multiple Sclerosis chapter of the Egyptian Society of Neurology, Board member of headache chapter of the Egyptian Society of Neurology, member of committee of Education of the international Headache Society (IHS), membership committee of IHS, and regional committee of HIS; outside the submitted work. I Ilic reports support for the present manuscript from the Ministry of Education, Science and Technological development, Republic of Serbia (project No 175042, 2011-2023). M Ilic reports support for the present manuscript from the Ministry of Education, Science and Technological development, Republic of Serbia (number 451-03-47/2023-01/200111). N E Ismail reports leadership or fiduciary role in other board, society, committee or advocacy group (paid or unpaid) as Council Member and The Bursar of Malaysian Academy of Pharmacy (MAP) (Malaysia) and as Committee Member of Malaysian Pharmacists Society (MPS) Education Chapter Committee (Malaysia); outside the submitted work. J J Jozwiak reports payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Novartis, Adamed, and Amgen; outside the submitted work. M S Khan reports consulting fees from Bayer and Novartis; outside the submitted work. B Lacey reports grants or contracts from UK Biobank, funded largely by the UK Medical Research Council and Wellcome; outside the submitted work. M Lee reports support for the present manuscript from the Ministry of Education of the Republic of Korea and the National Research Foundation of Korea (NRF-2023S1A3A2A05095298). M-C Li reports support for the present manuscript from the National Science and Technology Council, Taiwan (NSTC 113-2314-B-003-002); leadership or fiduciary role in other board, society, committee or advocacy group (paid or unpaid) as the technical editor of the Journal of the American Heart Association, outside the submitted work. D Lindholm reports stock options from AstraZeneca; and other financial/non-financial interests as a former employee of AstraZeneca; outside the submitted work. J Liu reports grants or contracts from the National Natural Science Foundation (72474005); outside the submitted work. S Lorkowski reports grants or contracts from dsm-firmenich (formerly DSM Nutritional Products) payments made to the institution; consulting fees from Danone, Novartis Pharma, and Swedish Orphan Biovitrum (SOBI); payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from AMARIN Germany, Amedes Holding, AMGEN, Berlin-Chemie, Boehringer Ingelheim Pharma, Daiichi Sankyo Deutschland, Danone, Hubert Burda Media Holding, Janssen-Cilag, Lilly Deutschland, Novartis Pharma, Novo Nordisk Pharma, Roche Pharma, Sanofi-Aventis, Swedish Orphan Biovitrum (SOBI), and SYNLAB Holding Deutschland; support for attending meetings and/or travel from AMGEN; participation on a Data Safety Monitoring Board of Advisory Board from AMGEN, Daiichi Sankyo Deutschland, Novartis Pharma, Sanofi-Aventis; outside the submitted work. H R Marateb reports grants or contracts with the Beatriu de Pinós post-doctoral programme from Agency for Management of University and Research Grants, Government of Catalonia program (#2020 BP 00261) and the Agency for Management of University and Research Grants, Knowledge Industry Grants for 2024- Modality A. LLAVOR (2024 LLAV 00083), payments made to Universitat Politècnica de Catalunya Barcelona Tech; outside the submitted work. S A Meo reports grants or contracts from the Researchers Supporting Project, King Saud University, (Riyadh, Saudi Arabia) (RSP-2025 R47); outside the submitted work. L Monasta reports support for the present manuscript from the Italian Ministry of Health (Ricerca Corrente 34/2017), payments made to the Institute for Maternal and Child Health IRCCS Burlo Garofolo. S Nomura reports support for the present manuscript from the Ministry of Education, Culture, Sports, Science and Technology of Japan (24H00663) grant and the Precursory Research for Embryonic Science and Technology from the Japan Science and Technology Agency (JPMJPR22R8) grant. B Oancea reports grants or contracts from the MRID, project PNRR-I8 no 842027778., contract no 760096; outside the submitted work. A Ortiz reports grants or contracts from Sanofi (Grant to institution: IIS-FJD UAM), and as the Director of the Catedra Mundipharma-UAM of diabetic kidney disease and the Catedra AstraZeneca-UAM of chronic kidney disease and electrolytes (Grants to Universidad Autonoma de Madrid (UAM)); consulting fees, travel fees, or speaker fees from Advicciene, Astellas, AstraZeneca, Amicus, Amgen, Fresenius Medical Care, GSK, Bayer, Sanofi-Genzyme, Menarini, Kyowa Kirin, Alexion, Idorsia, Chiesi, Otsuka, Novo-Nordisk and Vifor Fresenius Medical Care Renal Pharma; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Advicciene, Astellas, AstraZeneca, Amicus, Amgen, Fresenius Medical Care, GSK, Bayer, Sanofi-Genzyme, Menarini, Kyowa Kirin, Alexion, Idorsia, Chiesi, Otsuka, Novo-Nordisk and Vifor Fresenius Medical Care Renal Pharma; travel support from Advicciene, Astellas, AstraZeneca, Fresenius Medical Care, Boehringer-Ingelheim Bayer, Sanofi-Genzyme, Menarini, Chiesi, Otsuka, Sysmex; consultancy fees from Astellas, AstraZeneca, Boehringer-Ingelheim, Fresenius Medical Care, Bayer, Sanofi-Genzyme, Idorsia, Chiesi, Otsuka, Novo Nordisk, Sysmex; leadership or fiduciary role in other board, society, committee or advocacy group, unpaid from Council ERA. SOMANE; outside the submitted work. S K Panda reports support for the present manuscript from Siksha ‘O’ Anusandhan (Deemed to be University) (salary); grants or contracts from DST-GOVT. OF ODISHA (Letter Number 3444/ST); leadership or fiduciary role in other board, society, committee or advocacy group (paid or unpaid) as the Associate Editor of Heliyon; outside the submitted work. 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J A Singh reports consulting fees from ROMTech, Atheneum, Clearview healthcare partners, American College of Rheumatology, Yale, Hulio, Horizon Pharmaceuticals, DINORA, ANI/Exeltis, USA Inc, Frictionless Solutions, Schipher, Crealta/Horizon, Medisys, Fidia, PK Med, Two labs Inc, Adept Field Solutions, Clinical Care options, Putnam associates, Focus forward, Navigant consulting, Spherix, MedIQ, Jupiter Life Science, UBM LLC, Trio Health, Medscape, WebMD, and Practice Point communications; and the National Institutes of Health]; payment of honoraria for lectures, presentations, speakers bureaus, manuscript writing or education events as a member of the speaker's bureau of Simply Speaking; support for attending meetings as a past steering committee member of OMERACT; participation on a data safety monitoring board or advisory board with the FDA Arthritis Advisory Committee; leadership or fiduciary role in other board, society, committee or advocacy group, paid as a past steering committee member of the OMERACT (an international organization that develops measures for clinical trials and receives arm's length funding from 12 pharmaceutical companies), unpaid as a Co-Chair of the Veterans Affairs Rheumatology Field Advisory Committee, and unpaid as an editor and director of the UAB Cochrane Musculoskeletal Group Satellite Center on Network Meta-analysis; stock of stock options in Atai life sciences, Kintara therapeutics, Intelligent Biosolutions, Acumen pharmaceutical, TPT Global Tech, Vaxart pharmaceuticals, Atyu biopharma, Adaptimmune Therapeutics, GeoVax Labs, Pieris Pharmaceuticals, Enzolytics Inc, Seres Therapeutics, Tonix Pharmaceuticals Holding Corp., and Charlotte's Web Holdings, Inc and previous stock options in Amarin, Viking, and Moderna Pharmaceuticals; outside the submitted work. R Tabares-Seisdedos reports grants or contracts from Valencian Regional Government's Ministry of Education (PROMETEO/CIPROM/2022/58) and the Spanish Ministry of Science, Innovation and Universities (PID2021-129099OB-I00; the funders were not involved in the design of the manuscript or decision to submit the manuscript for publication, nor will they be involved in any aspect of the study's conduct); outside the submitted work. M V Titova reports support for the present manuscripts from the Ministry of Science and Higher Education of the Russian Federation (themes number 122042600086-7). D Trico reports payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from AstraZeneca, Eli Lilly, Novo Nordisk; support for attending meetings and/or travel from AstraZeneca; participation on a data safety monitoring board or advisory board from Amarin, Boehringer Ingelheim, Novo Nordisk; leadership or fiduciary role in other board, society, committee or advocacy group (paid or unpaid) with EASD Early Career Academy and EASD Committee on Clinical Affairs; receipt of equipment, materials, drugs, medical writing, gifts or other services from Abbott and PharmaNutra; outside the submitted work. E Upadhyay reports the following published patents: A system and method of reusable filters for anti-pollution mask; a system and method for electricity generation through crop stubble by using microbial fuel cells; a system for disposed personal protection equipment (PPE) into biofuel through pyrolysis and method; a novel herbal pharmaceutical aid for formulation of gel and method thereof; herbal drug formulation for treating lung tissue degenerated by particulate matter exposure; and a file patent for a method to transform cow dung into the wall paint by using natural materials composition thereof. E Upadhyay also reports leadership or fiduciary roles in board, society, committee or advocacy groups (paid or unpaid) with the Indian Meteorological Society, Jaipur Chapter (India) as joint secretary and DSTPURSE Program as member secretary; outside the submitted work. P Willeit reports consulting fees from Novartis Pharmaceuticals; outside the submitted work. G Zamagni reports support for the present manuscript from the Italian Ministry of Health (Ricerca Corrente 34/2017), payments made to the Institute for Maternal and Child Health IRCCS Burlo Garofolo. M Zielińska reports other financial interests as an Alexion, AstraZeneca Rare Disease employee; outside the submitted work.
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Comment in
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Forecasting the global obesity epidemic through 2050.Lancet. 2025 Mar 8;405(10481):756-757. doi: 10.1016/S0140-6736(25)00260-0. Epub 2025 Mar 3. Lancet. 2025. PMID: 40049184 No abstract available.
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