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
- PMID: 40049186
- PMCID: PMC11920007
- DOI: 10.1016/S0140-6736(25)00355-1
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
Erratum in
-
Department of Error.Lancet. 2025 Aug 23;406(10505):810. doi: 10.1016/S0140-6736(25)01722-2. Lancet. 2025. PMID: 40849136 No abstract available.
Abstract
Background: 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.
Funding: Bill & Melinda Gates Foundation.
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 Q E S Adnani reports grants or contracts from Online Library Data Research funds from Universitas Padjadjaran, Bandung, Indonesia, under contract number 2152/UN6.3.1/PT.00/2024 and Acceleration to Associate Professor Grant from Universitas Padjadjaran, Bandung, Indonesia under contract number 1592/UN6.3.1/PT.00/2024, outside the submitted work. S Afzal reports support for their support in the present manuscript from King Edward Medical University; payment or honoraria for lectures, presentations, 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 National Bioethics Committee Pakistan, King Edward Medical University Ethical Review Board, Ethical Review Board Fatima Jinnah Medical University and Sir Ganga Ram Hospital, Member Technical Working Group on Infectious Diseases to formulate guidelines; leadership or fiduciary role in other board, society, committee or advocacy group (paid or unpaid) 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; other financial or non-financial interests through serving as Dean of Public Health and Preventive Medicine King Edward Medical University, Chief Editor Annals of King Edward Medical University since 2014, Director Quality Enhancement Cell King Edward Medical University, 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 on Infectious Diseases to formulate guidelines Member Dengue Experts Advisory Group Chair, Punjab Residency Program Research Committee; all 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), from Thoracic Society of Australia and New Zealand; all 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; all outside the submitted work. J Ärnlöv reports Payment or honoraria for lectures from AstraZeneca and Boehringer Ingelheim; participation on a Advisory Board with AstraZeneca, Astella, outside the submitted work. O C Baltatu reports support for their participation in the current manuscript from Alfaisal University, Anima Institute (AI) Research Professor Fellowship, and National Council for Scientific and Technological Development Fellowship (CNPq, 304224/2022-7); leadership or fiduciary role in other board, society, committee or advocacy group (paid or unpaid), from VividiWise Analytics, and São José dos Campos Tech Park, outside the submitted work. L Belo reports other financial or non-financial 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 contacts from Japan Society for the Promotion of Science (JSPS), Japanese Ministry of Education, Culture, Sports, Science and Technology (MEXT) through Grant-in-Aid for Scientific Research (KAKENHI) (23KF0126) and JSPS and the Australian Academy of Science through JSPS International Fellowship (P23712); leadership or fiduciary role in other board, society, committee or advocacy group (paid or unpaid), with the Rotary District 9675, Sydney, Australia, Global Health & Migration Hub Community, Global Health Hub Germany, Berlin, Germany, PLOS One, BMC Neurology, Frontiers in Neurology, Frontiers in Stroke, Frontiers in Public Health, Journal of Aging Research & BMC Medical Research Methodology, College of Reviewers, Canadian Institutes of Health Research (CIHR), Government of Canada, World Headache Society, Bengaluru, India, Cariplo Foundation, Milan, Italy, National Cerebral and Cardiovascular Center, Department of Neurology, Division of Cerebrovascular Medicine and Neurology, Suita, Osaka, Japan, and Cardiff University Biobank, Cardiff, UK; all outside the submitted work. E J Boyko reports Payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Korean Diabetes Association, International Society for the Diabetic Foot, Diabetes Association of the R.O.C. (Taiwan), American Diabetes Association; support for attending meetings and/or travel from Korean Diabetes Association, Diabetes Association of the R.O.C. (Taiwan), International Society for the Diabetic Foot; all outside the submitted work. M Carvalho reports other financial or non-financial support from LAQV/REQUIMTE, University of Porto, Porto, Portugal, and FCT/MCTES under the scope of the project UIDP/50006/2020 (DOI 10.54499/UIDP/50006/2020). N Conrad reports grants or contracts from Research Foundation Flanders (grant number 12ZU922N) through payments to their institute, all outside the submitted work. D Flood reports grants or contracts from NHLBI (award number K23HL161271); consulting fees from serving as a diabetes consultant for the World Health Organization in 2023-2024; all outside the submitted work. A A Fomenkov reports support for their participation in the present manuscript from the Ministry of Science and Higher Educa-tion of the Russian Federation (themes no. 122042600086-7). R C Franklin reports Support for attending meetings and/or travel from ACTM – Annual Conference 2022-2024; leadership or fiduciary role in other board, society, committee or advocacy group (paid or unpaid), from President of Australasian College of Tropical Medicine, outside the submitted work. A Guha reports grants or contracts with the Department of Defense from 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; all outside the submitted work. A M Hopkins reports support for their participation in the manuscript from National Health and Medical Research Council (Australia); grants or contacts from Tour de Cure, The Hospital Research Foundation, and Grant funding from Boehringer Ingelheim, outside the submitted work. C Hu reports support for their participation in the present manuscript from the National Social Science Fund of China (grant number: 24CSH106).I Ilic reports support for their participation in 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 their participation in the present manuscript from the Ministry of Technological Development and Innovation of the Republic of Serbia (no. 451-03-47/2023-01/200111). R M Islam is Associate Editor of Climacteric, the official journal of the International Menopause Society (IMS), and a member of the IMS Publication Steering Committee; these roles are unrelated to the content of this submission. N E Ismail reports Leadership or fiduciary role in other board, society, committee or advocacy group, unpaid, Council Member and The Bursar, Malaysian Academy of Pharmacy (MAP), Malaysia, and the Committee Member, 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. S K Kamarajah reports support for their participation in the current manuscript from NIHR Doctoral Fellowship scheme (NIHR300175). The funders had no role in study design or writing of this report. The views expressed are those of the authors and not necessarily those of the National Health Service, the NIHR or the UK Department of Health and Social Care. M Kivamaki reports grants or contracts Wellcome Trust, UK (221854/Z/20/Z), National Institute on Aging (NIH), US (R01AG056477), Medical Research Council, UK (MR/R024227/1, MR/Y014154/1), Academy of Finland (350426) through grants to their institutions, outside the submitted work. K Krishan reports other non-financial support from the UGC Centre of Advanced Study, CAS II, awarded to the Department of Anthropology, Panjab University, Chandigarh, India, outside the submitted work. B Lacey reports grants or contracts from Support from UK Biobank, funded largely by the UK Medical Research Council and Wellcome through payments to their institutions, outside the submitted work. M Lee reports support for their participation in the current 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 their participation in the current manuscript from 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 Technical Editor, Journal of the American Heart Association, outside the submitted work. D Lindholm reports stock or stock options and other financial interests in AstraZeneca as a former employee, outside the submitted work. S Liu reports grants or contracts from NIH R01ES031391; R01DK125403; R01HL156518; R01HL164485l R01ES034014; U01CA259208; R01HL164485, Royalties or licenses from Uptodate.com; consulting fees from American Society for Nutrition, Fred Hutchinson Cancer Research Center, Guangdong Provincial Hospital, Novo Nordisk, Research Foundation of State University of New York, and Twinhealth.com; support for attending meetings and/or travel from the American Heart Association, Chinese Nutrition Society, European Diabetes and Nutrition Study Group, and American Society of Nutrition; participation on a data safety monitoring board or advisory board with The Select Trial sponsored by Novo Nordisk; all outside the submitted work. S Lorkowski reports grants or contacts from dsm-firmenich (formerly DSM Nutritional Products) through payments to their 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 or advisory board with AMGEN, Daiichi Sankyo Deutschland, Novartis Pharma, and Sanofi-Aventis; all outside the submitted work. E Lytvyak reports grants or contracts from College of Physicians and Surgeons of Alberta, Government of Alberta, and Advanz Pharma; other financial or non-financial interests in University of Alberta and Alberta Health Services; all outside the submitted work. H R Marateb reports grants or contracts from The Beatriu de Pinós post-doctoral programme from Agency for Management of University and Research Grants, Government of Catalonia program (#2020 BP 00261) through payments to their institution, and from Agency for Management of University and Re-search Grants, Knowledge Industry Grants for 2024. Modality A. LLAVOR (2024 LLAV 00083), outside the submitted work. S A Meo reports grants or contracts from Researchers Supporting Project, King Saud University, Riyadh, Saudi Arabia (RSP-2025 R47), outside the submitted work. S Nomura reports support for their participation in the current manuscript from Ministry of Education, Culture, Sports, Science and Technology of Japan (24H00663), and Precursory Research for Embryonic Science and Technology from the Japan Science and Technology Agency (JPMJPR22R8). 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 Sanofi and through the Catedra Mundipharma-UAM of diabetic kidney disease and the Catedra AstraZeneca-UAM of chronic kidney disease and electrolytes; consulting fees, speaker fees or travel support from Advicciene, Astellas, AstraZeneca, Amicus, Amgen, Fresenius Medical Care, GSK, Boehringer-Ingelheim, Bayer, Sanofi-Genzyme, Menarini, Kyowa Kirin, Alexion, Idorsia, Chiesi, Otsuka, Novo-Nordisk and Vifor Fresenius Medical Care Renal Pharma; leadership or fiduciary role in other board, society, committee or advocacy group, unpaid, with council ERA. SOMANE; all outside the submitted work. S K Panda reports support for their participation in the current manuscript from Siksha ‘O’ Anusandhan (Deemed to be University) through their salary; grants or contracts from DST-GOVT. OF ODISHA (Letter No. 3444/ST); leadership or fiduciary role in other board, society, committee or advocacy group (paid or unpaid) as associate editor at Heliyon; outside the submitted work. R Passera reports Participation on a data safety monitoring board or advisory board as Member of the Data Safety Monitoring Board of the clinical trial “Consolidation with ADCT-402 (loncastuximab tesirine) after immunochemotherapy: a phase II study in BTKi-treated/ineligible Relapse/Refractory Mantle Cell Lymphoma (MCL) patients” - FIL, Fondazione Italiana Linfomi, Alessandria; leadership or fiduciary role in other board, society, committee or advocacy group (paid or unpaid), as Member of the EBMT Statistical Committee, European Society for Blood and Marrow Transplantation, Paris (F), and as a past member 2020–2023 (biostatistician) of the IRB/IEC Comitato Etico AO SS. Antonio e Biagio Alessandria-ASL AL-VC; all outside the submitted work. S Rege reports Leadership or fiduciary role in other board, society, committee or advocacy group (paid or unpaid), as Operational Lead – International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Medication Adherence and Persistence (MAP) Special Interest Group (SIG), Review Editor – Editorial Board of Pharmacoepidemiology section within Frontiers in Pharmacology, and Academic Editor – PLOS ONE Editorial Board; outside the submitted work. Y Samodra reports leadership or fiduciary role in other board, society, committee or advocacy group (paid or unpaid), with the Benang Merah Research Center, Indonesia as co-founder; outside the submitted work. A E Schutte reports grants or contracts from National Health and Medical Research Council of Australia and Medical Research Future Fund; consulting fees from Sky Labs, Servier, and Medtronic; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Servier, Abbott, Sanofi, AstraZeneca, Medtronic, Omron, Aktiia; support for attending meetings and/or travel from Servier, and Medtronic; leadership or fiduciary role in other board, society, com-mittee or advo-cacy group (paid or unpaid), as Co-Chair, National Hypertension Taskforce of Australia, Secretary, Australian Cardiovascular Alliance, and Board Member, Hypertension Australia; all outside the submitted work. V Sharma reports other financial or non-financial support from DFSS (MHA)'s research project (DFSS28(1)2019/EMR/6) at Institute of Forensic Science & Criminology, Panjab University, Chandigarh, India, outside the submitted work. J A Singh reports consulting fees from ROMTech, Atheneum, Clearview healthcare partners, American College of Rheumatology, Yale, Hulio, Horizon Pharmaceuticals, DINORA, ANI/Exeltis, USA, Frictionless Solutions, Schipher, Crealta/Horizon, Medisys, Fidia, PK Med, Two labs, 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, Seres Therapeutics, Tonix Pharmaceuticals Holding Corp, and Charlotte's Web Holdings, 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); outside the submitted work. J H V Ticoalu reports Leadership or fiduciary role in other board, society, committee or advocacy group (paid or unpaid), with Benang Merah Research Center, Indonesia as co-founder, outside the submitted work. M V Titova reports support for their participation in the current manuscript from the Ministry of Science and Higher Education of the Russian Federation (themes no. 122042600086-7). D Trico reports Payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from AstraZeneca, Eli Lilly, and 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, and 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; all outside the submitted work. E Upadhyay reports patents issued, planned, or pending, for 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 method to transform cow dung into the wall paint by using natural materials and composition thereof; leadership or fiduciary role in other board, society, committee or advocacy group (paid or unpaid), with the Executive Council Member, Indian Meteorological Society, Jaipur Chapter. (India) and Member Secretary-DSTPURSE Program; all outside the submitted work. P Willeit reports grants or contracts from Novartis Pharmaceuticals, outside the submitted work. M Zielińska reports other financial or non-financial in Alexion, AstraZeneca Rare Disease as an employee. E Zweck reports Payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events and support for travel and/or travel from Abiomed, outside the submitted work.
Figures
Comment in
-
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.
References
-
- GBD 2021 Adolescent BMI Collaborators 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. Lancet. 2025 doi: 10.1016/S0140-6736(25)00397-6. published online March 3. - DOI - PubMed
