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. 2017 Jul 6;377(1):13-27.
doi: 10.1056/NEJMoa1614362. Epub 2017 Jun 12.

Health Effects of Overweight and Obesity in 195 Countries over 25 Years

GBD 2015 Obesity Collaborators; Ashkan Afshin, Mohammad H Forouzanfar, Marissa B Reitsma, Patrick Sur, Kara Estep, Alex Lee, Laurie Marczak, Ali H Mokdad, Maziar Moradi-Lakeh, Mohsen Naghavi, Joseph S Salama, Theo Vos, Kalkidan H Abate, Cristiana Abbafati, Muktar B Ahmed, Ziyad Al-Aly, Ala’a Alkerwi, Rajaa Al-Raddadi, Azmeraw T Amare, Alemayehu Amberbir, Adeladza K Amegah, Erfan Amini, Stephen M Amrock, Ranjit M Anjana, Johan Ärnlöv, Hamid Asayesh, Amitava Banerjee, Aleksandra Barac, Estifanos Baye, Derrick A Bennett, Addisu S Beyene, Sibhatu Biadgilign, Stan Biryukov, Espen Bjertness, Dube J Boneya, Ismael Campos-Nonato, Juan J Carrero, Pedro Cecilio, Kelly Cercy, Liliana G Ciobanu, Leslie Cornaby, Solomon A Damtew, Lalit Dandona, Rakhi Dandona, Samath D Dharmaratne, Bruce B Duncan, Babak Eshrati, Alireza Esteghamati, Valery L Feigin, João C Fernandes, Thomas Fürst, Tsegaye T Gebrehiwot, Audra Gold, Philimon N Gona, Atsushi Goto, Tesfa D Habtewold, Kokeb T Hadush, Nima Hafezi-Nejad, Simon I Hay, Masako Horino, Farhad Islami, Ritul Kamal, Amir Kasaeian, Srinivasa V Katikireddi, Andre P Kengne, Chandrasekharan N Kesavachandran, Yousef S Khader, Young-Ho Khang, Jagdish Khubchandani, Daniel Kim, Yun J Kim, Yohannes Kinfu, Soewarta Kosen, Tiffany Ku, Barthelemy Kuate Defo, G Anil Kumar, Heidi J Larson, Mall Leinsalu, Xiaofeng Liang, Stephen S Lim, Patrick Liu, Alan D Lopez, Rafael Lozano, Azeem Majeed, Reza Malekzadeh, Deborah C Malta, Mohsen Mazidi, Colm McAlinden, Stephen T McGarvey, Desalegn T Mengistu, George A Mensah, Gert B M Mensink, Haftay B Mezgebe, Erkin M Mirrakhimov, Ulrich O Mueller, Jean J Noubiap, Carla M Obermeyer, Felix A Ogbo, Mayowa O Owolabi, George C Patton, Farshad Pourmalek, Mostafa Qorbani, Anwar Rafay, Rajesh K Rai, Chhabi L Ranabhat, Nikolas Reinig, Saeid Safiri, Joshua A Salomon, Juan R Sanabria, Itamar S Santos, Benn Sartorius, Monika Sawhney, Josef Schmidhuber, Aletta E Schutte, Maria I Schmidt, Sadaf G Sepanlou, Moretza Shamsizadeh, Sara Sheikhbahaei, Min-Jeong Shin, Rahman Shiri, Ivy Shiue, Hirbo S Roba, Diego A S Silva, Jonathan I Silverberg, Jasvinder A Singh, Saverio Stranges, Soumya Swaminathan, Rafael Tabarés-Seisdedos, Fentaw Tadese, Bemnet A Tedla, Balewgizie S Tegegne, Abdullah S Terkawi, J S Thakur, Marcello Tonelli, Roman Topor-Madry, Stefanos Tyrovolas, Kingsley N Ukwaja, Olalekan A Uthman, Masoud Vaezghasemi, Tommi Vasankari, Vasiliy V Vlassov, Stein E Vollset, Elisabete Weiderpass, Andrea Werdecker, Joshua Wesana, Ronny Westerman, Yuichiro Yano, Naohiro Yonemoto, Gerald Yonga, Zoubida Zaidi, Zerihun M Zenebe, Ben Zipkin, Christopher J L Murray
Free PMC article

Health Effects of Overweight and Obesity in 195 Countries over 25 Years

GBD 2015 Obesity Collaborators et al. N Engl J Med. .
Free PMC article

Abstract

Background: Although the rising pandemic of obesity has received major attention in many countries, the effects of this attention on trends and the disease burden of obesity remain uncertain.

Methods: We analyzed data from 68.5 million persons to assess the trends in the prevalence of overweight and obesity among children and adults between 1980 and 2015. Using the Global Burden of Disease study data and methods, we also quantified the burden of disease related to high body-mass index (BMI), according to age, sex, cause, and BMI in 195 countries between 1990 and 2015.

Results: In 2015, a total of 107.7 million children and 603.7 million adults were obese. Since 1980, the prevalence of obesity has doubled in more than 70 countries and has continuously increased in most other countries. Although the prevalence of obesity among children has been lower than that among adults, the rate of increase in childhood obesity in many countries has been greater than the rate of increase in adult obesity. High BMI accounted for 4.0 million deaths globally, nearly 40% of which occurred in persons who were not obese. More than two thirds of deaths related to high BMI were due to cardiovascular disease. The disease burden related to high BMI has increased since 1990; however, the rate of this increase has been attenuated owing to decreases in underlying rates of death from cardiovascular disease.

Conclusions: The rapid increase in the prevalence and disease burden of elevated BMI highlights the need for continued focus on surveillance of BMI and identification, implementation, and evaluation of evidence-based interventions to address this problem. (Funded by the Bill and Melinda Gates Foundation.).

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Figures

Figure 1
Figure 1
Global prevalence of obesity in 2015 by age, sex, and quintile of Socio−demographic Index (a) and trends in age−standardized prevalence of obesity among children (b) adults (c).
Figure 1
Figure 1
Global prevalence of obesity in 2015 by age, sex, and quintile of Socio−demographic Index (a) and trends in age−standardized prevalence of obesity among children (b) adults (c).
Figure 1
Figure 1
Global prevalence of obesity in 2015 by age, sex, and quintile of Socio−demographic Index (a) and trends in age−standardized prevalence of obesity among children (b) adults (c).
Figure 2
Figure 2
Age−standardized national prevalence of obesity among adult (males [a], females [b]) and children (males [c], females [d]) in 2015.
Figure 2
Figure 2
Age−standardized national prevalence of obesity among adult (males [a], females [b]) and children (males [c], females [d]) in 2015.
Figure 2
Figure 2
Age−standardized national prevalence of obesity among adult (males [a], females [b]) and children (males [c], females [d]) in 2015.
Figure 2
Figure 2
Age−standardized national prevalence of obesity among adult (males [a], females [b]) and children (males [c], females [d]) in 2015.
Figure 3
Figure 3
Global disability-adjusted life years (in millions) related to high body mass index (BMI) among adults by cause and the level of BMI in 1990 (a) and 2015 (b) and global deaths (in millions) related to high BMI in 1990 (c) and 2015 (d).
Figure 3
Figure 3
Global disability-adjusted life years (in millions) related to high body mass index (BMI) among adults by cause and the level of BMI in 1990 (a) and 2015 (b) and global deaths (in millions) related to high BMI in 1990 (c) and 2015 (d).
Figure 3
Figure 3
Global disability-adjusted life years (in millions) related to high body mass index (BMI) among adults by cause and the level of BMI in 1990 (a) and 2015 (b) and global deaths (in millions) related to high BMI in 1990 (c) and 2015 (d).
Figure 3
Figure 3
Global disability-adjusted life years (in millions) related to high body mass index (BMI) among adults by cause and the level of BMI in 1990 (a) and 2015 (b) and global deaths (in millions) related to high BMI in 1990 (c) and 2015 (d).
Figure 4
Figure 4
Decomposition of percent changes in all−cause disability-adjusted life years (DALYs) (a) and deaths(b) related to high body mass index from 1990 to 2015 due to population growth, population ageing, risk exposure and the underlying rates of DALYs and deaths by quintiles of Socio−demographic Index. Locations are reported in order of percent change in the number of related DALYs from 1990 to 2015. DALYs=disability−adjusted life−years.
Figure 4
Figure 4
Decomposition of percent changes in all−cause disability-adjusted life years (DALYs) (a) and deaths(b) related to high body mass index from 1990 to 2015 due to population growth, population ageing, risk exposure and the underlying rates of DALYs and deaths by quintiles of Socio−demographic Index. Locations are reported in order of percent change in the number of related DALYs from 1990 to 2015. DALYs=disability−adjusted life−years.
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