Marie Ng1, Tom Fleming1, Margaret Robinson1, Blake Thomson1, Nicholas Graetz1, Christopher Margono1, Erin C Mullany1, Stan Biryukov1, Cristiana Abbafati2, Semaw Ferede Abera3, Jerry P Abraham4, Niveen M E Abu-Rmeileh5, Tom Achoki6, Fadia S AlBuhairan7, Zewdie A Alemu8, Rafael Alfonso9, Mohammed K Ali10, Raghib Ali11, Nelson Alvis Guzman12, Walid Ammar13, Palwasha Anwari14, Amitava Banerjee15, Simon Barquera16, Sanjay Basu17, Derrick A Bennett11, Zulfiqar Bhutta18, Jed Blore19, Norberto Cabral20, Ismael Campos Nonato16, Jung-Chen Chang21, Rajiv Chowdhury22, Karen J Courville23, Michael H Criqui24, David K Cundiff25, Kaustubh C Dabhadkar10, Lalit Dandona26, Adrian Davis27, Anand Dayama10, Samath D Dharmaratne28, Eric L Ding29, Adnan M Durrani30, Alireza Esteghamati31, Farshad Farzadfar31, Derek F J Fay27, Valery L Feigin32, Abraham Flaxman1, Mohammad H Forouzanfar1, Atsushi Goto33, Mark A Green34, Rajeev Gupta35, Nima Hafezi-Nejad31, Graeme J Hankey36, Heather C Harewood37, Rasmus Havmoeller38, Simon Hay11, Lucia Hernandez16, Abdullatif Husseini39, Bulat T Idrisov40, Nayu Ikeda41, Farhad Islami42, Eiman Jahangir43, Simerjot K Jassal44, Sun Ha Jee45, Mona Jeffreys46, Jost B Jonas47, Edmond K Kabagambe48, Shams Eldin Ali Hassan Khalifa49, Andre Pascal Kengne50, Yousef Saleh Khader51, Young-Ho Khang52, Daniel Kim53, Ruth W Kimokoti54, Jonas M Kinge55, Yoshihiro Kokubo56, Soewarta Kosen57, Gene Kwan58, Taavi Lai59, Mall Leinsalu60, Yichong Li61, Xiaofeng Liang62, Shiwei Liu62, Giancarlo Logroscino63, Paulo A Lotufo64, Yuan Lu29, Jixiang Ma62, Nana Kwaku Mainoo65, George A Mensah66, Tony R Merriman67, Ali H Mokdad1, Joanna Moschandreas68, Mohsen Naghavi1, Aliya Naheed69, Devina Nand70, K M Venkat Narayan10, Erica Leigh Nelson1, Marian L Neuhouser71, Muhammad Imran Nisar18, Takayoshi Ohkubo72, Samuel O Oti73, Andrea Pedroza16, Dorairaj Prabhakaran74, Nobhojit Roy75, Uchechukwu Sampson48, Hyeyoung Seo76, Sadaf G Sepanlou77, Kenji Shibuya78, Rahman Shiri79, Ivy Shiue80, Gitanjali M Singh29, Jasvinder A Singh81, Vegard Skirbekk55, Nicolas J C Stapelberg82, Lela Sturua83, Bryan L Sykes84, Martin Tobias1, Bach X Tran85, Leonardo Trasande86, Hideaki Toyoshima87, Steven van de Vijver73, Tommi J Vasankari88, J Lennert Veerman89, Gustavo Velasquez-Melendez90, Vasiliy Victorovich Vlassov91, Stein Emil Vollset92, Theo Vos1, Claire Wang93, XiaoRong Wang94, Elisabete Weiderpass95, Andrea Werdecker96, Jonathan L Wright97, Y Claire Yang98, Hiroshi Yatsuya99, Jihyun Yoon100, Seok-Jun Yoon101, Yong Zhao102, Maigeng Zhou61, Shankuan Zhu103, Alan D Lopez19, Christopher J L Murray1, Emmanuela Gakidou104. 1. Institute for Health Metrics and Evaluation, Seattle, WA, USA. 2. "La Sapienza" University of Rome, Rome, Italy. 3. School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia. 4. University of Texas School of Medicine, San Antonio, TX, USA. 5. Institute of Community and Public Health, Birzeti University, Ramallah, West Bank, Occupied Palestinian Territory. 6. Institute for Health Metrics and Evaluation, Seattle, WA, USA; Ministry of Health, Gaborone, Botswana. 7. King Abdulaziz Medical City, King Saud bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research Center, Riyadh, Saudi Arabia. 8. Debre Markos University, Debre Markos, Ethiopia. 9. University of Washington, Seattle, WA, USA. 10. Emory University, Atlanta, GA, USA. 11. University of Oxford, Oxford, UK. 12. Universidad de Cartagena, Cartagena de Indias, Colombia. 13. Ministry of Public Health, Beirut, Lebanon. 14. UNFPA, Kabul, Afghanistan. 15. University of Birmingham, Birmingham, UK. 16. National Institute of Public Health, Cuernavaca, Morelos, Mexico. 17. Stanford University, Stanford, CA, USA. 18. Aga Khan University Medical Center, Karachi, Pakistan. 19. University of Melbourne, Melbourne, VIC, Australia. 20. Universidad de Joinville-Univille, Joinville, Brazil. 21. National Taiwan University, Taipei, Taiwan. 22. University of Cambridge, Cambridge, UK. 23. Hospital Dr. Gustavo N. Collado, Chitre, Herrera, Panama. 24. University of California San Diego, San Diego, CA, USA. 25. Independent Researcher, Long Beach, CA, USA. 26. Institute for Health Metrics and Evaluation, Seattle, WA, USA; Public Health Foundation of India, New Delhi, India. 27. Public Health England, London, UK. 28. University of Peradeniya, Peradeniya, Sri Lanka. 29. Harvard School of Public Health, Boston, MA USA. 30. National Institutes of Health, Bethesda and Montgomery, MD, USA. 31. Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran. 32. National Institute for Stroke and Applied Neurosciences, AUT University, Auckland, New Zealand. 33. Department of Diabetes Research, National Center for Global Health and Medicine, Tokyo, Japan. 34. University of Sheffield, Sheffield, UK. 35. Fortis Escorts Hospital, Jaipur, India. 36. School of Medicine and Pharmacology, University of Western Australia, Perth, WA, Australia. 37. Eunice Gibson Polyclinic, Bridgetown, Barbados. 38. Karolinska Institute, Stockholm, Sweden. 39. Birzeit University, Birzeit, Ramallah, Palestine. 40. Brandeis University, Waltham, MA, USA. 41. National Institute of Health and Nutrition, Tokyo, Japan. 42. American Cancer Society, Atlanta, GA, USA. 43. Ochsner Medical Center, New Orleans, LA, USA. 44. VA San Diego, University of California San Diego, San Diego, CA, USA. 45. Graduate School of Public Health, Yonsei University, Seoul, Korea. 46. University of Bristol, Bristol, UK. 47. Department of Ophthalmology, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany. 48. Vanderbilt University, Nashville, TN, USA. 49. Supreme Council of Health, Doha, Qatar. 50. South African Medical Research Council, Cape Town, South Africa. 51. Jordan University of Science and Technology, AlRamtha, Jordan. 52. Institute of Health Policy and Management, Seoul National University College of Medicine, Seoul, Korea. 53. Northeastern University, Boston, MA, USA. 54. Simmons College, Boston, MA, USA. 55. The Norwegian Institute of Public Health, Oslo, Norway. 56. Department of Preventive Cardiology, Department of Preventive Medicine and Epidemiologic Informatics, National Cerebral and Cardiovascular Center, Osaka, Japan. 57. Center for Community Empowerment, Health Policy & Informatics, NIHRD, Jakarta, Indonesia. 58. Boston Medical Center, Boston, MA, USA. 59. Fourth View Consulting, Tallinn, Estonia. 60. The National Institute for Health Development, Tallinn, Estonia. 61. National Center for Chronic and Non-communicable Disease Control and Prevention, Beijing, China. 62. Chinese Center for Disease Control and Prevention, Beijing, China. 63. University of Bari, Bari, Italy. 64. University of São Paulo, São Paulo, Brazil. 65. Xpharmconsult, Kumasi, Ghana. 66. Center for Translation Research and Implementation Science (CTRIS), National Heart, Lung, and Blood Institute, Bethesda and Montgomery, MD, USA. 67. University of Otago, Dunedin, New Zealand. 68. University of Crete, Crete, Greece. 69. International Centre for Diarrhoeal Diseases Research, Dhaka, Bangladesh. 70. Ministry of Health, Suva, Republic of Fiji. 71. Fred Hutchinson Cancer Research Center, Seattle, WA, USA. 72. Teikyo University School of Medicine, Tokyo, Japan. 73. African Population and Health Research Center, Nairobi, Kenya. 74. Centre for Chronic Disease Control, New Delhi, India. 75. BARC Hospital, Mumbai, Maharashtra, India. 76. Department of Public Health, Graduate School, Seoul, Korea. 77. Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran. 78. University of Tokyo, Tokyo, Japan. 79. Finnish institute of Occupational Health, Helsinki, Finland. 80. Heriot-Watt University, Edinburgh, Scotland, UK. 81. University of Alabama at Birmingham, Birmingham, AL, USA. 82. Griffith University, Southport, QLD, Australia. 83. National Center for Disease Control and Public Health, Tbilisi, Georgia. 84. University of California-Irvine, Irvine, CA USA. 85. Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. 86. NYU School of Medicine, New York, NY, USA. 87. Health Care Center of Anjo Kosei Hospital, Anjo City, Japan. 88. UKK Institute for Health Promotion Research, Tampere, Finland. 89. University of Queensland, Brisbane, QLD, Australia. 90. Universidade Federal de Minas Gerais, Escola de Enfermagem, Belo Horizonte, Minas Gerais, Brazil. 91. National Research University Higher School of Economics, Moscow, Russia. 92. The Norwegian Institute of Public Health, Oslo, Norway; University of Bergen, Bergen, Norway. 93. Columbia University, New York, NY, USA. 94. Shandong University affiliated Jinan Central Hospital, Jinan, China. 95. Department of Medical Epidemiology and Biostatistics, Stockholm, Sweden. 96. Institute of Medical Sociology and Social Medicine, Marburg, Hessen, Germany. 97. School of Medicine, Seattle, WA, USA. 98. University of North Carolina, Chapel Hill, NC, USA. 99. Fujita Health University, Toyoake, Japan. 100. Department of Preventive Medicine, Seoul, Korea. 101. Korea University, Seoul, Korea. 102. Chongqing Medical University, Chongqing, China. 103. Zhejiang University School of Public Health, Hangzhou, China. 104. Institute for Health Metrics and Evaluation, Seattle, WA, USA. Electronic address: gakidou@uw.edu.
Abstract
BACKGROUND: In 2010, overweight and obesity were estimated to cause 3·4 million deaths, 3·9% of years of life lost, and 3·8% of disability-adjusted life-years (DALYs) worldwide. The rise in obesity has led to widespread calls for regular monitoring of changes in overweight and obesity prevalence in all populations. Comparable, up-to-date information about levels and trends is essential to quantify population health effects and to prompt decision makers to prioritise action. We estimate the global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013. METHODS: We systematically identified surveys, reports, and published studies (n=1769) that included data for height and weight, both through physical measurements and self-reports. We used mixed effects linear regression to correct for bias in self-reports. We obtained data for prevalence of obesity and overweight by age, sex, country, and year (n=19,244) with a spatiotemporal Gaussian process regression model to estimate prevalence with 95% uncertainty intervals (UIs). FINDINGS: Worldwide, the proportion of adults with a body-mass index (BMI) of 25 kg/m(2) or greater increased between 1980 and 2013 from 28·8% (95% UI 28·4-29·3) to 36·9% (36·3-37·4) in men, and from 29·8% (29·3-30·2) to 38·0% (37·5-38·5) in women. Prevalence has increased substantially in children and adolescents in developed countries; 23·8% (22·9-24·7) of boys and 22·6% (21·7-23·6) of girls were overweight or obese in 2013. The prevalence of overweight and obesity has also increased in children and adolescents in developing countries, from 8·1% (7·7-8·6) to 12·9% (12·3-13·5) in 2013 for boys and from 8·4% (8·1-8·8) to 13·4% (13·0-13·9) in girls. In adults, estimated prevalence of obesity exceeded 50% in men in Tonga and in women in Kuwait, Kiribati, Federated States of Micronesia, Libya, Qatar, Tonga, and Samoa. Since 2006, the increase in adult obesity in developed countries has slowed down. INTERPRETATION: Because of the established health risks and substantial increases in prevalence, obesity has become a major global health challenge. Not only is obesity increasing, but no national success stories have been reported in the past 33 years. Urgent global action and leadership is needed to help countries to more effectively intervene. FUNDING: Bill & Melinda Gates Foundation.
BACKGROUND: In 2010, overweight and obesity were estimated to cause 3·4 million deaths, 3·9% of years of life lost, and 3·8% of disability-adjusted life-years (DALYs) worldwide. The rise in obesity has led to widespread calls for regular monitoring of changes in overweight and obesity prevalence in all populations. Comparable, up-to-date information about levels and trends is essential to quantify population health effects and to prompt decision makers to prioritise action. We estimate the global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013. METHODS: We systematically identified surveys, reports, and published studies (n=1769) that included data for height and weight, both through physical measurements and self-reports. We used mixed effects linear regression to correct for bias in self-reports. We obtained data for prevalence of obesity and overweight by age, sex, country, and year (n=19,244) with a spatiotemporal Gaussian process regression model to estimate prevalence with 95% uncertainty intervals (UIs). FINDINGS: Worldwide, the proportion of adults with a body-mass index (BMI) of 25 kg/m(2) or greater increased between 1980 and 2013 from 28·8% (95% UI 28·4-29·3) to 36·9% (36·3-37·4) in men, and from 29·8% (29·3-30·2) to 38·0% (37·5-38·5) in women. Prevalence has increased substantially in children and adolescents in developed countries; 23·8% (22·9-24·7) of boys and 22·6% (21·7-23·6) of girls were overweight or obese in 2013. The prevalence of overweight and obesity has also increased in children and adolescents in developing countries, from 8·1% (7·7-8·6) to 12·9% (12·3-13·5) in 2013 for boys and from 8·4% (8·1-8·8) to 13·4% (13·0-13·9) in girls. In adults, estimated prevalence of obesity exceeded 50% in men in Tonga and in women in Kuwait, Kiribati, Federated States of Micronesia, Libya, Qatar, Tonga, and Samoa. Since 2006, the increase in adult obesity in developed countries has slowed down. INTERPRETATION: Because of the established health risks and substantial increases in prevalence, obesity has become a major global health challenge. Not only is obesity increasing, but no national success stories have been reported in the past 33 years. Urgent global action and leadership is needed to help countries to more effectively intervene. FUNDING: Bill & Melinda Gates Foundation.
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