National, regional, and global trends in adult overweight and obesity prevalences

Abstract

Background: Overweight and obesity prevalence are commonly used for public and policy communication of the extent of the obesity epidemic, yet comparable estimates of trends in overweight and obesity prevalence by country are not available.

Methods: We estimated trends between 1980 and 2008 in overweight and obesity prevalence and their uncertainty for adults 20 years of age and older in 199 countries and territories. Data were from a previous study, which used a Bayesian hierarchical model to estimate mean body mass index (BMI) based on published and unpublished health examination surveys and epidemiologic studies. Here, we used the estimated mean BMIs in a regression model to predict overweight and obesity prevalence by age, country, year, and sex. The uncertainty of the estimates included both those of the Bayesian hierarchical model and the uncertainty due to cross-walking from mean BMI to overweight and obesity prevalence.

Results: The global age-standardized prevalence of obesity nearly doubled from 6.4% (95% uncertainty interval 5.7-7.2%) in 1980 to 12.0% (11.5-12.5%) in 2008. Half of this rise occurred in the 20 years between 1980 and 2000, and half occurred in the 8 years between 2000 and 2008. The age-standardized prevalence of overweight increased from 24.6% (22.7-26.7%) to 34.4% (33.2-35.5%) during the same 28-year period. In 2008, female obesity prevalence ranged from 1.4% (0.7-2.2%) in Bangladesh and 1.5% (0.9-2.4%) in Madagascar to 70.4% (61.9-78.9%) in Tonga and 74.8% (66.7-82.1%) in Nauru. Male obesity was below 1% in Bangladesh, Democratic Republic of the Congo, and Ethiopia, and was highest in Cook Islands (60.1%, 52.6-67.6%) and Nauru (67.9%, 60.5-75.0%).

Conclusions: Globally, the prevalence of overweight and obesity has increased since 1980, and the increase has accelerated. Although obesity increased in most countries, levels and trends varied substantially. These data on trends in overweight and obesity may be used to set targets for obesity prevalence as requested at the United Nations high-level meeting on Prevention and Control of NCDs.

Figures

Figure 1

Mean BMI vs. prevalence of overweight (BMI ≥ 25 kg/m2), (A) by gender and (C) by decade; and mean BMI vs. prevalence of obesity (BMI ≥ 30 kg/m2), (B) by gender and (D) by decade. Data are from 243 health examination surveys, by age and sex.

Figure 2

Age-standardized prevalence of (a) overweight in 1980, 1990, 2000, and 2008, for males and females, (b) obesity in 1980, 1990, 2000, and 2008, for males and females, adults ≥ 20 years. Panels (c) and (d) show the posterior standard deviation (akin to standard error) of each estimate.

Figure 3

Trends in age-standardized mean obesity (BMI ≥ 30 kg/m2) by subregion between 1980 and 2008, adults ≥ 20 years. See Additional file 4 for trends by country. The solid line represents the posterior mean estimate and the shaded area the 95% uncertainty interval.

Figure 4

Trends in age-standardized mean overweight (BMI ≥ 25 kg/m2) by subregion between 1980 and 2008, adults ≥ 20 years. See Additional file 3 for trends by country. The solid line represents the posterior mean estimate and the shaded area the 95% uncertainty interval.

Figure 5

Change in the age-standardized prevalences of obesity (BMI ≥ 30 kg/m2) and overweight (BMI ≥ 25 kg/m2) in high-income regions and Central and Eastern Europe for male and female adults ≥ 20 years, percentage points per decade. Note that the absolute change in prevalence is shown, rather than a relative change in the prevalence of obesity / overweight.

Figure 6

Change in the age-standardized prevalences of obesity (BMI ≥ 30 kg/m2) and overweight (BMI ≥ 25 kg/m2) in Asia and Oceania for male and female adults ≥ 20 years, percentage points per decade. Note that the absolute change in prevalence is shown, rather than a relative change in the prevalence of obesity / overweight.

Figure 7

Change in the age-standardized prevalences of obesity (BMI ≥ 30 kg/m2) and overweight (BMI ≥ 25 kg/m2) in sub-Saharan Africa for male and female adults ≥ 20 years, percentage points per decade. Note that the absolute change in prevalence is shown, rather than a relative change in the prevalence of obesity / overweight.

Figure 8

Change in the age-standardized prevalences of obesity (BMI ≥ 30 kg/m2) and overweight (BMI ≥ 25 kg/m2) in Latin America and Caribbean for male and female adults ≥ 20 years, percentage points per decade. Note that the absolute change in prevalence is shown, rather than a relative change in the prevalence of obesity / overweight.

Figure 9

Change in the age-standardized prevalences of obesity (BMI ≥ 30 kg/m2) and overweight (BMI ≥ 25 kg/m2) in North Africa and Middle East for male and female adults ≥ 20 years, percentage points per decade. Note that the absolute change in prevalence is shown, rather than a relative change in the prevalence of obesity / overweight.