National, regional, and global trends in body-mass index since 1980: systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9·1 million participants
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Summary Background Rising body weight is a major public health concern. However there have been few worldwide comparative analyses of long-term trends of body mass index (BMI), and none that have used recent national health examination surveys. Methods We estimated trends in mean in BMI and their uncertainties for adults 20 years of age and older in 199 countries and territories. Data were from published and unpublished health examination surveys and epidemiologic studies. For each sex, we used a Bayesian hierarchical model to estimate BMI by age, country, and year, accounting for whether a given study was nationally representative. Findings Between 1980 and 2008, global mean BMI increased at an annualized rate of 0.4 (95% uncertainty interval 0.2, 0.6, posterior probability (PP) of being a true increase > 0.999) kg/m2/decade for men and 0.5 (0.3–0.7, PP > 0.999) for women. National BMI change for women ranged from non-significant declines in 19 countries to rising over 2.5 (PP > 0.999) kg/m2/decade in Tonga and Cook Islands. There was an increase in male BMI in all but a few countries, reaching over 2 kg/m2/decade in Nauru and Cook Islands, PP > 0.999. Male and female BMIs in 2008 were highest in some Oceania countries, reaching 33.9 (32.8, 35.0) kg/m2 (men) and 35.0 (33.6, 36.3) (women) in Nauru. Female BMI was lowest in Bangladesh (20.5; 19.8, 21.3) kg/m2 and male BMI in Democratic Republic of the Congo 19.9 (18.2, 21.5), with BMI also below 21.5 kg/m2 for both sexes in a few countries in sub-Saharan Africa, and East, South, and Southeast Asia. USA had the highest BMI among high-income countries, followed by New Zealand. In 2008, an estimated 1.47 billion adults worldwide had BMI ≥ 25 kg/m2; of these 205 (193, 217) million men and 297 (280, 315) million women were obese. Interpretation Globally, mean BMI increased since 1980. The trends since 1980, and mean population BMI in 2008, varied substantially across nations. Interventions and policies that can curb or reverse the increase, and mitigate the health effects of high BMI by targeting its metabolic mediators, are needed in most countries.
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The worldwide increase in body-mass index and blood glucose is of particular concern because of the absence of effective interventions.
“The worldwide increase in body-mass index and blood glucose is of particular concern in view of the absence of effective interventions.62,74”
Because of the worldwide diabetes epidemic and increasing prevalence of other cardiovascular risk factors in young adults and overall, especially in low-income and middle-income countries, the shift in stroke burden towards younger populations is likely to continue globally unless effective preventive strategies are urgently implemented.
“In view of the worldwide epidemic of diabetes38 and increasing prevalence of other cardiovascular risk factors in young adults39,40 and overall,41–45 especially in low-income and middle-income countries, the shift in stroke burden towards younger populations is likely to continue globally unless effective preventive strategies are urgently implemented.”
From Global and regional burden of stroke during 1990-2010: findings from the Global Burden of Disease Study 2010 (2014) · cites this paper as [43]
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- Authors
- Finucane, M. M., Stevens, G. A., Cowan, M. J., Danaei, G., Lin, J. K., Paciorek, C. J., Singh, G. M., Gutierrez, H. R., Lu, Y., Bahalim, A. N., Farzadfar, F., Riley, L. M., & Ezzati, M.
- Affiliations
- Harvard University (US)
- World Health Organization (CH)
- University of California, Berkeley (US)
- Corresponding author
- Ezzati, Majid
- ORCID
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2011-02
- Volume
- 377
- Issue
- 9765
- Pages
- 557-567
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- PMC
- PMC4472365
- OpenAlex
- W2158569927
- Semantic Scholar
- bb36dfb4edae9fe5689e11318064287de613cfec
- Cited by
- 4,050
- References
- 64
- Citations by year
- 2026: 31 · 2025: 79 · 2024: 137 · 2023: 149 · 2022: 163 · 2021: 208 · 2020: 236 · 2019: 249 · 2018: 263 · 2017: 306 · 2016: 421 · 2015: 477 · 2014: 461 · 2013: 387 · 2012: 337
- FWCI
- 415.52
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (publishedVersion, other-oa)
- University of Southern Denmark Research Portal (University of Southern Denmark) (publishedVersion)
- SERVAL (Université de Lausanne) (publishedVersion, other-oa)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Dépôt institutionnel de l'Université libre de Bruxelles (Université Libre de Bruxelles) (submittedVersion)
- IRIS (submittedVersion)
- AYBU AVESIS (submittedVersion)
- Americanae (AECID Library) (submittedVersion, other-oa)
- CINECA IRIS Institutial research information system (University of Pisa) (submittedVersion)
- Institutional Research Information System (Università degli Studi di Brescia) (submittedVersion)
- Nova Science Publishers (Nova Science Publishers, Inc.) (submittedVersion)
- Griffith Research Online (submittedVersion, cc-by-nc-nd)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (submittedVersion)
- Funders
- Harvard University
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Oncology › Cancer Risks and Factors
- Keywords
- body mass index, obesity trends, adult obesity, sex differences in BMI, global obesity, Nauru, Oceania, sub-Saharan Africa, health examination surveys, Bayesian hierarchical model
- MeSH terms
- Adult, Bayes Theorem, Female, Health Surveys, Humans, Male, Global Health, Body Mass Index, Logistic Models, Young Adult
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