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id	title	slug	type	status	content	archieml	archieml_update_statistics	published_at	updated_at	gdocSuccessorId	authors	excerpt	created_at_in_wordpress	updated_at_in_wordpress	featured_image	formattingOptions	markdown	wpApiSnapshot
12778	Obesity	obesity	page	publish	<!-- wp:paragraph --> <p>Obesity is most commonly measured using the body mass index (BMI) scale. The World Health Organization <a rel="noopener noreferrer" href="https://web.archive.org/web/20220219072441/https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight" target="_blank">define BMI</a> as: "<span class="storydeck">a simple index of weight-for-height that is commonly used to classify underweight, overweight and obesity in adults."{ref}BMI is defined as the weight in kilograms divided by the square of the height in metres (kg/m<sup>2</sup>). For example, an adult who weighs 70kg and whose height is 1.75m will have a BMI of 22.9.</span> This is calculated as 70kg / 1.75<sup>2</sup> = 70 / 3.06 = 22.9{/ref}</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>BMI values are used to define whether an individual is considered to be underweight, healthy, overweight or obese. The WHO defines these categories using the cut-off points: an individual with a BMI between 25.0 and 30.0 is considered to be 'overweight'; a BMI greater than 30.0 is defined as 'obese'.{ref}World Health Organization. BMI Classification. <em>Global Database on Body Mass Index</em>. Available <a href="https://knoema.com/WHOGDOBMIMay/who-global-database-on-body-mass-index-bmi">online</a>.{/ref}</p> <!-- /wp:paragraph --> <!-- wp:owid/summary --> <!-- wp:list --> <ul><li><a href="https://ourworldindata.org/obesity#obesity-is-one-of-the-leading-risk-factors-for-early-death">Obesity is one of the leading risk factors for premature death. It was linked to 4.7 million deaths globally in 2017.</a></li><li><a href="https://ourworldindata.org/obesity#8-of-global-deaths-are-attributed-to-obesity">8% of global deaths were attributed to obesity in 2017.</a></li><li><a href="https://ourworldindata.org/obesity#there-is-a-10-fold-difference-in-death-rates-from-obesity-across-the-world">There are large differences – 10-fold – in death rates from obesity across the world.</a></li><li><a href="https://ourworldindata.org/obesity#what-share-of-adults-are-obese">13% of adults in the world are obese.</a></li><li><a href="https://ourworldindata.org/obesity#what-share-of-adults-are-overweight">39% of adults in the world are overweight.</a></li><li><a href="https://ourworldindata.org/obesity#childhood-obesity">One-in-five children and adolescents, globally, are overweight.</a></li><li><a href="https://ourworldindata.org/obesity#what-are-the-drivers-of-obesity">Obesity is determined by the balance of energy intake and expenditure. Rates have increased as the calories have become more readily available.</a></li></ul> <!-- /wp:list --> <!-- /wp:owid/summary --> <!-- wp:paragraph --> <p><strong>Related research entries</strong></p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p><a href="https://owid.cloud/food-per-person">Food per person</a> – food availability has increased significantly in most countries across the world. How does the supply of calories, protein and fats vary between countries? How has this changed over time?</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p><a href="https://owid.cloud/hunger-and-undernourishment">Hunger and Undernourishment</a> – obesity rates have now overtaken hunger rates globally. But it remains the case that high levels of obesity and hunger can occur in a country at any given time. How does undernourishment vary across the world? How has it changed over time?</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p><a href="https://owid.cloud/micronutrient-deficiency">Micronutrient Deficiency</a> – getting sufficient intake of calories (a requirement for obesity) does not guarantee an individual gets the full range of essential vitamins and minerals (micronutrients) for good health. Dietary diversity varies significantly across the world. How common is micronutrient deficiency and who is most at risk?</p> <!-- /wp:paragraph --> <!-- wp:heading --> <h2>Obesity is one of the leading risk factors for early death</h2> <!-- /wp:heading --> <!-- wp:heading {"level":4} --> <h4>Obesity is responsible for 4.7 million premature deaths each year</h4> <!-- /wp:heading --> <!-- wp:paragraph --> <p>Obesity is one of the world's largest health problems – one that has shifted from being a problem in rich countries, to one that spans all income levels.<br><br>The <em>Global Burden of Disease</em> is a major global study on the causes and risk factors for death and disease published in the medical journal <em>The Lancet</em>.{ref}The latest study can be found at the website of the Lancet here: <a href="https://www.thelancet.com/gbd">TheLancet.com/GBD</a><br><br>The 2017 study was published as GBD 2017 Risk Factor Collaborators – "Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017" and is online <a href="http://www.healthdata.org/research-article/global-regional-and-national-comparative-risk-assessment-84-behavioral-0">here</a>.{/ref} These estimates of the annual number of deaths attributed to a wide range of risk factors are shown here. This chart is shown for the global total, but can be explored for any country or region using the "change country" toggle.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Obesity – defined as having a high body-mass index – is a risk factor for several of the world's leading causes of death, including heart disease, stroke, diabetes and various types of cancer.{ref}WHO (2018) – Fact sheet – Obesity and overweight. Updated February 2018. Online <a href="https://www.who.int/en/news-room/fact-sheets/detail/obesity-and-overweight">here</a>.{/ref} Obesity does not directly <em>cause</em> of any of these health impacts but can increase their likelihood of occurring. In the chart we see that it is one of the leading risk factors for death globally. </p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>According to the <em>Global Burden of Disease</em> study 4.7 million people died prematurely in 2017 as a result of obesity. To put this into context: this was close to four times the number that died in <a href="https://ourworldindata.org/grapher/road-deaths-by-type">road accidents</a>, and close to five times the number that died from <a href="https://owid.cloud/hiv-aids">HIV/AIDS</a> in 2017.{ref}The <em>Global Burden of Disease</em> study <a href="https://ourworldindata.org/grapher/annual-number-of-deaths-by-cause">estimates that</a> around 1.2 million died in road accidents in 2017, and just under 1 million from HIV/AIDS.{/ref}</p> <!-- /wp:paragraph --> <!-- wp:html --> <iframe src="https://ourworldindata.org/grapher/number-of-deaths-by-risk-factor" style="width: 100%; height: 600px; border: 0px none;"></iframe> <!-- /wp:html --> <!-- wp:heading --> <h2>The global distribution of health impacts from obesity</h2> <!-- /wp:heading --> <!-- wp:heading {"level":4} --> <h4>8% of global deaths are the result of obesity</h4> <!-- /wp:heading --> <!-- wp:paragraph --> <p>Globally, <a href="https://ourworldindata.org/grapher/share-of-deaths-obesity?tab=chart&country=OWID_WRL">8% of deaths</a> in 2017 were the result of obesity – this represents an increase from 4.5% in 1990.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>This share varies significantly across the world. In the map here we see the share of deaths attributed to obesity across countries.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Across many middle-income countries – particularly across Eastern Europe, Central Asia, North Africa, and Latin America – more than 15% of deaths were attributed to obesity in 2017. This most likely results from having a high prevalence of obesity, but poorer overall health and healthcare systems relatively to high-income countries with similarly high levels of obesity. <br><br>In most high-income countries this share is in the range of 8 to 10%. This is about half the share of many middle-income countries. The large outliers among rich countries are Japan and South Korea: there only around 5% of premature deaths are attributed to obesity. </p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Across low-income countries – especially across Sub-Saharan Africa – obesity accounts for less than 5% of deaths.</p> <!-- /wp:paragraph --> <!-- wp:html --> <iframe src="https://ourworldindata.org/grapher/share-of-deaths-obesity" style="width: 100%; height: 600px; border: 0px none;"></iframe> <!-- /wp:html --> <!-- wp:heading {"level":4} --> <h4>There is a 10-fold difference in death rates from obesity across the world</h4> <!-- /wp:heading --> <!-- wp:paragraph --> <p>Death rates from obesity give us an accurate comparison of differences in its mortality impacts between countries and over time. In contrast to the share of deaths that we studied before, death rates are not influenced by how other causes or risk factors for death are changing.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>In the map here we see differences in death rates from obesity across the world. Globally, <a href="https://ourworldindata.org/grapher/death-rate-from-obesity?tab=chart&country=OWID_WRL">the death rate</a> from obesity was around 60 per 100,000 in 2017.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>The overall picture does in fact match closely with the share of deaths: death rates are high across middle-income countries, especially across Eastern Europe, Central Asia, North Africa and Latin America. Rates there can be close to 200 per 100,000. This is more than ten times greater than rates at the bottom: Japan and South Korea have the lowest rates in the world at 14 and 20 deaths per 100,000, respectively.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>When we look at the <a href="https://ourworldindata.org/grapher/death-rate-vs-share-obesity">relationship between</a> death rates and the prevalence of obesity we find a positive one: death rates tend to be higher in countries where more people have obesity. But what we also notice is that for a given prevalence of obesity, death rates can vary by a factor of four. 23% of Russian and Norwegian are obese, yet Russia's death rate is four times higher. Clearly it's not <em>only</em> the prevalence of obesity that plays a role but also other factors such as underlying health, other confounding risk factors (such as <a href="https://owid.cloud/alcohol-consumption">alcohol</a>, <a href="https://owid.cloud/drug-use">drugs</a>, <a href="https://owid.cloud/smoking">smoking</a> and other lifestyle factors) and healthcare systems.</p> <!-- /wp:paragraph --> <!-- wp:html --> <iframe src="https://ourworldindata.org/grapher/death-rate-from-obesity" style="width: 100%; height: 600px; border: 0px none;"></iframe> <!-- /wp:html --> <!-- wp:heading --> <h2>What share of adults are obese?</h2> <!-- /wp:heading --> <!-- wp:heading {"level":4} --> <h4>13% of adults in the world are obese</h4> <!-- /wp:heading --> <!-- wp:paragraph --> <p>Globally, 13% of adults aged 18 years and older were obese in 2016.{ref}WHO (2018) – Fact sheet – Obesity and overweight. Updated February 2018. Online <a href="https://www.who.int/en/news-room/fact-sheets/detail/obesity-and-overweight">here</a>.{/ref} Obesity <a href="https://ourworldindata.org/obesity#definitions-measurement">is defined</a> as having a body-mass index equal to or greater than 30. </p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>In the map here we see the share of adults who are obese across countries. Overall we see a pattern roughly in line with prosperity: the prevalence of obesity tends to be higher in richer countries across Europe, North America, and Oceania. Obesity rates are much lower across South Asia and Sub-Saharan Africa. </p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>More than one-in-three (36%) of adults in the United States were obese in 2016. In India this share was around 10 times lower (3.9%).</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>The relationship between income and obesity generally holds true – as we see in the comparison <a href="https://ourworldindata.org/grapher/obesity-vs-gdp">here</a>. But there are some notable exceptions. The small Pacific Island States stand out clearly: they have very high rates of obesity – 61% in Nauru and 55% in Palau – for their level of income. At the other end of the spectrum, Japan, South Korea and Singapore have very low levels of obesity for their level of income.</p> <!-- /wp:paragraph --> <!-- wp:html --> <iframe style="width: 100%; height: 600px; border: 0px none;" src="https://ourworldindata.org/grapher/share-of-adults-defined-as-obese"></iframe> <!-- /wp:html --> <!-- wp:quote --> <blockquote class="wp-block-quote"><p><strong>Related charts – share of men and women that are obese.</strong> <a href="https://ourworldindata.org/grapher/share-of-men-defined-as-obese">This map</a> allows you to explore the share of men that are obese; <a href="https://ourworldindata.org/grapher/share-of-females-defined-as-obese">this map</a> allows you to explore this data for women across the world. <a href="https://ourworldindata.org/grapher/obesity-in-men-vs-obesity-in-women">This chart</a> shows the comparison of obesity in men and women.</p></blockquote> <!-- /wp:quote --> <!-- wp:heading --> <h2>What share of adults are overweight?</h2> <!-- /wp:heading --> <!-- wp:heading {"level":4} --> <h4>39% of adults in the world are overweight or obese</h4> <!-- /wp:heading --> <!-- wp:paragraph --> <p>Globally, 39% of adults aged 18 years and older were overweight or obese in 2016.{ref}WHO (2018) – Fact sheet – Obesity and overweight. Updated February 2018. Online <a href="https://www.who.int/en/news-room/fact-sheets/detail/obesity-and-overweight">here</a>.{/ref} Being overweight <a href="https://ourworldindata.org/obesity#definitions-measurement">is also defined</a> based on body-mass index: the threshold value is lower than for obesity, with a BMI equal to or greater than 25.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>In the map here we see the share of adults who are overweight or obese across countries. The overall pattern is very closely aligned with the distribution of obesity across the world: the share of people who are overweight tends to be higher in richer countries and lower at lower incomes. What is of course true is that the share who are overweight (have a BMI greater than or equal to 25) is much higher than the share that are obese (a BMI of 30 or greater).</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>In most high-income countries, around two-thirds of adults are overweight or obese. In the US, 70% are. At the lowest end of the scale, across South Asia and Sub-Saharan Africa around 1-in-5 adults have a BMI greater than 25.</p> <!-- /wp:paragraph --> <!-- wp:quote --> <blockquote class="wp-block-quote"><p><strong>Related charts – share of men and women that are overweight</strong> <strong>or obese</strong>. <a href="https://ourworldindata.org/grapher/share-of-men-defined-as-overweight">This map</a> allows you to explore the share of men that are overweight or obese; <a href="https://ourworldindata.org/grapher/share-of-females-defined-as-overweight">this map</a> allows you to explore this data for women across the world.</p></blockquote> <!-- /wp:quote --> <!-- wp:html --> <iframe style="width: 100%; height: 600px; border: 0px none;" src="https://ourworldindata.org/grapher/share-of-adults-who-are-overweight"></iframe> <!-- /wp:html --> <!-- wp:heading --> <h2>Body Mass Index (BMI)</h2> <!-- /wp:heading --> <!-- wp:heading {"level":4} --> <h4>Mean BMI in adult women</h4> <!-- /wp:heading --> <!-- wp:paragraph --> <p>Body Mass Index (BMI) is <a href="https://ourworldindata.org/obesity#definitions-measurement">used to define</a> the share of individuals that are underweight, in the 'healthy' range, overweight and obese.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>In the map here we see the distribution of mean BMI for adult women – aged 18 years and older – across the world. The <a href="https://ourworldindata.org/grapher/mean-body-mass-index-bmi-in-adult-women?tab=chart&country=OWID_WRL">global mean BMI</a> for women in 2016 was 25 – just on the threshold from the WHO's 'healthy' to 'overweight' classification. This has increased from a mean BMI of 22 – in the mid-range of 'healthy' – in the 1970s.</p> <!-- /wp:paragraph --> <!-- wp:html --> <iframe style="width: 100%; height: 600px; border: 0px none;" src="https://ourworldindata.org/grapher/mean-body-mass-index-bmi-in-adult-women" width="300" height="150"></iframe> <!-- /wp:html --> <!-- wp:heading {"level":4} --> <h4>Mean BMI in adult men</h4> <!-- /wp:heading --> <!-- wp:paragraph --> <p>Body Mass Index (BMI) is <a href="https://ourworldindata.org/obesity#definitions-measurement">used to define</a> the share of individuals that are underweight, in the 'healthy' range, overweight and obese.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>In the map here we see the distribution of mean BMI for adult men – aged 18 years and older – across the world. The <a href="https://ourworldindata.org/grapher/mean-body-mass-index-bmi-in-adult-males?tab=chart&country=OWID_WRL">global mean BMI</a> for men in 2016 was 24.5 – just on the threshold from the WHO's 'healthy' to 'overweight' classification. This has increased from a mean BMI of 21.7 – in the mid-range of 'healthy' – in the 1970s.</p> <!-- /wp:paragraph --> <!-- wp:html --> <iframe style="width: 100%; height: 600px; border: 0px none;" src="https://ourworldindata.org/grapher/mean-body-mass-index-bmi-in-adult-males" width="300" height="150"></iframe> <!-- /wp:html --> <!-- wp:heading --> <h2>Childhood obesity</h2> <!-- /wp:heading --> <!-- wp:heading {"level":4} --> <h4>Share of children that are overweight</h4> <!-- /wp:heading --> <!-- wp:paragraph --> <p>Obesity and overweight in children are also measured on the basis of body-mass-index (BMI). However, interpretation of BMI scores is treated differently for children and adolescents. Weight categories are defined in relation to WHO Growth Standards – a child is defined as overweight if their weight-for-height is more than two standard deviations from the median of the WHO Child Growth Standards.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>The World Health Organization reports that the share of children and adolescents aged 5-19 who are overweight or obese has risen from 4% in 1975 to around 18% in 2016.{ref}WHO (2018) – Fact sheet – Obesity and overweight. Updated February 2018. Online <a href="https://www.who.int/en/news-room/fact-sheets/detail/obesity-and-overweight">here</a>.{/ref}</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>In the map here we see the share of very young children – aged 2 to 4 years old – who are overweight based on WHO Child Growth Standards. In many countries as many as every third or fourth child is overweight.</p> <!-- /wp:paragraph --> <!-- wp:html --> <iframe src="https://ourworldindata.org/grapher/children-who-are-overweight-sdgs?time=1990..2016" style="width: 100%; height: 600px; border: 0px none;"></iframe> <!-- /wp:html --> <!-- wp:heading --> <h2>What are the drivers of obesity?</h2> <!-- /wp:heading --> <!-- wp:paragraph --> <p>At a basic level, weight gain – eventually leading to being overweight or obesity – is determined by a balance of energy.{ref}Hall, K. D., Heymsfield, S. B., Kemnitz, J. W., Klein, S., Schoeller, D. A., & Speakman, J. R. (2012). <a href="https://academic.oup.com/ajcn/article/95/4/989/4576902">Energy balance and its components: implications for body weight regulation</a>. <em>The American Journal of Clinical Nutrition</em>, <em>95</em>(4), 989-994.{/ref} When we consume more energy – typically measured in kilocalories – than the energy expended to maintain life and carry out daily activites, we gain weight. This is a called an energy surplus. When we consume less energy than we expend, we lose weight – this is an energy deficit. </p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>This means there are two potential drivers of the increase in obesity rates in recent decades: either an increase in kilocalorie intake i.e. we eat more; or we expend less energy in daily life through lower activity levels. Both elements are likely to play a role in the rise in obesity.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>To tackle obesity it's likely that interventions which address both components: energy intake and expenditure are necessary.{ref}Hill, J. O., Wyatt, H. R., & Peters, J. C. (2012). <a href="https://www.ahajournals.org/doi/full/10.1161/circulationaha.111.087213">Energy balance and obesity</a>. <em>Circulation</em>, <em>126</em>(1), 126-132.{/ref}</p> <!-- /wp:paragraph --> <!-- wp:heading {"level":4} --> <h4>Daily supply of calories</h4> <!-- /wp:heading --> <!-- wp:paragraph --> <p>Over the past century – but particularly over the past 50 years – the <a href="https://owid.cloud/food-per-person">supply of calories</a> has increased across the world. In the 1960s, the global <a href="https://ourworldindata.org/grapher/daily-per-capita-caloric-supply?tab=chart&country=Asia~Europe~North+America~South+America~Africa">average supply of calories</a> (that is, the availability of calories for consumers to eat) was 2200kcal per person per day. By 2013 this had increased to 2800kcal.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Across most countries, energy consumption has therefore increased. If this increase was not met with an increase in energy expenditure, weight gain and a rise in obesity rates is the result. </p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>In the chart here we see the relationship between the share of men that are overweight or obese (on the y-axis) versus the daily average supply of kilocalories per person. Overall we see a strong positive relationship: countries with higher rates of overweight tend to have a higher supply of calories. </p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>If you press 'play' on the interactive timeline you can see how this has changed for each country over time. Most countries move upwards and to the right: the supply of calories has increased at the same time as obesity rates have increased.</p> <!-- /wp:paragraph --> <!-- wp:html --> <iframe style="width: 100%; height: 600px; border: 0px none;" src="https://ourworldindata.org/grapher/share-of-adult-men-overweight-or-obese-vs-daily-supply-of-calories" width="300" height="150"></iframe> <!-- /wp:html --> <!-- wp:heading --> <h2>Definitions & Measurement</h2> <!-- /wp:heading --> <!-- wp:heading {"level":4} --> <h4>How do we measure obesity in adults?</h4> <!-- /wp:heading --> <!-- wp:paragraph --> <p>The most common metric used for assessing the prevalence of obesity is the body mass index (BMI) scale. The World Health Organization <a rel="noopener noreferrer" href="https://web.archive.org/web/20220219072441/https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight" target="_blank">define BMI</a> as: "<span class="storydeck">a simple index of weight-for-height that is commonly used to classify underweight, overweight and obesity in adults. It is defined as the weight in kilograms divided by the square of the height in metres (kg/m<sup>2</sup>). For example, an adult who weighs 70kg and whose height is 1.75m will have a BMI of 22.9."</span>{ref}This is calculated as 70kg / 1.75<sup>2</sup> = 70 / 3.06 = 22.9{/ref}</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Measured BMI values are used to define whether an individual is considered to be underweight, healthy, overweight or obese. The WHO defines these categories using the cut-off points in the table. For example, an individual with a BMI between 25.0 and 30.0 is considered to be 'overweight'; a BMI greater than 30.0 is defined as 'obese'.{ref}World Health Organization. BMI Classification. <em>Global Database on Body Mass Index</em>. Available <a href="https://knoema.com/WHOGDOBMIMay/who-global-database-on-body-mass-index-bmi">online</a>.{/ref}</p> <!-- /wp:paragraph --> <!-- wp:image {"align":"center","id":12788,"linkDestination":"custom"} --> <div class="wp-block-image"><figure class="aligncenter"><a href="https://ourworldindata.org/app/uploads/2017/08/BMI-classification.png"><img src="https://ourworldindata.org/app/uploads/2017/08/BMI-classification.png" alt="" class="wp-image-12788"/></a></figure></div> <!-- /wp:image --> <!-- wp:heading {"level":4} --> <h4>How do we measure obesity in children and adolescents?</h4> <!-- /wp:heading --> <!-- wp:paragraph --> <p>The metric for measuring bodyweight in children and adolescents is also the body mass index (BMI) scale, measured in the same way described above. However, interpretation of BMI scores is treated differently for children and adolescents. Whilst there is no differentiation of weight categories in adults based on sex or age, these are important factors in the body composition of children. Factors such as age, gender and sexual maturation affect the BMI of younger individuals. For interpretation of individuals between the ages of 2 and 20 years old, BMI is measured relative to peers of the same age and gender, with weight classifications judged as shown in the table.{ref}Centers for Disease Control and Prevention. Body Mass Index: Considerations for Practitioners. Available <a href="https://www.cdc.gov/obesity/downloads/bmiforpactitioners.pdf">online</a>.{/ref}</p> <!-- /wp:paragraph --> <!-- wp:image {"align":"center","id":12825,"linkDestination":"custom"} --> <div class="wp-block-image"><figure class="aligncenter"><a href="https://ourworldindata.org/app/uploads/2017/08/BMI-classification-children.png"><img src="https://ourworldindata.org/app/uploads/2017/08/BMI-classification-children.png" alt="" class="wp-image-12825"/></a></figure></div> <!-- /wp:image --> <!-- wp:heading {"level":4} --> <h4>Is BMI an appropriate measure of weight-related health?</h4> <!-- /wp:heading --> <!-- wp:paragraph --> <p>The merits of using BMI as an indicator of body fat and obesity are still contested. A key contention to the use of BMI indicators is that it provides a measure of body mass/weight rather than providing a direct measure of body fat. Whilst physicians continue to use BMI as a general indicator of weight-related health risks, there are some cases where its use should be considered more carefully{ref}Centers for Disease Control and Prevention. Body Mass Index: Considerations for Practitioners. Available <a href="https://www.cdc.gov/obesity/downloads/bmiforpactitioners.pdf">online</a>.{/ref}:</p> <!-- /wp:paragraph --> <!-- wp:list --> <ul><li>muscle mass can increase bodyweight; this means athletes or individuals with a high muscle mass percentage can be deemed overweight on the BMI scale, even if they have a low or healthy body fat percentage;</li><li>muscle and bone density tends to decline as we get older; this means that an older individual may have a higher percentage body fat than a younger individual with the same BMI;</li><li>women tend to have a higher body fat percentage than men for a given BMI.</li></ul> <!-- /wp:list --> <!-- wp:paragraph --> <p>Physicians must therefore evaluate BMI results carefully on a individual basis. Despite outlier cases where BMI is an inappropriate indicator of body fat, its use provides a reasonable measure of the risk of weight-related health factors across most individuals across the general population.</p> <!-- /wp:paragraph --> <!-- wp:heading --> <h2>Data sources</h2> <!-- /wp:heading --> <!-- wp:heading {"level":4} --> <h4>NCD Risk Factor Collaboration</h4> <!-- /wp:heading --> <!-- wp:list --> <ul><li><strong>Data</strong>: Mean and distributions of body mass index (BMI), by country</li><li><strong>Geographical coverage: </strong>Global- by country</li><li><strong>Time span: </strong>1975 onwards</li><li><strong>Available at:</strong> <a rel="noopener noreferrer" href="http://www.ncdrisc.org/index.html" target="_blank">http://www.ncdrisc.org/index.html</a></li></ul> <!-- /wp:list --> <!-- wp:heading {"level":4} --> <h4>WHO Global Database on Body Mass Index</h4> <!-- /wp:heading --> <!-- wp:list --> <ul><li><strong>Data</strong>: Share of population by weight category</li><li><strong>Geographical coverage: </strong>Global – by country</li><li><strong>Time span: </strong>1960 onwards</li><li><strong>Available at:</strong> <a href="https://www.who.int/data/gho/data/themes/topics/topic-details/GHO/body-mass-index" target="_blank" rel="noreferrer noopener">https://www.who.int/data/gho/data/themes/topics/topic-details/GHO/body-mass-index</a></li></ul> <!-- /wp:list --> <!-- wp:heading {"level":4} --> <h4>Institute of Health Metrics and Evaluation (IHME) Global Burden of Disease (GBDx) Data Tool</h4> <!-- /wp:heading --> <!-- wp:list --> <ul><li><strong>Data</strong>: Number of deaths and death rates from obesity</li><li><strong>Geographical coverage: </strong>Global – by country</li><li><strong>Time span: </strong>1990 onwards</li><li><strong>Available at: </strong><a rel="noopener noreferrer" href="http://www.healthdata.org/results/data-visualizations" target="_blank">http://www.healthdata.org/results/data-visualizations</a></li></ul> <!-- /wp:list -->	{ "id": "wp-12778", "slug": "obesity", "content": { "toc": [], "body": [ { "type": "text", "value": [ { "text": "Obesity is most commonly measured using the body mass index (BMI) scale. The World Health Organization ", "spanType": "span-simple-text" }, { "url": "https://web.archive.org/web/20220219072441/https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight", "children": [ { "text": "define BMI", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": " as: \"", "spanType": "span-simple-text" }, { "children": [ { "text": "a simple index of weight-for-height that is commonly used to classify underweight, overweight and obesity in adults.\"{ref}BMI is defined as the weight in kilograms divided by the square of the height in metres (kg/m", "spanType": "span-simple-text" }, { "children": [ { "text": "2", "spanType": "span-simple-text" } ], "spanType": "span-superscript" }, { "text": "). For example, an adult who weighs 70kg and whose height is 1.75m will have a BMI of 22.9.", "spanType": "span-simple-text" } ], "spanType": "span-fallback" }, { "text": " This is calculated as 70kg / 1.75", "spanType": "span-simple-text" }, { "children": [ { "text": "2", "spanType": "span-simple-text" } ], "spanType": "span-superscript" }, { "text": " = 70 / 3.06 = 22.9{/ref}", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "BMI values are used to define whether an individual is considered to be underweight, healthy, overweight or obese. The WHO defines these categories using the cut-off points: an individual with a BMI between 25.0 and 30.0 is considered to be 'overweight'; a BMI greater than 30.0 is defined as 'obese'.{ref}World Health Organization. BMI Classification.\u00a0", "spanType": "span-simple-text" }, { "children": [ { "text": "Global Database on Body Mass Index", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": ". Available ", "spanType": "span-simple-text" }, { "url": "https://knoema.com/WHOGDOBMIMay/who-global-database-on-body-mass-index-bmi", "children": [ { "text": "online", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": ".{/ref}", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "entry-summary", "items": [ { "slug": "obesity-is-one-of-the-leading-risk-factors-for-early-death", "text": "Obesity is one of the leading risk factors for premature death. It was linked to 4.7 million deaths globally in 2017." }, { "slug": "8-of-global-deaths-are-attributed-to-obesity", "text": "8% of global deaths were attributed to obesity in 2017." }, { "slug": "there-is-a-10-fold-difference-in-death-rates-from-obesity-across-the-world", "text": "There are large differences \u2013 10-fold \u2013 in death rates from obesity across the world." }, { "slug": "what-share-of-adults-are-obese", "text": "13% of adults in the world are obese." }, { "slug": "what-share-of-adults-are-overweight", "text": "39% of adults in the world are overweight." }, { "slug": "childhood-obesity", "text": "One-in-five children and adolescents, globally, are overweight." }, { "slug": "what-are-the-drivers-of-obesity", "text": "Obesity is determined by the balance of energy intake and expenditure. Rates have increased as the calories have become more readily available." } ], "parseErrors": [] }, { "type": "text", "value": [ { "children": [ { "text": "Related research entries", "spanType": "span-simple-text" } ], "spanType": "span-bold" } ], "parseErrors": [] }, { "type": "text", "value": [ { "url": "https://owid.cloud/food-per-person", "children": [ { "text": "Food per person", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": " \u2013 food availability has increased significantly in most countries across the world. How does the supply of calories, protein and fats vary between countries? How has this changed over time?", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "url": "https://owid.cloud/hunger-and-undernourishment", "children": [ { "text": "Hunger and Undernourishment", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": " \u2013 obesity rates have now overtaken hunger rates globally. But it remains the case that high levels of obesity and hunger can occur in a country at any given time. How does undernourishment vary across the world? How has it changed over time?", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "url": "https://owid.cloud/micronutrient-deficiency", "children": [ { "text": "Micronutrient Deficiency", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": " \u2013 getting sufficient intake of calories (a requirement for obesity) does not guarantee an individual gets the full range of essential vitamins and minerals (micronutrients) for good health. Dietary diversity varies significantly across the world. How common is micronutrient deficiency and who is most at risk?", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "horizontal-rule", "parseErrors": [] }, { "text": [ { "text": "Obesity is one of the leading risk factors for early death", "spanType": "span-simple-text" } ], "type": "heading", "level": 1, "parseErrors": [] }, { "type": "horizontal-rule", "parseErrors": [] }, { "text": [ { "text": "Obesity is responsible for 4.7 million premature deaths each year", "spanType": "span-simple-text" } ], "type": "heading", "level": 3, "parseErrors": [] }, { "type": "text", "value": [ { "text": "Obesity is one of the world's largest health problems \u2013 one that has shifted from being a problem in rich countries, to one that spans all income levels.", "spanType": "span-simple-text" }, { "spanType": "span-newline" }, { "spanType": "span-newline" }, { "text": "The ", "spanType": "span-simple-text" }, { "children": [ { "text": "Global Burden of Disease", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": " is a major global study on the causes and risk factors for death and disease published in the medical journal ", "spanType": "span-simple-text" }, { "children": [ { "text": "The Lancet", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": ".{ref}The latest study can be found at the website of the Lancet here: ", "spanType": "span-simple-text" }, { "url": "https://www.thelancet.com/gbd", "children": [ { "text": "TheLancet.com/GBD", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "spanType": "span-newline" }, { "spanType": "span-newline" }, { "text": "The 2017 study was published as GBD 2017 Risk Factor Collaborators \u2013 \"Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017\" and is online ", "spanType": "span-simple-text" }, { "url": "http://www.healthdata.org/research-article/global-regional-and-national-comparative-risk-assessment-84-behavioral-0", "children": [ { "text": "here", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": ".{/ref} These estimates of the annual number of deaths attributed to a wide range of risk factors are shown here. This chart is shown for the global total, but can be explored for any country or region using the \"change country\" toggle.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "Obesity \u2013 defined as having a high body-mass index \u2013 is a risk factor for several of the world's leading causes of death, including heart disease, stroke, diabetes and various types of cancer.{ref}WHO (2018) \u2013 Fact sheet \u2013 Obesity and overweight. Updated February 2018. Online ", "spanType": "span-simple-text" }, { "url": "https://www.who.int/en/news-room/fact-sheets/detail/obesity-and-overweight", "children": [ { "text": "here", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": ".{/ref} Obesity does not directly ", "spanType": "span-simple-text" }, { "children": [ { "text": "cause", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": " of any of these health impacts but can increase their likelihood of occurring. In the chart we see that it is one of the leading risk factors for death globally. ", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "According to the ", "spanType": "span-simple-text" }, { "children": [ { "text": "Global Burden of Disease", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": " study 4.7 million people died prematurely in 2017 as a result of obesity. To put this into context: this was close to four times the number that died in ", "spanType": "span-simple-text" }, { "url": "https://ourworldindata.org/grapher/road-deaths-by-type", "children": [ { "text": "road accidents", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": ", and close to five times the number that died from ", "spanType": "span-simple-text" }, { "url": "https://owid.cloud/hiv-aids", "children": [ { "text": "HIV/AIDS", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": " in 2017.{ref}The ", "spanType": "span-simple-text" }, { "children": [ { "text": "Global Burden of Disease", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": " study ", "spanType": "span-simple-text" }, { "url": "https://ourworldindata.org/grapher/annual-number-of-deaths-by-cause", "children": [ { "text": "estimates that", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": " around 1.2 million died in road accidents in 2017, and just under 1 million from HIV/AIDS.{/ref}", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "url": "https://ourworldindata.org/grapher/number-of-deaths-by-risk-factor", "type": "chart", "parseErrors": [] }, { "type": "horizontal-rule", "parseErrors": [] }, { "text": [ { "text": "The global distribution of health impacts from obesity", "spanType": "span-simple-text" } ], "type": "heading", "level": 1, "parseErrors": [] }, { "type": "horizontal-rule", "parseErrors": [] }, { "text": [ { "text": "8% of global deaths are the result of obesity", "spanType": "span-simple-text" } ], "type": "heading", "level": 3, "parseErrors": [] }, { "type": "text", "value": [ { "text": "Globally, ", "spanType": "span-simple-text" }, { "url": "https://ourworldindata.org/grapher/share-of-deaths-obesity?tab=chart&country=OWID_WRL", "children": [ { "text": "8% of deaths", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": " in 2017 were the result of obesity \u2013 this represents an increase from 4.5% in 1990.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "This share varies significantly across the world. In the map here we see the share of deaths attributed to obesity across countries.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "Across many middle-income countries \u2013 particularly across Eastern Europe, Central Asia, North Africa, and Latin America \u2013 more than 15% of deaths were attributed to obesity in 2017. This most likely results from having a high prevalence of obesity, but poorer overall health and healthcare systems relatively to high-income countries with similarly high levels of obesity. ", "spanType": "span-simple-text" }, { "spanType": "span-newline" }, { "spanType": "span-newline" }, { "text": "In most high-income countries this share is in the range of 8 to 10%. This is about half the share of many middle-income countries. The large outliers among rich countries are Japan and South Korea: there only around 5% of premature deaths are attributed to obesity. ", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "Across low-income countries \u2013 especially across Sub-Saharan Africa \u2013 obesity accounts for less than 5% of deaths.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "url": "https://ourworldindata.org/grapher/share-of-deaths-obesity", "type": "chart", "parseErrors": [] }, { "text": [ { "text": "There is a 10-fold difference in death rates from obesity across the world", "spanType": "span-simple-text" } ], "type": "heading", "level": 3, "parseErrors": [] }, { "type": "text", "value": [ { "text": "Death rates from obesity give us an accurate comparison of differences in its mortality impacts between countries and over time. In contrast to the share of deaths that we studied before, death rates are not influenced by how other causes or risk factors for death are changing.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "In the map here we see differences in death rates from obesity across the world. Globally, ", "spanType": "span-simple-text" }, { "url": "https://ourworldindata.org/grapher/death-rate-from-obesity?tab=chart&country=OWID_WRL", "children": [ { "text": "the death rate", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": " from obesity was around 60 per 100,000 in 2017.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "The overall picture does in fact match closely with the share of deaths: death rates are high across middle-income countries, especially across Eastern Europe, Central Asia, North Africa and Latin America. Rates there can be close to 200 per 100,000. This is more than ten times greater than rates at the bottom: Japan and South Korea have the lowest rates in the world at 14 and 20 deaths per 100,000, respectively.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "When we look at the ", "spanType": "span-simple-text" }, { "url": "https://ourworldindata.org/grapher/death-rate-vs-share-obesity", "children": [ { "text": "relationship between", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": " death rates and the prevalence of obesity we find a positive one: death rates tend to be higher in countries where more people have obesity. But what we also notice is that for a given prevalence of obesity, death rates can vary by a factor of four. 23% of Russian and Norwegian are obese, yet Russia's death rate is four times higher. Clearly it's not ", "spanType": "span-simple-text" }, { "children": [ { "text": "only", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": " the prevalence of obesity that plays a role but also other factors such as underlying health, other confounding risk factors (such as ", "spanType": "span-simple-text" }, { "url": "https://owid.cloud/alcohol-consumption", "children": [ { "text": "alcohol", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": ", ", "spanType": "span-simple-text" }, { "url": "https://owid.cloud/drug-use", "children": [ { "text": "drugs", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": ", ", "spanType": "span-simple-text" }, { "url": "https://owid.cloud/smoking", "children": [ { "text": "smoking", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": " and other lifestyle factors) and healthcare systems.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "url": "https://ourworldindata.org/grapher/death-rate-from-obesity", "type": "chart", "parseErrors": [] }, { "type": "horizontal-rule", "parseErrors": [] }, { "text": [ { "text": "What share of adults are obese?", "spanType": "span-simple-text" } ], "type": "heading", "level": 1, "parseErrors": [] }, { "type": "horizontal-rule", "parseErrors": [] }, { "text": [ { "text": "13% of adults in the world are obese", "spanType": "span-simple-text" } ], "type": "heading", "level": 3, "parseErrors": [] }, { "type": "text", "value": [ { "text": "Globally, 13% of adults aged 18 years and older were obese in 2016.{ref}WHO (2018) \u2013 Fact sheet \u2013 Obesity and overweight. Updated February 2018. Online ", "spanType": "span-simple-text" }, { "url": "https://www.who.int/en/news-room/fact-sheets/detail/obesity-and-overweight", "children": [ { "text": "here", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": ".{/ref} Obesity ", "spanType": "span-simple-text" }, { "url": "https://ourworldindata.org/obesity#definitions-measurement", "children": [ { "text": "is defined", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": " as having a body-mass index equal to or greater than 30. ", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "In the map here we see the share of adults who are obese across countries. Overall we see a pattern roughly in line with prosperity: the prevalence of obesity tends to be higher in richer countries across Europe, North America, and Oceania. Obesity rates are much lower across South Asia and Sub-Saharan Africa. ", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "More than one-in-three (36%) of adults in the United States were obese in 2016. In India this share was around 10 times lower (3.9%).", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "The relationship between income and obesity generally holds true \u2013 as we see in the comparison ", "spanType": "span-simple-text" }, { "url": "https://ourworldindata.org/grapher/obesity-vs-gdp", "children": [ { "text": "here", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": ". But there are some notable exceptions. The small Pacific Island States stand out clearly: they have very high rates of obesity \u2013 61% in Nauru and 55% in Palau \u2013 for their level of income. At the other end of the spectrum, Japan, South Korea and Singapore have very low levels of obesity for their level of income.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "url": "https://ourworldindata.org/grapher/share-of-adults-defined-as-obese", "type": "chart", "parseErrors": [] }, { "url": "https://ourworldindata.org/grapher/obesity-in-men-vs-obesity-in-women", "type": "prominent-link", "parseErrors": [] }, { "type": "horizontal-rule", "parseErrors": [] }, { "text": [ { "text": "What share of adults are overweight?", "spanType": "span-simple-text" } ], "type": "heading", "level": 1, "parseErrors": [] }, { "type": "horizontal-rule", "parseErrors": [] }, { "text": [ { "text": "39% of adults in the world are overweight or obese", "spanType": "span-simple-text" } ], "type": "heading", "level": 3, "parseErrors": [] }, { "type": "text", "value": [ { "text": "Globally, 39% of adults aged 18 years and older were overweight or obese in 2016.{ref}WHO (2018) \u2013 Fact sheet \u2013 Obesity and overweight. Updated February 2018. Online ", "spanType": "span-simple-text" }, { "url": "https://www.who.int/en/news-room/fact-sheets/detail/obesity-and-overweight", "children": [ { "text": "here", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": ".{/ref} Being overweight ", "spanType": "span-simple-text" }, { "url": "https://ourworldindata.org/obesity#definitions-measurement", "children": [ { "text": "is also defined", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": " based on body-mass index: the threshold value is lower than for obesity, with a BMI equal to or greater than 25.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "In the map here we see the share of adults who are overweight or obese across countries. The overall pattern is very closely aligned with the distribution of obesity across the world: the share of people who are overweight tends to be higher in richer countries and lower at lower incomes. What is of course true is that the share who are overweight (have a BMI greater than or equal to 25) is much higher than the share that are obese (a BMI of 30 or greater).", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "In most high-income countries, around two-thirds of adults are overweight or obese. In the US, 70% are. At the lowest end of the scale, across South Asia and Sub-Saharan Africa around 1-in-5 adults have a BMI greater than 25.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "url": "https://ourworldindata.org/grapher/share-of-females-defined-as-overweight", "type": "prominent-link", "parseErrors": [] }, { "url": "https://ourworldindata.org/grapher/share-of-adults-who-are-overweight", "type": "chart", "parseErrors": [] }, { "type": "horizontal-rule", "parseErrors": [] }, { "text": [ { "text": "Body Mass Index (BMI)", "spanType": "span-simple-text" } ], "type": "heading", "level": 1, "parseErrors": [] }, { "type": "horizontal-rule", "parseErrors": [] }, { "text": [ { "text": "Mean BMI in adult women", "spanType": "span-simple-text" } ], "type": "heading", "level": 3, "parseErrors": [] }, { "type": "text", "value": [ { "text": "Body Mass Index (BMI) is ", "spanType": "span-simple-text" }, { "url": "https://ourworldindata.org/obesity#definitions-measurement", "children": [ { "text": "used to define", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": " the share of individuals that are underweight, in the 'healthy' range, overweight and obese.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "In the map here we see the distribution of mean BMI for adult women \u2013 aged 18 years and older \u2013 across the world. The ", "spanType": "span-simple-text" }, { "url": "https://ourworldindata.org/grapher/mean-body-mass-index-bmi-in-adult-women?tab=chart&country=OWID_WRL", "children": [ { "text": "global mean BMI", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": " for women in 2016 was 25 \u2013 just on the threshold from the WHO's 'healthy' to 'overweight' classification. This has increased from a mean BMI of 22 \u2013 in the mid-range of 'healthy' \u2013 in the 1970s.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "url": "https://ourworldindata.org/grapher/mean-body-mass-index-bmi-in-adult-women", "type": "chart", "parseErrors": [] }, { "text": [ { "text": "Mean BMI in adult men", "spanType": "span-simple-text" } ], "type": "heading", "level": 3, "parseErrors": [] }, { "type": "text", "value": [ { "text": "Body Mass Index (BMI) is ", "spanType": "span-simple-text" }, { "url": "https://ourworldindata.org/obesity#definitions-measurement", "children": [ { "text": "used to define", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": " the share of individuals that are underweight, in the 'healthy' range, overweight and obese.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "In the map here we see the distribution of mean BMI for adult men \u2013 aged 18 years and older \u2013 across the world. The ", "spanType": "span-simple-text" }, { "url": "https://ourworldindata.org/grapher/mean-body-mass-index-bmi-in-adult-males?tab=chart&country=OWID_WRL", "children": [ { "text": "global mean BMI", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": " for men in 2016 was 24.5 \u2013 just on the threshold from the WHO's 'healthy' to 'overweight' classification. This has increased from a mean BMI of 21.7 \u2013 in the mid-range of 'healthy' \u2013 in the 1970s.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "url": "https://ourworldindata.org/grapher/mean-body-mass-index-bmi-in-adult-males", "type": "chart", "parseErrors": [] }, { "type": "horizontal-rule", "parseErrors": [] }, { "text": [ { "text": "Childhood obesity", "spanType": "span-simple-text" } ], "type": "heading", "level": 1, "parseErrors": [] }, { "type": "horizontal-rule", "parseErrors": [] }, { "text": [ { "text": "Share of children that are overweight", "spanType": "span-simple-text" } ], "type": "heading", "level": 3, "parseErrors": [] }, { "type": "text", "value": [ { "text": "Obesity and overweight in children are also measured on the basis of body-mass-index (BMI). However, interpretation of BMI scores is treated differently for children and adolescents.\u00a0Weight categories are defined in relation to WHO Growth Standards \u2013 a child is defined as overweight if their weight-for-height is more than two standard deviations from the median of the WHO Child Growth Standards.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "The World Health Organization reports that the share of children and adolescents aged 5-19 who are overweight or obese has risen from 4% in 1975 to around 18% in 2016.{ref}WHO (2018) \u2013 Fact sheet \u2013 Obesity and overweight. Updated February 2018. Online ", "spanType": "span-simple-text" }, { "url": "https://www.who.int/en/news-room/fact-sheets/detail/obesity-and-overweight", "children": [ { "text": "here", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": ".{/ref}", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "In the map here we see the share of very young children \u2013 aged 2 to 4 years old \u2013 who are overweight based on WHO Child Growth Standards. In many countries as many as every third or fourth child is overweight.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "url": "https://ourworldindata.org/grapher/children-who-are-overweight-sdgs?time=1990..2016", "type": "chart", "parseErrors": [] }, { "type": "horizontal-rule", "parseErrors": [] }, { "text": [ { "text": "What are the drivers of obesity?", "spanType": "span-simple-text" } ], "type": "heading", "level": 1, "parseErrors": [] }, { "type": "horizontal-rule", "parseErrors": [] }, { "type": "text", "value": [ { "text": "At a basic level, weight gain \u2013 eventually leading to being overweight or obesity \u2013 is determined by a balance of energy.{ref}Hall, K. D., Heymsfield, S. B., Kemnitz, J. W., Klein, S., Schoeller, D. A., & Speakman, J. R. (2012). ", "spanType": "span-simple-text" }, { "url": "https://academic.oup.com/ajcn/article/95/4/989/4576902", "children": [ { "text": "Energy balance and its components: implications for body weight regulation", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": ".\u00a0", "spanType": "span-simple-text" }, { "children": [ { "text": "The American Journal of Clinical Nutrition", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": ",\u00a0", "spanType": "span-simple-text" }, { "children": [ { "text": "95", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": "(4), 989-994.{/ref} When we consume more energy \u2013 typically measured in kilocalories \u2013 than the energy expended to maintain life and carry out daily activites, we gain weight. This is a called an energy surplus. When we consume less energy than we expend, we lose weight \u2013 this is an energy deficit. ", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "This means there are two potential drivers of the increase in obesity rates in recent decades: either an increase in kilocalorie intake i.e. we eat more; or we expend less energy in daily life through lower activity levels. Both elements are likely to play a role in the rise in obesity.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "To tackle obesity it's likely that interventions which address both components: energy intake and expenditure are necessary.{ref}Hill, J. O., Wyatt, H. R., & Peters, J. C. (2012). ", "spanType": "span-simple-text" }, { "url": "https://www.ahajournals.org/doi/full/10.1161/circulationaha.111.087213", "children": [ { "text": "Energy balance and obesity", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": ".\u00a0", "spanType": "span-simple-text" }, { "children": [ { "text": "Circulation", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": ",\u00a0", "spanType": "span-simple-text" }, { "children": [ { "text": "126", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": "(1), 126-132.{/ref}", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "text": [ { "text": "Daily supply of calories", "spanType": "span-simple-text" } ], "type": "heading", "level": 3, "parseErrors": [] }, { "type": "text", "value": [ { "text": "Over the past century \u2013 but particularly over the past 50 years \u2013 the ", "spanType": "span-simple-text" }, { "url": "https://owid.cloud/food-per-person", "children": [ { "text": "supply of calories", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": " has increased across the world. In the 1960s, the global ", "spanType": "span-simple-text" }, { "url": "https://ourworldindata.org/grapher/daily-per-capita-caloric-supply?tab=chart&country=Asia~Europe~North+America~South+America~Africa", "children": [ { "text": "average supply of calories", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": " (that is, the availability of calories for consumers to eat) was 2200kcal per person per day. By 2013 this had increased to 2800kcal.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "Across most countries, energy consumption has therefore increased. If this increase was not met with an increase in energy expenditure, weight gain and a rise in obesity rates is the result. ", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "In the chart here we see the relationship between the share of men that are overweight or obese (on the y-axis) versus the daily average supply of kilocalories per person. Overall we see a strong positive relationship: countries with higher rates of overweight tend to have a higher supply of calories. ", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "If you press 'play' on the interactive timeline you can see how this has changed for each country over time. Most countries move upwards and to the right: the supply of calories has increased at the same time as obesity rates have increased.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "url": "https://ourworldindata.org/grapher/share-of-adult-men-overweight-or-obese-vs-daily-supply-of-calories", "type": "chart", "parseErrors": [] }, { "type": "horizontal-rule", "parseErrors": [] }, { "text": [ { "text": "Definitions & Measurement", "spanType": "span-simple-text" } ], "type": "heading", "level": 1, "parseErrors": [] }, { "type": "horizontal-rule", "parseErrors": [] }, { "text": [ { "text": "How do we measure obesity in adults?", "spanType": "span-simple-text" } ], "type": "heading", "level": 3, "parseErrors": [] }, { "type": "text", "value": [ { "text": "The most common metric used for assessing the prevalence of obesity is the body mass index (BMI) scale. The World Health Organization ", "spanType": "span-simple-text" }, { "url": "https://web.archive.org/web/20220219072441/https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight", "children": [ { "text": "define BMI", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": " as: \"", "spanType": "span-simple-text" }, { "children": [ { "text": "a simple index of weight-for-height that is commonly used to classify underweight, overweight and obesity in adults. It is defined as the weight in kilograms divided by the square of the height in metres (kg/m", "spanType": "span-simple-text" }, { "children": [ { "text": "2", "spanType": "span-simple-text" } ], "spanType": "span-superscript" }, { "text": "). For example, an adult who weighs 70kg and whose height is 1.75m will have a BMI of 22.9.\"", "spanType": "span-simple-text" } ], "spanType": "span-fallback" }, { "text": "{ref}This is calculated as 70kg / 1.75", "spanType": "span-simple-text" }, { "children": [ { "text": "2", "spanType": "span-simple-text" } ], "spanType": "span-superscript" }, { "text": " = 70 / 3.06 = 22.9{/ref}", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "Measured BMI values are used to define whether an individual is considered to be underweight, healthy, overweight or obese. The WHO defines these categories using the cut-off points in the table. For example, an individual with a BMI between 25.0 and 30.0 is considered to be 'overweight'; a BMI greater than 30.0 is defined as 'obese'.{ref}World Health Organization. BMI Classification.\u00a0", "spanType": "span-simple-text" }, { "children": [ { "text": "Global Database on Body Mass Index", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": ". Available ", "spanType": "span-simple-text" }, { "url": "https://knoema.com/WHOGDOBMIMay/who-global-database-on-body-mass-index-bmi", "children": [ { "text": "online", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": ".{/ref}", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "alt": "", "size": "wide", "type": "image", "filename": "BMI-classification.png", "parseErrors": [] }, { "text": [ { "text": "How do we measure obesity in children and adolescents?", "spanType": "span-simple-text" } ], "type": "heading", "level": 3, "parseErrors": [] }, { "type": "text", "value": [ { "text": "The metric for measuring bodyweight in children and adolescents is also the body mass index (BMI) scale, measured in the same way described above. However, interpretation of BMI scores is treated differently for children and adolescents. Whilst there is no differentiation of weight categories in adults based on sex or age, these are important factors in the body composition of children. Factors such as age, gender and sexual maturation affect the BMI of younger individuals. For interpretation of individuals between the ages of 2 and 20 years old, BMI is measured relative to peers of the same age and gender, with weight classifications judged as shown in the table.{ref}Centers for Disease Control and Prevention.\u00a0Body Mass Index: Considerations for Practitioners. Available ", "spanType": "span-simple-text" }, { "url": "https://www.cdc.gov/obesity/downloads/bmiforpactitioners.pdf", "children": [ { "text": "online", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": ".{/ref}", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "alt": "", "size": "wide", "type": "image", "filename": "BMI-classification-children.png", "parseErrors": [] }, { "text": [ { "text": "Is BMI an appropriate measure of weight-related health?", "spanType": "span-simple-text" } ], "type": "heading", "level": 3, "parseErrors": [] }, { "type": "text", "value": [ { "text": "The merits of using BMI as an indicator of body fat and obesity are still contested. A key contention to the use of BMI indicators is that it provides a measure of body mass/weight rather than providing a direct measure of body fat. Whilst physicians continue to use BMI as a general indicator of weight-related health risks, there are some cases where its use should be considered more carefully{ref}Centers for Disease Control and Prevention.\u00a0Body Mass Index: Considerations for Practitioners. 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How do rates vary across the world? What is the health impact?", "dateline": "August 11, 2017", "subtitle": "When did obesity increase? How do rates vary across the world? What is the health impact?", "sticky-nav": [], "sidebar-toc": true, "featured-image": "Screen-Shot-2021-02-15-at-16.41.53.png" }, "createdAt": "2019-02-05T21:12:15.000Z", "published": false, "updatedAt": "2023-01-09T11:17:40.000Z", "revisionId": null, "publishedAt": "2017-08-11T14:05:14.000Z", "relatedCharts": [], "publicationContext": "listed" }	{ "errors": [ { "name": "unexpected wp component tag", "details": "Found unhandled wp:comment tag quote" }, { "name": "unexpected wp component tag", "details": "Found unhandled wp:comment tag quote" }, { "name": "unexpected wp component tag", "details": "Found unhandled wp:comment tag image" }, { "name": "unexpected wp component tag", "details": "Found unhandled wp:comment tag image" }, { "name": "unexpected wp component tag", "details": "Found unhandled wp:comment tag list" }, { "name": "unexpected wp component tag", "details": "Found unhandled wp:comment tag list" }, { "name": "unexpected wp component tag", "details": "Found unhandled wp:comment tag list" }, { "name": "unexpected wp component tag", "details": "Found unhandled wp:comment tag list" } ], "numBlocks": 103, "numErrors": 8, "wpTagCounts": { "html": 9, "list": 5, "image": 2, "quote": 2, "heading": 24, "paragraph": 43, "owid/summary": 1 }, "htmlTagCounts": { "p": 45, "h2": 9, "h4": 15, "ul": 5, "div": 2, "figure": 2, "iframe": 9, "blockquote": 2 } }	2017-08-11 14:05:14	2024-02-16 14:22:39		[ "Hannah Ritchie" ]	When did obesity increase? How do rates vary across the world? What is the health impact?	2019-02-05 21:12:15	2023-01-09 11:17:40	https://ourworldindata.org/wp-content/uploads/2021/02/Screen-Shot-2021-02-15-at-16.41.53.png	{}	Obesity is most commonly measured using the body mass index (BMI) scale. The World Health Organization [define BMI](https://web.archive.org/web/20220219072441/https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight) as: "a simple index of weight-for-height that is commonly used to classify underweight, overweight and obesity in adults."{ref}BMI is defined as the weight in kilograms divided by the square of the height in metres (kg/m2). For example, an adult who weighs 70kg and whose height is 1.75m will have a BMI of 22.9. This is calculated as 70kg / 1.752 = 70 / 3.06 = 22.9{/ref} BMI values are used to define whether an individual is considered to be underweight, healthy, overweight or obese. The WHO defines these categories using the cut-off points: an individual with a BMI between 25.0 and 30.0 is considered to be 'overweight'; a BMI greater than 30.0 is defined as 'obese'.{ref}World Health Organization. BMI Classification. _Global Database on Body Mass Index_. Available [online](https://knoema.com/WHOGDOBMIMay/who-global-database-on-body-mass-index-bmi).{/ref} Related research entries [Food per person](https://owid.cloud/food-per-person) – food availability has increased significantly in most countries across the world. How does the supply of calories, protein and fats vary between countries? How has this changed over time? [Hunger and Undernourishment](https://owid.cloud/hunger-and-undernourishment) – obesity rates have now overtaken hunger rates globally. But it remains the case that high levels of obesity and hunger can occur in a country at any given time. How does undernourishment vary across the world? How has it changed over time? [Micronutrient Deficiency](https://owid.cloud/micronutrient-deficiency) – getting sufficient intake of calories (a requirement for obesity) does not guarantee an individual gets the full range of essential vitamins and minerals (micronutrients) for good health. Dietary diversity varies significantly across the world. How common is micronutrient deficiency and who is most at risk? --- # Obesity is one of the leading risk factors for early death --- ### Obesity is responsible for 4.7 million premature deaths each year Obesity is one of the world's largest health problems – one that has shifted from being a problem in rich countries, to one that spans all income levels. The _Global Burden of Disease_ is a major global study on the causes and risk factors for death and disease published in the medical journal _The Lancet_.{ref}The latest study can be found at the website of the Lancet here: [TheLancet.com/GBD](https://www.thelancet.com/gbd) The 2017 study was published as GBD 2017 Risk Factor Collaborators – "Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017" and is online [here](http://www.healthdata.org/research-article/global-regional-and-national-comparative-risk-assessment-84-behavioral-0).{/ref} These estimates of the annual number of deaths attributed to a wide range of risk factors are shown here. This chart is shown for the global total, but can be explored for any country or region using the "change country" toggle. Obesity – defined as having a high body-mass index – is a risk factor for several of the world's leading causes of death, including heart disease, stroke, diabetes and various types of cancer.{ref}WHO (2018) – Fact sheet – Obesity and overweight. Updated February 2018. Online [here](https://www.who.int/en/news-room/fact-sheets/detail/obesity-and-overweight).{/ref} Obesity does not directly _cause_ of any of these health impacts but can increase their likelihood of occurring. In the chart we see that it is one of the leading risk factors for death globally. According to the _Global Burden of Disease_ study 4.7 million people died prematurely in 2017 as a result of obesity. To put this into context: this was close to four times the number that died in [road accidents](https://ourworldindata.org/grapher/road-deaths-by-type), and close to five times the number that died from [HIV/AIDS](https://owid.cloud/hiv-aids) in 2017.{ref}The _Global Burden of Disease_ study [estimates that](https://ourworldindata.org/grapher/annual-number-of-deaths-by-cause) around 1.2 million died in road accidents in 2017, and just under 1 million from HIV/AIDS.{/ref} <Chart url="https://ourworldindata.org/grapher/number-of-deaths-by-risk-factor"/> --- # The global distribution of health impacts from obesity --- ### 8% of global deaths are the result of obesity Globally, [8% of deaths](https://ourworldindata.org/grapher/share-of-deaths-obesity?tab=chart&country=OWID_WRL) in 2017 were the result of obesity – this represents an increase from 4.5% in 1990. This share varies significantly across the world. In the map here we see the share of deaths attributed to obesity across countries. Across many middle-income countries – particularly across Eastern Europe, Central Asia, North Africa, and Latin America – more than 15% of deaths were attributed to obesity in 2017. This most likely results from having a high prevalence of obesity, but poorer overall health and healthcare systems relatively to high-income countries with similarly high levels of obesity. In most high-income countries this share is in the range of 8 to 10%. This is about half the share of many middle-income countries. The large outliers among rich countries are Japan and South Korea: there only around 5% of premature deaths are attributed to obesity. Across low-income countries – especially across Sub-Saharan Africa – obesity accounts for less than 5% of deaths. <Chart url="https://ourworldindata.org/grapher/share-of-deaths-obesity"/> ### There is a 10-fold difference in death rates from obesity across the world Death rates from obesity give us an accurate comparison of differences in its mortality impacts between countries and over time. In contrast to the share of deaths that we studied before, death rates are not influenced by how other causes or risk factors for death are changing. In the map here we see differences in death rates from obesity across the world. Globally, [the death rate](https://ourworldindata.org/grapher/death-rate-from-obesity?tab=chart&country=OWID_WRL) from obesity was around 60 per 100,000 in 2017. The overall picture does in fact match closely with the share of deaths: death rates are high across middle-income countries, especially across Eastern Europe, Central Asia, North Africa and Latin America. Rates there can be close to 200 per 100,000. This is more than ten times greater than rates at the bottom: Japan and South Korea have the lowest rates in the world at 14 and 20 deaths per 100,000, respectively. When we look at the [relationship between](https://ourworldindata.org/grapher/death-rate-vs-share-obesity) death rates and the prevalence of obesity we find a positive one: death rates tend to be higher in countries where more people have obesity. But what we also notice is that for a given prevalence of obesity, death rates can vary by a factor of four. 23% of Russian and Norwegian are obese, yet Russia's death rate is four times higher. Clearly it's not _only_ the prevalence of obesity that plays a role but also other factors such as underlying health, other confounding risk factors (such as [alcohol](https://owid.cloud/alcohol-consumption), [drugs](https://owid.cloud/drug-use), [smoking](https://owid.cloud/smoking) and other lifestyle factors) and healthcare systems. <Chart url="https://ourworldindata.org/grapher/death-rate-from-obesity"/> --- # What share of adults are obese? --- ### 13% of adults in the world are obese Globally, 13% of adults aged 18 years and older were obese in 2016.{ref}WHO (2018) – Fact sheet – Obesity and overweight. Updated February 2018. Online [here](https://www.who.int/en/news-room/fact-sheets/detail/obesity-and-overweight).{/ref} Obesity [is defined](https://ourworldindata.org/obesity#definitions-measurement) as having a body-mass index equal to or greater than 30. In the map here we see the share of adults who are obese across countries. Overall we see a pattern roughly in line with prosperity: the prevalence of obesity tends to be higher in richer countries across Europe, North America, and Oceania. Obesity rates are much lower across South Asia and Sub-Saharan Africa. More than one-in-three (36%) of adults in the United States were obese in 2016. In India this share was around 10 times lower (3.9%). The relationship between income and obesity generally holds true – as we see in the comparison [here](https://ourworldindata.org/grapher/obesity-vs-gdp). But there are some notable exceptions. The small Pacific Island States stand out clearly: they have very high rates of obesity – 61% in Nauru and 55% in Palau – for their level of income. At the other end of the spectrum, Japan, South Korea and Singapore have very low levels of obesity for their level of income. <Chart url="https://ourworldindata.org/grapher/share-of-adults-defined-as-obese"/> ### undefined undefined https://ourworldindata.org/grapher/obesity-in-men-vs-obesity-in-women --- # What share of adults are overweight? --- ### 39% of adults in the world are overweight or obese Globally, 39% of adults aged 18 years and older were overweight or obese in 2016.{ref}WHO (2018) – Fact sheet – Obesity and overweight. Updated February 2018. Online [here](https://www.who.int/en/news-room/fact-sheets/detail/obesity-and-overweight).{/ref} Being overweight [is also defined](https://ourworldindata.org/obesity#definitions-measurement) based on body-mass index: the threshold value is lower than for obesity, with a BMI equal to or greater than 25. In the map here we see the share of adults who are overweight or obese across countries. The overall pattern is very closely aligned with the distribution of obesity across the world: the share of people who are overweight tends to be higher in richer countries and lower at lower incomes. What is of course true is that the share who are overweight (have a BMI greater than or equal to 25) is much higher than the share that are obese (a BMI of 30 or greater). In most high-income countries, around two-thirds of adults are overweight or obese. In the US, 70% are. At the lowest end of the scale, across South Asia and Sub-Saharan Africa around 1-in-5 adults have a BMI greater than 25. ### undefined undefined https://ourworldindata.org/grapher/share-of-females-defined-as-overweight <Chart url="https://ourworldindata.org/grapher/share-of-adults-who-are-overweight"/> --- # Body Mass Index (BMI) --- ### Mean BMI in adult women Body Mass Index (BMI) is [used to define](https://ourworldindata.org/obesity#definitions-measurement) the share of individuals that are underweight, in the 'healthy' range, overweight and obese. In the map here we see the distribution of mean BMI for adult women – aged 18 years and older – across the world. The [global mean BMI](https://ourworldindata.org/grapher/mean-body-mass-index-bmi-in-adult-women?tab=chart&country=OWID_WRL) for women in 2016 was 25 – just on the threshold from the WHO's 'healthy' to 'overweight' classification. This has increased from a mean BMI of 22 – in the mid-range of 'healthy' – in the 1970s. <Chart url="https://ourworldindata.org/grapher/mean-body-mass-index-bmi-in-adult-women"/> ### Mean BMI in adult men Body Mass Index (BMI) is [used to define](https://ourworldindata.org/obesity#definitions-measurement) the share of individuals that are underweight, in the 'healthy' range, overweight and obese. In the map here we see the distribution of mean BMI for adult men – aged 18 years and older – across the world. The [global mean BMI](https://ourworldindata.org/grapher/mean-body-mass-index-bmi-in-adult-males?tab=chart&country=OWID_WRL) for men in 2016 was 24.5 – just on the threshold from the WHO's 'healthy' to 'overweight' classification. This has increased from a mean BMI of 21.7 – in the mid-range of 'healthy' – in the 1970s. <Chart url="https://ourworldindata.org/grapher/mean-body-mass-index-bmi-in-adult-males"/> --- # Childhood obesity --- ### Share of children that are overweight Obesity and overweight in children are also measured on the basis of body-mass-index (BMI). However, interpretation of BMI scores is treated differently for children and adolescents. Weight categories are defined in relation to WHO Growth Standards – a child is defined as overweight if their weight-for-height is more than two standard deviations from the median of the WHO Child Growth Standards. The World Health Organization reports that the share of children and adolescents aged 5-19 who are overweight or obese has risen from 4% in 1975 to around 18% in 2016.{ref}WHO (2018) – Fact sheet – Obesity and overweight. Updated February 2018. Online [here](https://www.who.int/en/news-room/fact-sheets/detail/obesity-and-overweight).{/ref} In the map here we see the share of very young children – aged 2 to 4 years old – who are overweight based on WHO Child Growth Standards. In many countries as many as every third or fourth child is overweight. <Chart url="https://ourworldindata.org/grapher/children-who-are-overweight-sdgs?time=1990..2016"/> --- # What are the drivers of obesity? --- At a basic level, weight gain – eventually leading to being overweight or obesity – is determined by a balance of energy.{ref}Hall, K. D., Heymsfield, S. B., Kemnitz, J. W., Klein, S., Schoeller, D. A., & Speakman, J. R. (2012). [Energy balance and its components: implications for body weight regulation](https://academic.oup.com/ajcn/article/95/4/989/4576902). _The American Journal of Clinical Nutrition_, _95_(4), 989-994.{/ref} When we consume more energy – typically measured in kilocalories – than the energy expended to maintain life and carry out daily activites, we gain weight. This is a called an energy surplus. When we consume less energy than we expend, we lose weight – this is an energy deficit. This means there are two potential drivers of the increase in obesity rates in recent decades: either an increase in kilocalorie intake i.e. we eat more; or we expend less energy in daily life through lower activity levels. Both elements are likely to play a role in the rise in obesity. To tackle obesity it's likely that interventions which address both components: energy intake and expenditure are necessary.{ref}Hill, J. O., Wyatt, H. R., & Peters, J. C. (2012). [Energy balance and obesity](https://www.ahajournals.org/doi/full/10.1161/circulationaha.111.087213). _Circulation_, _126_(1), 126-132.{/ref} ### Daily supply of calories Over the past century – but particularly over the past 50 years – the [supply of calories](https://owid.cloud/food-per-person) has increased across the world. In the 1960s, the global [average supply of calories](https://ourworldindata.org/grapher/daily-per-capita-caloric-supply?tab=chart&country=Asia~Europe~North+America~South+America~Africa) (that is, the availability of calories for consumers to eat) was 2200kcal per person per day. By 2013 this had increased to 2800kcal. Across most countries, energy consumption has therefore increased. If this increase was not met with an increase in energy expenditure, weight gain and a rise in obesity rates is the result. In the chart here we see the relationship between the share of men that are overweight or obese (on the y-axis) versus the daily average supply of kilocalories per person. Overall we see a strong positive relationship: countries with higher rates of overweight tend to have a higher supply of calories. If you press 'play' on the interactive timeline you can see how this has changed for each country over time. Most countries move upwards and to the right: the supply of calories has increased at the same time as obesity rates have increased. <Chart url="https://ourworldindata.org/grapher/share-of-adult-men-overweight-or-obese-vs-daily-supply-of-calories"/> --- # Definitions & Measurement --- ### How do we measure obesity in adults? The most common metric used for assessing the prevalence of obesity is the body mass index (BMI) scale. The World Health Organization [define BMI](https://web.archive.org/web/20220219072441/https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight) as: "a simple index of weight-for-height that is commonly used to classify underweight, overweight and obesity in adults. It is defined as the weight in kilograms divided by the square of the height in metres (kg/m2). For example, an adult who weighs 70kg and whose height is 1.75m will have a BMI of 22.9."{ref}This is calculated as 70kg / 1.752 = 70 / 3.06 = 22.9{/ref} Measured BMI values are used to define whether an individual is considered to be underweight, healthy, overweight or obese. The WHO defines these categories using the cut-off points in the table. For example, an individual with a BMI between 25.0 and 30.0 is considered to be 'overweight'; a BMI greater than 30.0 is defined as 'obese'.{ref}World Health Organization. BMI Classification. _Global Database on Body Mass Index_. Available [online](https://knoema.com/WHOGDOBMIMay/who-global-database-on-body-mass-index-bmi).{/ref} <Image filename="BMI-classification.png" alt=""/> ### How do we measure obesity in children and adolescents? The metric for measuring bodyweight in children and adolescents is also the body mass index (BMI) scale, measured in the same way described above. However, interpretation of BMI scores is treated differently for children and adolescents. Whilst there is no differentiation of weight categories in adults based on sex or age, these are important factors in the body composition of children. Factors such as age, gender and sexual maturation affect the BMI of younger individuals. For interpretation of individuals between the ages of 2 and 20 years old, BMI is measured relative to peers of the same age and gender, with weight classifications judged as shown in the table.{ref}Centers for Disease Control and Prevention. Body Mass Index: Considerations for Practitioners. Available [online](https://www.cdc.gov/obesity/downloads/bmiforpactitioners.pdf).{/ref} <Image filename="BMI-classification-children.png" alt=""/> ### Is BMI an appropriate measure of weight-related health? The merits of using BMI as an indicator of body fat and obesity are still contested. A key contention to the use of BMI indicators is that it provides a measure of body mass/weight rather than providing a direct measure of body fat. Whilst physicians continue to use BMI as a general indicator of weight-related health risks, there are some cases where its use should be considered more carefully{ref}Centers for Disease Control and Prevention. Body Mass Index: Considerations for Practitioners. Available [online](https://www.cdc.gov/obesity/downloads/bmiforpactitioners.pdf).{/ref}: * muscle mass can increase bodyweight; this means athletes or individuals with a high muscle mass percentage can be deemed overweight on the BMI scale, even if they have a low or healthy body fat percentage; * muscle and bone density tends to decline as we get older; this means that an older individual may have a higher percentage body fat than a younger individual with the same BMI; * women tend to have a higher body fat percentage than men for a given BMI. Physicians must therefore evaluate BMI results carefully on a individual basis. Despite outlier cases where BMI is an inappropriate indicator of body fat, its use provides a reasonable measure of the risk of weight-related health factors across most individuals across the general population. --- # Data sources --- ### NCD Risk Factor Collaboration * Data: Mean and distributions of body mass index (BMI), by country * Geographical coverage: Global- by country * Time span: 1975 onwards * Available at:[http://www.ncdrisc.org/index.html](http://www.ncdrisc.org/index.html) ### WHO Global Database on Body Mass Index * Data: Share of population by weight category * Geographical coverage: Global – by country * Time span: 1960 onwards * Available at:[https://www.who.int/data/gho/data/themes/topics/topic-details/GHO/body-mass-index](https://www.who.int/data/gho/data/themes/topics/topic-details/GHO/body-mass-index) ### Institute of Health Metrics and Evaluation (IHME) Global Burden of Disease (GBDx) Data Tool * Data: Number of deaths and death rates from obesity * Geographical coverage: Global – by country * Time span: 1990 onwards * Available at: [http://www.healthdata.org/results/data-visualizations](http://www.healthdata.org/results/data-visualizations)	{ "id": 12778, "date": "2017-08-11T15:05:14", "guid": { "rendered": "https://ourworldindata.org/?page_id=12778" }, "link": "https://owid.cloud/obesity", "meta": { "owid_publication_context_meta_field": [], "owid_key_performance_indicators_meta_field": { "raw": "13% of adults are obese, globally.\n\nObesity is responsible for 5 million premature deaths every year.", "rendered": "<p><strong>13% of adults</strong> are obese, globally.</p>\n<p>Obesity is responsible for <strong>5 million</strong> premature deaths every year.</p>\n" } }, "slug": "obesity", "tags": [], "type": "page", "title": { "rendered": "Obesity" }, "_links": { "self": [ { "href": "https://owid.cloud/wp-json/wp/v2/pages/12778" } ], "about": [ { "href": "https://owid.cloud/wp-json/wp/v2/types/page" } ], "author": [ { "href": "https://owid.cloud/wp-json/wp/v2/users/17", "embeddable": true } ], "curies": [ { "href": "https://api.w.org/{rel}", "name": "wp", "templated": true } ], "replies": [ { "href": "https://owid.cloud/wp-json/wp/v2/comments?post=12778", "embeddable": true } ], "wp:term": [ { "href": "https://owid.cloud/wp-json/wp/v2/categories?post=12778", "taxonomy": "category", "embeddable": true }, { "href": "https://owid.cloud/wp-json/wp/v2/tags?post=12778", "taxonomy": "post_tag", "embeddable": true } ], "collection": [ { "href": "https://owid.cloud/wp-json/wp/v2/pages" } ], "wp:attachment": [ { "href": "https://owid.cloud/wp-json/wp/v2/media?parent=12778" } ], "version-history": [ { "href": "https://owid.cloud/wp-json/wp/v2/pages/12778/revisions", "count": 30 } ], "wp:featuredmedia": [ { "href": "https://owid.cloud/wp-json/wp/v2/media/40768", "embeddable": true } ], "predecessor-version": [ { "id": 55385, "href": "https://owid.cloud/wp-json/wp/v2/pages/12778/revisions/55385" } ] }, "author": 17, "parent": 0, "status": "publish", "content": { "rendered": "\n<p>Obesity is most commonly measured using the body mass index (BMI) scale. The World Health Organization <a rel=\"noopener noreferrer\" href=\"https://web.archive.org/web/20220219072441/https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight\" target=\"_blank\">define BMI</a> as: “<span class=\"storydeck\">a simple index of weight-for-height that is commonly used to classify underweight, overweight and obesity in adults.”{ref}BMI is defined as the weight in kilograms divided by the square of the height in metres (kg/m<sup>2</sup>). For example, an adult who weighs 70kg and whose height is 1.75m will have a BMI of 22.9.</span> This is calculated as 70kg / 1.75<sup>2</sup> = 70 / 3.06 = 22.9{/ref}</p>\n\n\n\n<p>BMI values are used to define whether an individual is considered to be underweight, healthy, overweight or obese. The WHO defines these categories using the cut-off points: an individual with a BMI between 25.0 and 30.0 is considered to be ‘overweight’; a BMI greater than 30.0 is defined as ‘obese’.{ref}World Health Organization. BMI Classification. <em>Global Database on Body Mass Index</em>. Available <a href=\"https://knoema.com/WHOGDOBMIMay/who-global-database-on-body-mass-index-bmi\">online</a>.{/ref}</p>\n\n\n\t<div class=\"wp-block-owid-summary\">\n\t\t<h2>Summary</h2>\n\t\t\n\n<ul><li><a href=\"https://ourworldindata.org/obesity#obesity-is-one-of-the-leading-risk-factors-for-early-death\">Obesity is one of the leading risk factors for premature death. It was linked to 4.7 million deaths globally in 2017.</a></li><li><a href=\"https://ourworldindata.org/obesity#8-of-global-deaths-are-attributed-to-obesity\">8% of global deaths were attributed to obesity in 2017.</a></li><li><a href=\"https://ourworldindata.org/obesity#there-is-a-10-fold-difference-in-death-rates-from-obesity-across-the-world\">There are large differences \u2013 10-fold \u2013 in death rates from obesity across the world.</a></li><li><a href=\"https://ourworldindata.org/obesity#what-share-of-adults-are-obese\">13% of adults in the world are obese.</a></li><li><a href=\"https://ourworldindata.org/obesity#what-share-of-adults-are-overweight\">39% of adults in the world are overweight.</a></li><li><a href=\"https://ourworldindata.org/obesity#childhood-obesity\">One-in-five children and adolescents, globally, are overweight.</a></li><li><a href=\"https://ourworldindata.org/obesity#what-are-the-drivers-of-obesity\">Obesity is determined by the balance of energy intake and expenditure. Rates have increased as the calories have become more readily available.</a></li></ul>\n\n\n\t</div>\n\n\n<p><strong>Related research entries</strong></p>\n\n\n\n<p><a href=\"https://owid.cloud/food-per-person\">Food per person</a> \u2013 food availability has increased significantly in most countries across the world. How does the supply of calories, protein and fats vary between countries? How has this changed over time?</p>\n\n\n\n<p><a href=\"https://owid.cloud/hunger-and-undernourishment\">Hunger and Undernourishment</a> \u2013 obesity rates have now overtaken hunger rates globally. But it remains the case that high levels of obesity and hunger can occur in a country at any given time. How does undernourishment vary across the world? How has it changed over time?</p>\n\n\n\n<p><a href=\"https://owid.cloud/micronutrient-deficiency\">Micronutrient Deficiency</a> \u2013 getting sufficient intake of calories (a requirement for obesity) does not guarantee an individual gets the full range of essential vitamins and minerals (micronutrients) for good health. Dietary diversity varies significantly across the world. How common is micronutrient deficiency and who is most at risk?</p>\n\n\n\n<h2>Obesity is one of the leading risk factors for early death</h2>\n\n\n\n<h4>Obesity is responsible for 4.7 million premature deaths each year</h4>\n\n\n\n<p>Obesity is one of the world’s largest health problems \u2013 one that has shifted from being a problem in rich countries, to one that spans all income levels.<br><br>The <em>Global Burden of Disease</em> is a major global study on the causes and risk factors for death and disease published in the medical journal <em>The Lancet</em>.{ref}The latest study can be found at the website of the Lancet here: <a href=\"https://www.thelancet.com/gbd\">TheLancet.com/GBD</a><br><br>The 2017 study was published as GBD 2017 Risk Factor Collaborators \u2013 “Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017” and is online <a href=\"http://www.healthdata.org/research-article/global-regional-and-national-comparative-risk-assessment-84-behavioral-0\">here</a>.{/ref} These estimates of the annual number of deaths attributed to a wide range of risk factors are shown here. This chart is shown for the global total, but can be explored for any country or region using the “change country” toggle.</p>\n\n\n\n<p>Obesity \u2013 defined as having a high body-mass index \u2013 is a risk factor for several of the world’s leading causes of death, including heart disease, stroke, diabetes and various types of cancer.{ref}WHO (2018) \u2013 Fact sheet \u2013 Obesity and overweight. Updated February 2018. Online <a href=\"https://www.who.int/en/news-room/fact-sheets/detail/obesity-and-overweight\">here</a>.{/ref} Obesity does not directly <em>cause</em> of any of these health impacts but can increase their likelihood of occurring. In the chart we see that it is one of the leading risk factors for death globally. </p>\n\n\n\n<p>According to the <em>Global Burden of Disease</em> study 4.7 million people died prematurely in 2017 as a result of obesity. To put this into context: this was close to four times the number that died in <a href=\"https://ourworldindata.org/grapher/road-deaths-by-type\">road accidents</a>, and close to five times the number that died from <a href=\"https://owid.cloud/hiv-aids\">HIV/AIDS</a> in 2017.{ref}The <em>Global Burden of Disease</em> study <a href=\"https://ourworldindata.org/grapher/annual-number-of-deaths-by-cause\">estimates that</a> around 1.2 million died in road accidents in 2017, and just under 1 million from HIV/AIDS.{/ref}</p>\n\n\n\n<iframe src=\"https://ourworldindata.org/grapher/number-of-deaths-by-risk-factor\" style=\"width: 100%; height: 600px; border: 0px none;\"></iframe>\n\n\n\n<h2>The global distribution of health impacts from obesity</h2>\n\n\n\n<h4>8% of global deaths are the result of obesity</h4>\n\n\n\n<p>Globally, <a href=\"https://ourworldindata.org/grapher/share-of-deaths-obesity?tab=chart&country=OWID_WRL\">8% of deaths</a> in 2017 were the result of obesity \u2013 this represents an increase from 4.5% in 1990.</p>\n\n\n\n<p>This share varies significantly across the world. In the map here we see the share of deaths attributed to obesity across countries.</p>\n\n\n\n<p>Across many middle-income countries \u2013 particularly across Eastern Europe, Central Asia, North Africa, and Latin America \u2013 more than 15% of deaths were attributed to obesity in 2017. This most likely results from having a high prevalence of obesity, but poorer overall health and healthcare systems relatively to high-income countries with similarly high levels of obesity. <br><br>In most high-income countries this share is in the range of 8 to 10%. This is about half the share of many middle-income countries. The large outliers among rich countries are Japan and South Korea: there only around 5% of premature deaths are attributed to obesity. </p>\n\n\n\n<p>Across low-income countries \u2013 especially across Sub-Saharan Africa \u2013 obesity accounts for less than 5% of deaths.</p>\n\n\n\n<iframe src=\"https://ourworldindata.org/grapher/share-of-deaths-obesity\" style=\"width: 100%; height: 600px; border: 0px none;\"></iframe>\n\n\n\n<h4>There is a 10-fold difference in death rates from obesity across the world</h4>\n\n\n\n<p>Death rates from obesity give us an accurate comparison of differences in its mortality impacts between countries and over time. In contrast to the share of deaths that we studied before, death rates are not influenced by how other causes or risk factors for death are changing.</p>\n\n\n\n<p>In the map here we see differences in death rates from obesity across the world. Globally, <a href=\"https://ourworldindata.org/grapher/death-rate-from-obesity?tab=chart&country=OWID_WRL\">the death rate</a> from obesity was around 60 per 100,000 in 2017.</p>\n\n\n\n<p>The overall picture does in fact match closely with the share of deaths: death rates are high across middle-income countries, especially across Eastern Europe, Central Asia, North Africa and Latin America. Rates there can be close to 200 per 100,000. This is more than ten times greater than rates at the bottom: Japan and South Korea have the lowest rates in the world at 14 and 20 deaths per 100,000, respectively.</p>\n\n\n\n<p>When we look at the <a href=\"https://ourworldindata.org/grapher/death-rate-vs-share-obesity\">relationship between</a> death rates and the prevalence of obesity we find a positive one: death rates tend to be higher in countries where more people have obesity. But what we also notice is that for a given prevalence of obesity, death rates can vary by a factor of four. 23% of Russian and Norwegian are obese, yet Russia’s death rate is four times higher. Clearly it’s not <em>only</em> the prevalence of obesity that plays a role but also other factors such as underlying health, other confounding risk factors (such as <a href=\"https://owid.cloud/alcohol-consumption\">alcohol</a>, <a href=\"https://owid.cloud/drug-use\">drugs</a>, <a href=\"https://owid.cloud/smoking\">smoking</a> and other lifestyle factors) and healthcare systems.</p>\n\n\n\n<iframe src=\"https://ourworldindata.org/grapher/death-rate-from-obesity\" style=\"width: 100%; height: 600px; border: 0px none;\"></iframe>\n\n\n\n<h2>What share of adults are obese?</h2>\n\n\n\n<h4>13% of adults in the world are obese</h4>\n\n\n\n<p>Globally, 13% of adults aged 18 years and older were obese in 2016.{ref}WHO (2018) \u2013 Fact sheet \u2013 Obesity and overweight. Updated February 2018. Online <a href=\"https://www.who.int/en/news-room/fact-sheets/detail/obesity-and-overweight\">here</a>.{/ref} Obesity <a href=\"https://ourworldindata.org/obesity#definitions-measurement\">is defined</a> as having a body-mass index equal to or greater than 30. </p>\n\n\n\n<p>In the map here we see the share of adults who are obese across countries. Overall we see a pattern roughly in line with prosperity: the prevalence of obesity tends to be higher in richer countries across Europe, North America, and Oceania. Obesity rates are much lower across South Asia and Sub-Saharan Africa. </p>\n\n\n\n<p>More than one-in-three (36%) of adults in the United States were obese in 2016. In India this share was around 10 times lower (3.9%).</p>\n\n\n\n<p>The relationship between income and obesity generally holds true \u2013 as we see in the comparison <a href=\"https://ourworldindata.org/grapher/obesity-vs-gdp\">here</a>. But there are some notable exceptions. The small Pacific Island States stand out clearly: they have very high rates of obesity \u2013 61% in Nauru and 55% in Palau \u2013 for their level of income. At the other end of the spectrum, Japan, South Korea and Singapore have very low levels of obesity for their level of income.</p>\n\n\n\n<iframe style=\"width: 100%; height: 600px; border: 0px none;\" src=\"https://ourworldindata.org/grapher/share-of-adults-defined-as-obese\"></iframe>\n\n\n\n<blockquote class=\"wp-block-quote\"><p><strong>Related charts \u2013 share of men and women that are obese.</strong> <a href=\"https://ourworldindata.org/grapher/share-of-men-defined-as-obese\">This map</a> allows you to explore the share of men that are obese; <a href=\"https://ourworldindata.org/grapher/share-of-females-defined-as-obese\">this map</a> allows you to explore this data for women across the world. <a href=\"https://ourworldindata.org/grapher/obesity-in-men-vs-obesity-in-women\">This chart</a> shows the comparison of obesity in men and women.</p></blockquote>\n\n\n\n<h2>What share of adults are overweight?</h2>\n\n\n\n<h4>39% of adults in the world are overweight or obese</h4>\n\n\n\n<p>Globally, 39% of adults aged 18 years and older were overweight or obese in 2016.{ref}WHO (2018) \u2013 Fact sheet \u2013 Obesity and overweight. Updated February 2018. Online <a href=\"https://www.who.int/en/news-room/fact-sheets/detail/obesity-and-overweight\">here</a>.{/ref} Being overweight <a href=\"https://ourworldindata.org/obesity#definitions-measurement\">is also defined</a> based on body-mass index: the threshold value is lower than for obesity, with a BMI equal to or greater than 25.</p>\n\n\n\n<p>In the map here we see the share of adults who are overweight or obese across countries. The overall pattern is very closely aligned with the distribution of obesity across the world: the share of people who are overweight tends to be higher in richer countries and lower at lower incomes. What is of course true is that the share who are overweight (have a BMI greater than or equal to 25) is much higher than the share that are obese (a BMI of 30 or greater).</p>\n\n\n\n<p>In most high-income countries, around two-thirds of adults are overweight or obese. In the US, 70% are. At the lowest end of the scale, across South Asia and Sub-Saharan Africa around 1-in-5 adults have a BMI greater than 25.</p>\n\n\n\n<blockquote class=\"wp-block-quote\"><p><strong>Related charts \u2013 share of men and women that are overweight</strong> <strong>or obese</strong>. <a href=\"https://ourworldindata.org/grapher/share-of-men-defined-as-overweight\">This map</a> allows you to explore the share of men that are overweight or obese; <a href=\"https://ourworldindata.org/grapher/share-of-females-defined-as-overweight\">this map</a> allows you to explore this data for women across the world.</p></blockquote>\n\n\n\n<iframe style=\"width: 100%; height: 600px; border: 0px none;\" src=\"https://ourworldindata.org/grapher/share-of-adults-who-are-overweight\"></iframe>\n\n\n\n<h2>Body Mass Index (BMI)</h2>\n\n\n\n<h4>Mean BMI in adult women</h4>\n\n\n\n<p>Body Mass Index (BMI) is <a href=\"https://ourworldindata.org/obesity#definitions-measurement\">used to define</a> the share of individuals that are underweight, in the ‘healthy’ range, overweight and obese.</p>\n\n\n\n<p>In the map here we see the distribution of mean BMI for adult women \u2013 aged 18 years and older \u2013 across the world. The <a href=\"https://ourworldindata.org/grapher/mean-body-mass-index-bmi-in-adult-women?tab=chart&country=OWID_WRL\">global mean BMI</a> for women in 2016 was 25 \u2013 just on the threshold from the WHO’s ‘healthy’ to ‘overweight’ classification. This has increased from a mean BMI of 22 \u2013 in the mid-range of ‘healthy’ \u2013 in the 1970s.</p>\n\n\n\n<iframe loading=\"lazy\" style=\"width: 100%; height: 600px; border: 0px none;\" src=\"https://ourworldindata.org/grapher/mean-body-mass-index-bmi-in-adult-women\" width=\"300\" height=\"150\"></iframe>\n\n\n\n<h4>Mean BMI in adult men</h4>\n\n\n\n<p>Body Mass Index (BMI) is <a href=\"https://ourworldindata.org/obesity#definitions-measurement\">used to define</a> the share of individuals that are underweight, in the ‘healthy’ range, overweight and obese.</p>\n\n\n\n<p>In the map here we see the distribution of mean BMI for adult men \u2013 aged 18 years and older \u2013 across the world. The <a href=\"https://ourworldindata.org/grapher/mean-body-mass-index-bmi-in-adult-males?tab=chart&country=OWID_WRL\">global mean BMI</a> for men in 2016 was 24.5 \u2013 just on the threshold from the WHO’s ‘healthy’ to ‘overweight’ classification. This has increased from a mean BMI of 21.7 \u2013 in the mid-range of ‘healthy’ \u2013 in the 1970s.</p>\n\n\n\n<iframe loading=\"lazy\" style=\"width: 100%; height: 600px; border: 0px none;\" src=\"https://ourworldindata.org/grapher/mean-body-mass-index-bmi-in-adult-males\" width=\"300\" height=\"150\"></iframe>\n\n\n\n<h2>Childhood obesity</h2>\n\n\n\n<h4>Share of children that are overweight</h4>\n\n\n\n<p>Obesity and overweight in children are also measured on the basis of body-mass-index (BMI). However, interpretation of BMI scores is treated differently for children and adolescents. Weight categories are defined in relation to WHO Growth Standards \u2013 a child is defined as overweight if their weight-for-height is more than two standard deviations from the median of the WHO Child Growth Standards.</p>\n\n\n\n<p>The World Health Organization reports that the share of children and adolescents aged 5-19 who are overweight or obese has risen from 4% in 1975 to around 18% in 2016.{ref}WHO (2018) \u2013 Fact sheet \u2013 Obesity and overweight. Updated February 2018. Online <a href=\"https://www.who.int/en/news-room/fact-sheets/detail/obesity-and-overweight\">here</a>.{/ref}</p>\n\n\n\n<p>In the map here we see the share of very young children \u2013 aged 2 to 4 years old \u2013 who are overweight based on WHO Child Growth Standards. In many countries as many as every third or fourth child is overweight.</p>\n\n\n\n<iframe src=\"https://ourworldindata.org/grapher/children-who-are-overweight-sdgs?time=1990..2016\" style=\"width: 100%; height: 600px; border: 0px none;\"></iframe>\n\n\n\n<h2>What are the drivers of obesity?</h2>\n\n\n\n<p>At a basic level, weight gain \u2013 eventually leading to being overweight or obesity \u2013 is determined by a balance of energy.{ref}Hall, K. D., Heymsfield, S. B., Kemnitz, J. W., Klein, S., Schoeller, D. A., & Speakman, J. R. (2012). <a href=\"https://academic.oup.com/ajcn/article/95/4/989/4576902\">Energy balance and its components: implications for body weight regulation</a>. <em>The American Journal of Clinical Nutrition</em>, <em>95</em>(4), 989-994.{/ref} When we consume more energy \u2013 typically measured in kilocalories \u2013 than the energy expended to maintain life and carry out daily activites, we gain weight. This is a called an energy surplus. When we consume less energy than we expend, we lose weight \u2013 this is an energy deficit. </p>\n\n\n\n<p>This means there are two potential drivers of the increase in obesity rates in recent decades: either an increase in kilocalorie intake i.e. we eat more; or we expend less energy in daily life through lower activity levels. Both elements are likely to play a role in the rise in obesity.</p>\n\n\n\n<p>To tackle obesity it’s likely that interventions which address both components: energy intake and expenditure are necessary.{ref}Hill, J. O., Wyatt, H. R., & Peters, J. C. (2012). <a href=\"https://www.ahajournals.org/doi/full/10.1161/circulationaha.111.087213\">Energy balance and obesity</a>. <em>Circulation</em>, <em>126</em>(1), 126-132.{/ref}</p>\n\n\n\n<h4>Daily supply of calories</h4>\n\n\n\n<p>Over the past century \u2013 but particularly over the past 50 years \u2013 the <a href=\"https://owid.cloud/food-per-person\">supply of calories</a> has increased across the world. In the 1960s, the global <a href=\"https://ourworldindata.org/grapher/daily-per-capita-caloric-supply?tab=chart&country=Asia~Europe~North+America~South+America~Africa\">average supply of calories</a> (that is, the availability of calories for consumers to eat) was 2200kcal per person per day. By 2013 this had increased to 2800kcal.</p>\n\n\n\n<p>Across most countries, energy consumption has therefore increased. If this increase was not met with an increase in energy expenditure, weight gain and a rise in obesity rates is the result. </p>\n\n\n\n<p>In the chart here we see the relationship between the share of men that are overweight or obese (on the y-axis) versus the daily average supply of kilocalories per person. Overall we see a strong positive relationship: countries with higher rates of overweight tend to have a higher supply of calories. </p>\n\n\n\n<p>If you press ‘play’ on the interactive timeline you can see how this has changed for each country over time. Most countries move upwards and to the right: the supply of calories has increased at the same time as obesity rates have increased.</p>\n\n\n\n<iframe loading=\"lazy\" style=\"width: 100%; height: 600px; border: 0px none;\" src=\"https://ourworldindata.org/grapher/share-of-adult-men-overweight-or-obese-vs-daily-supply-of-calories\" width=\"300\" height=\"150\"></iframe>\n\n\n\n<h2>Definitions & Measurement</h2>\n\n\n\n<h4>How do we measure obesity in adults?</h4>\n\n\n\n<p>The most common metric used for assessing the prevalence of obesity is the body mass index (BMI) scale. The World Health Organization <a rel=\"noopener noreferrer\" href=\"https://web.archive.org/web/20220219072441/https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight\" target=\"_blank\">define BMI</a> as: “<span class=\"storydeck\">a simple index of weight-for-height that is commonly used to classify underweight, overweight and obesity in adults. It is defined as the weight in kilograms divided by the square of the height in metres (kg/m<sup>2</sup>). For example, an adult who weighs 70kg and whose height is 1.75m will have a BMI of 22.9.”</span>{ref}This is calculated as 70kg / 1.75<sup>2</sup> = 70 / 3.06 = 22.9{/ref}</p>\n\n\n\n<p>Measured BMI values are used to define whether an individual is considered to be underweight, healthy, overweight or obese. The WHO defines these categories using the cut-off points in the table. For example, an individual with a BMI between 25.0 and 30.0 is considered to be ‘overweight’; a BMI greater than 30.0 is defined as ‘obese’.{ref}World Health Organization. BMI Classification. <em>Global Database on Body Mass Index</em>. Available <a href=\"https://knoema.com/WHOGDOBMIMay/who-global-database-on-body-mass-index-bmi\">online</a>.{/ref}</p>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter\"><a href=\"https://ourworldindata.org/app/uploads/2017/08/BMI-classification.png\"><img loading=\"lazy\" width=\"494\" height=\"373\" src=\"https://ourworldindata.org/app/uploads/2017/08/BMI-classification.png\" alt=\"\" class=\"wp-image-12788\" srcset=\"https://owid.cloud/app/uploads/2017/08/BMI-classification.png 494w, https://owid.cloud/app/uploads/2017/08/BMI-classification-150x113.png 150w, https://owid.cloud/app/uploads/2017/08/BMI-classification-400x302.png 400w\" sizes=\"(max-width: 494px) 100vw, 494px\" /></a></figure></div>\n\n\n\n<h4>How do we measure obesity in children and adolescents?</h4>\n\n\n\n<p>The metric for measuring bodyweight in children and adolescents is also the body mass index (BMI) scale, measured in the same way described above. However, interpretation of BMI scores is treated differently for children and adolescents. Whilst there is no differentiation of weight categories in adults based on sex or age, these are important factors in the body composition of children. Factors such as age, gender and sexual maturation affect the BMI of younger individuals. For interpretation of individuals between the ages of 2 and 20 years old, BMI is measured relative to peers of the same age and gender, with weight classifications judged as shown in the table.{ref}Centers for Disease Control and Prevention. Body Mass Index: Considerations for Practitioners. Available <a href=\"https://www.cdc.gov/obesity/downloads/bmiforpactitioners.pdf\">online</a>.{/ref}</p>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter\"><a href=\"https://ourworldindata.org/app/uploads/2017/08/BMI-classification-children.png\"><img loading=\"lazy\" width=\"474\" height=\"113\" src=\"https://ourworldindata.org/app/uploads/2017/08/BMI-classification-children.png\" alt=\"\" class=\"wp-image-12825\" srcset=\"https://owid.cloud/app/uploads/2017/08/BMI-classification-children.png 474w, https://owid.cloud/app/uploads/2017/08/BMI-classification-children-150x36.png 150w, https://owid.cloud/app/uploads/2017/08/BMI-classification-children-400x95.png 400w\" sizes=\"(max-width: 474px) 100vw, 474px\" /></a></figure></div>\n\n\n\n<h4>Is BMI an appropriate measure of weight-related health?</h4>\n\n\n\n<p>The merits of using BMI as an indicator of body fat and obesity are still contested. A key contention to the use of BMI indicators is that it provides a measure of body mass/weight rather than providing a direct measure of body fat. Whilst physicians continue to use BMI as a general indicator of weight-related health risks, there are some cases where its use should be considered more carefully{ref}Centers for Disease Control and Prevention. Body Mass Index: Considerations for Practitioners. Available <a href=\"https://www.cdc.gov/obesity/downloads/bmiforpactitioners.pdf\">online</a>.{/ref}:</p>\n\n\n\n<ul><li>muscle mass can increase bodyweight; this means athletes or individuals with a high muscle mass percentage can be deemed overweight on the BMI scale, even if they have a low or healthy body fat percentage;</li><li>muscle and bone density tends to decline as we get older; this means that an older individual may have a higher percentage body fat than a younger individual with the same BMI;</li><li>women tend to have a higher body fat percentage than men for a given BMI.</li></ul>\n\n\n\n<p>Physicians must therefore evaluate BMI results carefully on a individual basis. Despite outlier cases where BMI is an inappropriate indicator of body fat, its use provides a reasonable measure of the risk of weight-related health factors across most individuals across the general population.</p>\n\n\n\n<h2>Data sources</h2>\n\n\n\n<h4>NCD Risk Factor Collaboration</h4>\n\n\n\n<ul><li><strong>Data</strong>: Mean and distributions of body mass index (BMI), by country</li><li><strong>Geographical coverage: </strong>Global- by country</li><li><strong>Time span: </strong>1975 onwards</li><li><strong>Available at:</strong> <a rel=\"noopener noreferrer\" href=\"http://www.ncdrisc.org/index.html\" target=\"_blank\">http://www.ncdrisc.org/index.html</a></li></ul>\n\n\n\n<h4>WHO Global Database on Body Mass Index</h4>\n\n\n\n<ul><li><strong>Data</strong>: Share of population by weight category</li><li><strong>Geographical coverage: </strong>Global \u2013 by country</li><li><strong>Time span:\u00a0</strong>1960 onwards</li><li><strong>Available at:</strong>\u00a0<a href=\"https://www.who.int/data/gho/data/themes/topics/topic-details/GHO/body-mass-index\" target=\"_blank\" rel=\"noreferrer noopener\">https://www.who.int/data/gho/data/themes/topics/topic-details/GHO/body-mass-index</a></li></ul>\n\n\n\n<h4>Institute of Health Metrics and Evaluation (IHME) Global Burden of Disease (GBDx) Data Tool</h4>\n\n\n\n<ul><li><strong>Data</strong>: Number of deaths and death rates from obesity</li><li><strong>Geographical coverage: </strong>Global \u2013 by country</li><li><strong>Time span: </strong>1990 onwards</li><li><strong>Available at: </strong><a rel=\"noopener noreferrer\" href=\"http://www.healthdata.org/results/data-visualizations\" target=\"_blank\">http://www.healthdata.org/results/data-visualizations</a></li></ul>\n", "protected": false }, "excerpt": { "rendered": "When did obesity increase? How do rates vary across the world? What is the health impact?", "protected": false }, "date_gmt": "2017-08-11T14:05:14", "modified": "2023-01-09T11:17:40", "template": "", "categories": [ 44, 170, 47, 182 ], "menu_order": 272, "ping_status": "closed", "authors_name": [ "Hannah Ritchie" ], "modified_gmt": "2023-01-09T11:17:40", "comment_status": "closed", "featured_media": 40768, "featured_media_paths": { "thumbnail": "/app/uploads/2021/02/Screen-Shot-2021-02-15-at-16.41.53-150x78.png", "medium_large": "/app/uploads/2021/02/Screen-Shot-2021-02-15-at-16.41.53-768x400.png" } }

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Obesity

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<p>Obesity is most commonly measured using the body mass index (BMI) scale. The World Health Organization <a rel="noopener noreferrer" href="https://web.archive.org/web/20220219072441/https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight" target="_blank">define BMI</a> as: "<span class="storydeck">a simple index of weight-for-height that is commonly used to classify underweight, overweight and obesity in adults."{ref}BMI is defined as the weight in kilograms divided by the square of the height in metres (kg/m<sup>2</sup>). For example, an adult who weighs 70kg and whose height is 1.75m will have a BMI of 22.9.</span> This is calculated as 70kg / 1.75<sup>2</sup> = 70 / 3.06 = 22.9{/ref}</p>   <p>BMI values are used to define whether an individual is considered to be underweight, healthy, overweight or obese. The WHO defines these categories using the cut-off points: an individual with a BMI between 25.0 and 30.0 is considered to be 'overweight'; a BMI greater than 30.0 is defined as 'obese'.{ref}World Health Organization. BMI Classification. <em>Global Database on Body Mass Index</em>. Available <a href="https://knoema.com/WHOGDOBMIMay/who-global-database-on-body-mass-index-bmi">online</a>.{/ref}</p>    <ul><li><a href="https://ourworldindata.org/obesity#obesity-is-one-of-the-leading-risk-factors-for-early-death">Obesity is one of the leading risk factors for premature death. It was linked to 4.7 million deaths globally in 2017.</a></li><li><a href="https://ourworldindata.org/obesity#8-of-global-deaths-are-attributed-to-obesity">8% of global deaths were attributed to obesity in 2017.</a></li><li><a href="https://ourworldindata.org/obesity#there-is-a-10-fold-difference-in-death-rates-from-obesity-across-the-world">There are large differences – 10-fold – in death rates from obesity across the world.</a></li><li><a href="https://ourworldindata.org/obesity#what-share-of-adults-are-obese">13% of adults in the world are obese.</a></li><li><a href="https://ourworldindata.org/obesity#what-share-of-adults-are-overweight">39% of adults in the world are overweight.</a></li><li><a href="https://ourworldindata.org/obesity#childhood-obesity">One-in-five children and adolescents, globally, are overweight.</a></li><li><a href="https://ourworldindata.org/obesity#what-are-the-drivers-of-obesity">Obesity is determined by the balance of energy intake and expenditure. Rates have increased as the calories have become more readily available.</a></li></ul>    <p><strong>Related research entries</strong></p>   <p><a href="https://owid.cloud/food-per-person">Food per person</a> – food availability has increased significantly in most countries across the world. How does the supply of calories, protein and fats vary between countries? How has this changed over time?</p>   <p><a href="https://owid.cloud/hunger-and-undernourishment">Hunger and Undernourishment</a> – obesity rates have now overtaken hunger rates globally. But it remains the case that high levels of obesity and hunger can occur in a country at any given time. How does undernourishment vary across the world? How has it changed over time?</p>   <p><a href="https://owid.cloud/micronutrient-deficiency">Micronutrient Deficiency</a> – getting sufficient intake of calories (a requirement for obesity) does not guarantee an individual gets the full range of essential vitamins and minerals (micronutrients) for good health. Dietary diversity varies significantly across the world. How common is micronutrient deficiency and who is most at risk?</p>   <h2>Obesity is one of the leading risk factors for early death</h2>   <h4>Obesity is responsible for 4.7 million premature deaths each year</h4>   <p>Obesity is one of the world's largest health problems – one that has shifted from being a problem in rich countries, to one that spans all income levels.<br><br>The <em>Global Burden of Disease</em> is a major global study on the causes and risk factors for death and disease published in the medical journal <em>The Lancet</em>.{ref}The latest study can be found at the website of the Lancet here: <a href="https://www.thelancet.com/gbd">TheLancet.com/GBD</a><br><br>The 2017 study was published as GBD 2017 Risk Factor Collaborators – "Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017" and is online <a href="http://www.healthdata.org/research-article/global-regional-and-national-comparative-risk-assessment-84-behavioral-0">here</a>.{/ref} These estimates of the annual number of deaths attributed to a wide range of risk factors are shown here. This chart is shown for the global total, but can be explored for any country or region using the "change country" toggle.</p>   <p>Obesity – defined as having a high body-mass index – is a risk factor for several of the world's leading causes of death, including heart disease, stroke, diabetes and various types of cancer.{ref}WHO (2018) – Fact sheet – Obesity and overweight. Updated February 2018. Online <a href="https://www.who.int/en/news-room/fact-sheets/detail/obesity-and-overweight">here</a>.{/ref} Obesity does not directly <em>cause</em> of any of these health impacts but can increase their likelihood of occurring. In the chart we see that it is one of the leading risk factors for death globally. </p>   <p>According to the <em>Global Burden of Disease</em> study 4.7 million people died prematurely in 2017 as a result of obesity. To put this into context: this was close to four times the number that died in <a href="https://ourworldindata.org/grapher/road-deaths-by-type">road accidents</a>, and close to five times the number that died from <a href="https://owid.cloud/hiv-aids">HIV/AIDS</a> in 2017.{ref}The <em>Global Burden of Disease</em> study <a href="https://ourworldindata.org/grapher/annual-number-of-deaths-by-cause">estimates that</a> around 1.2 million died in road accidents in 2017, and just under 1 million from HIV/AIDS.{/ref}</p>   <iframe src="https://ourworldindata.org/grapher/number-of-deaths-by-risk-factor" style="width: 100%; height: 600px; border: 0px none;"></iframe>   <h2>The global distribution of health impacts from obesity</h2>   <h4>8% of global deaths are the result of obesity</h4>   <p>Globally, <a href="https://ourworldindata.org/grapher/share-of-deaths-obesity?tab=chart&country=OWID_WRL">8% of deaths</a> in 2017 were the result of obesity – this represents an increase from 4.5% in 1990.</p>   <p>This share varies significantly across the world. In the map here we see the share of deaths attributed to obesity across countries.</p>   <p>Across many middle-income countries – particularly across Eastern Europe, Central Asia, North Africa, and Latin America – more than 15% of deaths were attributed to obesity in 2017. This most likely results from having a high prevalence of obesity, but poorer overall health and healthcare systems relatively to high-income countries with similarly high levels of obesity. <br><br>In most high-income countries this share is in the range of 8 to 10%. This is about half the share of many middle-income countries. The large outliers among rich countries are Japan and South Korea: there only around 5% of premature deaths are attributed to obesity. </p>   <p>Across low-income countries – especially across Sub-Saharan Africa – obesity accounts for less than 5% of deaths.</p>   <iframe src="https://ourworldindata.org/grapher/share-of-deaths-obesity" style="width: 100%; height: 600px; border: 0px none;"></iframe>   <h4>There is a 10-fold difference in death rates from obesity across the world</h4>   <p>Death rates from obesity give us an accurate comparison of differences in its mortality impacts between countries and over time. In contrast to the share of deaths that we studied before, death rates are not influenced by how other causes or risk factors for death are changing.</p>   <p>In the map here we see differences in death rates from obesity across the world. Globally, <a href="https://ourworldindata.org/grapher/death-rate-from-obesity?tab=chart&country=OWID_WRL">the death rate</a> from obesity was around 60 per 100,000 in 2017.</p>   <p>The overall picture does in fact match closely with the share of deaths: death rates are high across middle-income countries, especially across Eastern Europe, Central Asia, North Africa and Latin America. Rates there can be close to 200 per 100,000. This is more than ten times greater than rates at the bottom: Japan and South Korea have the lowest rates in the world at 14 and 20 deaths per 100,000, respectively.</p>   <p>When we look at the <a href="https://ourworldindata.org/grapher/death-rate-vs-share-obesity">relationship between</a> death rates and the prevalence of obesity we find a positive one: death rates tend to be higher in countries where more people have obesity. But what we also notice is that for a given prevalence of obesity, death rates can vary by a factor of four. 23% of Russian and Norwegian are obese, yet Russia's death rate is four times higher. Clearly it's not <em>only</em> the prevalence of obesity that plays a role but also other factors such as underlying health, other confounding risk factors (such as <a href="https://owid.cloud/alcohol-consumption">alcohol</a>, <a href="https://owid.cloud/drug-use">drugs</a>, <a href="https://owid.cloud/smoking">smoking</a> and other lifestyle factors) and healthcare systems.</p>   <iframe src="https://ourworldindata.org/grapher/death-rate-from-obesity" style="width: 100%; height: 600px; border: 0px none;"></iframe>   <h2>What share of adults are obese?</h2>   <h4>13% of adults in the world are obese</h4>   <p>Globally, 13% of adults aged 18 years and older were obese in 2016.{ref}WHO (2018) – Fact sheet – Obesity and overweight. Updated February 2018. Online <a href="https://www.who.int/en/news-room/fact-sheets/detail/obesity-and-overweight">here</a>.{/ref} Obesity <a href="https://ourworldindata.org/obesity#definitions-measurement">is defined</a> as having a body-mass index equal to or greater than 30. </p>   <p>In the map here we see the share of adults who are obese across countries. Overall we see a pattern roughly in line with prosperity: the prevalence of obesity tends to be higher in richer countries across Europe, North America, and Oceania. Obesity rates are much lower across South Asia and Sub-Saharan Africa. </p>   <p>More than one-in-three (36%) of adults in the United States were obese in 2016. In India this share was around 10 times lower (3.9%).</p>   <p>The relationship between income and obesity generally holds true – as we see in the comparison <a href="https://ourworldindata.org/grapher/obesity-vs-gdp">here</a>. But there are some notable exceptions. The small Pacific Island States stand out clearly: they have very high rates of obesity – 61% in Nauru and 55% in Palau – for their level of income. At the other end of the spectrum, Japan, South Korea and Singapore have very low levels of obesity for their level of income.</p>   <iframe style="width: 100%; height: 600px; border: 0px none;" src="https://ourworldindata.org/grapher/share-of-adults-defined-as-obese"></iframe>   <blockquote class="wp-block-quote"><p><strong>Related charts – share of men and women that are obese.</strong> <a href="https://ourworldindata.org/grapher/share-of-men-defined-as-obese">This map</a> allows you to explore the share of men that are obese; <a href="https://ourworldindata.org/grapher/share-of-females-defined-as-obese">this map</a> allows you to explore this data for women across the world. <a href="https://ourworldindata.org/grapher/obesity-in-men-vs-obesity-in-women">This chart</a> shows the comparison of obesity in men and women.</p></blockquote>   <h2>What share of adults are overweight?</h2>   <h4>39% of adults in the world are overweight or obese</h4>   <p>Globally, 39% of adults aged 18 years and older were overweight or obese in 2016.{ref}WHO (2018) – Fact sheet – Obesity and overweight. Updated February 2018. Online <a href="https://www.who.int/en/news-room/fact-sheets/detail/obesity-and-overweight">here</a>.{/ref} Being overweight <a href="https://ourworldindata.org/obesity#definitions-measurement">is also defined</a> based on body-mass index: the threshold value is lower than for obesity, with a BMI equal to or greater than 25.</p>   <p>In the map here we see the share of adults who are overweight or obese across countries. The overall pattern is very closely aligned with the distribution of obesity across the world: the share of people who are overweight tends to be higher in richer countries and lower at lower incomes. What is of course true is that the share who are overweight (have a BMI greater than or equal to 25) is much higher than the share that are obese (a BMI of 30 or greater).</p>   <p>In most high-income countries, around two-thirds of adults are overweight or obese. In the US, 70% are. At the lowest end of the scale, across South Asia and Sub-Saharan Africa around 1-in-5 adults have a BMI greater than 25.</p>   <blockquote class="wp-block-quote"><p><strong>Related charts – share of men and women that are overweight</strong> <strong>or obese</strong>. <a href="https://ourworldindata.org/grapher/share-of-men-defined-as-overweight">This map</a> allows you to explore the share of men that are overweight or obese; <a href="https://ourworldindata.org/grapher/share-of-females-defined-as-overweight">this map</a> allows you to explore this data for women across the world.</p></blockquote>   <iframe style="width: 100%; height: 600px; border: 0px none;" src="https://ourworldindata.org/grapher/share-of-adults-who-are-overweight"></iframe>   <h2>Body Mass Index (BMI)</h2>   <h4>Mean BMI in adult women</h4>   <p>Body Mass Index (BMI) is <a href="https://ourworldindata.org/obesity#definitions-measurement">used to define</a> the share of individuals that are underweight, in the 'healthy' range, overweight and obese.</p>   <p>In the map here we see the distribution of mean BMI for adult women – aged 18 years and older – across the world. The <a href="https://ourworldindata.org/grapher/mean-body-mass-index-bmi-in-adult-women?tab=chart&country=OWID_WRL">global mean BMI</a> for women in 2016 was 25 – just on the threshold from the WHO's 'healthy' to 'overweight' classification. This has increased from a mean BMI of 22 – in the mid-range of 'healthy' – in the 1970s.</p>   <iframe style="width: 100%; height: 600px; border: 0px none;" src="https://ourworldindata.org/grapher/mean-body-mass-index-bmi-in-adult-women" width="300" height="150"></iframe>   <h4>Mean BMI in adult men</h4>   <p>Body Mass Index (BMI) is <a href="https://ourworldindata.org/obesity#definitions-measurement">used to define</a> the share of individuals that are underweight, in the 'healthy' range, overweight and obese.</p>   <p>In the map here we see the distribution of mean BMI for adult men – aged 18 years and older – across the world. The <a href="https://ourworldindata.org/grapher/mean-body-mass-index-bmi-in-adult-males?tab=chart&country=OWID_WRL">global mean BMI</a> for men in 2016 was 24.5 – just on the threshold from the WHO's 'healthy' to 'overweight' classification. This has increased from a mean BMI of 21.7 – in the mid-range of 'healthy' – in the 1970s.</p>   <iframe style="width: 100%; height: 600px; border: 0px none;" src="https://ourworldindata.org/grapher/mean-body-mass-index-bmi-in-adult-males" width="300" height="150"></iframe>   <h2>Childhood obesity</h2>   <h4>Share of children that are overweight</h4>   <p>Obesity and overweight in children are also measured on the basis of body-mass-index (BMI). However, interpretation of BMI scores is treated differently for children and adolescents. Weight categories are defined in relation to WHO Growth Standards – a child is defined as overweight if their weight-for-height is more than two standard deviations from the median of the WHO Child Growth Standards.</p>   <p>The World Health Organization reports that the share of children and adolescents aged 5-19 who are overweight or obese has risen from 4% in 1975 to around 18% in 2016.{ref}WHO (2018) – Fact sheet – Obesity and overweight. Updated February 2018. Online <a href="https://www.who.int/en/news-room/fact-sheets/detail/obesity-and-overweight">here</a>.{/ref}</p>   <p>In the map here we see the share of very young children – aged 2 to 4 years old – who are overweight based on WHO Child Growth Standards. In many countries as many as every third or fourth child is overweight.</p>   <iframe src="https://ourworldindata.org/grapher/children-who-are-overweight-sdgs?time=1990..2016" style="width: 100%; height: 600px; border: 0px none;"></iframe>   <h2>What are the drivers of obesity?</h2>   <p>At a basic level, weight gain – eventually leading to being overweight or obesity – is determined by a balance of energy.{ref}Hall, K. D., Heymsfield, S. B., Kemnitz, J. W., Klein, S., Schoeller, D. A., & Speakman, J. R. (2012). <a href="https://academic.oup.com/ajcn/article/95/4/989/4576902">Energy balance and its components: implications for body weight regulation</a>. <em>The American Journal of Clinical Nutrition</em>, <em>95</em>(4), 989-994.{/ref} When we consume more energy – typically measured in kilocalories – than the energy expended to maintain life and carry out daily activites, we gain weight. This is a called an energy surplus. When we consume less energy than we expend, we lose weight – this is an energy deficit. </p>   <p>This means there are two potential drivers of the increase in obesity rates in recent decades: either an increase in kilocalorie intake i.e. we eat more; or we expend less energy in daily life through lower activity levels. Both elements are likely to play a role in the rise in obesity.</p>   <p>To tackle obesity it's likely that interventions which address both components: energy intake and expenditure are necessary.{ref}Hill, J. O., Wyatt, H. R., & Peters, J. C. (2012). <a href="https://www.ahajournals.org/doi/full/10.1161/circulationaha.111.087213">Energy balance and obesity</a>. <em>Circulation</em>, <em>126</em>(1), 126-132.{/ref}</p>   <h4>Daily supply of calories</h4>   <p>Over the past century – but particularly over the past 50 years – the <a href="https://owid.cloud/food-per-person">supply of calories</a> has increased across the world. In the 1960s, the global <a href="https://ourworldindata.org/grapher/daily-per-capita-caloric-supply?tab=chart&country=Asia~Europe~North+America~South+America~Africa">average supply of calories</a> (that is, the availability of calories for consumers to eat) was 2200kcal per person per day. By 2013 this had increased to 2800kcal.</p>   <p>Across most countries, energy consumption has therefore increased. If this increase was not met with an increase in energy expenditure, weight gain and a rise in obesity rates is the result. </p>   <p>In the chart here we see the relationship between the share of men that are overweight or obese (on the y-axis) versus the daily average supply of kilocalories per person. Overall we see a strong positive relationship: countries with higher rates of overweight tend to have a higher supply of calories. </p>   <p>If you press 'play' on the interactive timeline you can see how this has changed for each country over time. Most countries move upwards and to the right: the supply of calories has increased at the same time as obesity rates have increased.</p>   <iframe style="width: 100%; height: 600px; border: 0px none;" src="https://ourworldindata.org/grapher/share-of-adult-men-overweight-or-obese-vs-daily-supply-of-calories" width="300" height="150"></iframe>   <h2>Definitions & Measurement</h2>   <h4>How do we measure obesity in adults?</h4>   <p>The most common metric used for assessing the prevalence of obesity is the body mass index (BMI) scale. The World Health Organization <a rel="noopener noreferrer" href="https://web.archive.org/web/20220219072441/https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight" target="_blank">define BMI</a> as: "<span class="storydeck">a simple index of weight-for-height that is commonly used to classify underweight, overweight and obesity in adults. It is defined as the weight in kilograms divided by the square of the height in metres (kg/m<sup>2</sup>). For example, an adult who weighs 70kg and whose height is 1.75m will have a BMI of 22.9."</span>{ref}This is calculated as 70kg / 1.75<sup>2</sup> = 70 / 3.06 = 22.9{/ref}</p>   <p>Measured BMI values are used to define whether an individual is considered to be underweight, healthy, overweight or obese. The WHO defines these categories using the cut-off points in the table. For example, an individual with a BMI between 25.0 and 30.0 is considered to be 'overweight'; a BMI greater than 30.0 is defined as 'obese'.{ref}World Health Organization. BMI Classification. <em>Global Database on Body Mass Index</em>. Available <a href="https://knoema.com/WHOGDOBMIMay/who-global-database-on-body-mass-index-bmi">online</a>.{/ref}</p>   <div class="wp-block-image"><figure class="aligncenter"><a href="https://ourworldindata.org/app/uploads/2017/08/BMI-classification.png"><img src="https://ourworldindata.org/app/uploads/2017/08/BMI-classification.png" alt="" class="wp-image-12788"/></a></figure></div>   <h4>How do we measure obesity in children and adolescents?</h4>   <p>The metric for measuring bodyweight in children and adolescents is also the body mass index (BMI) scale, measured in the same way described above. However, interpretation of BMI scores is treated differently for children and adolescents. Whilst there is no differentiation of weight categories in adults based on sex or age, these are important factors in the body composition of children. Factors such as age, gender and sexual maturation affect the BMI of younger individuals. For interpretation of individuals between the ages of 2 and 20 years old, BMI is measured relative to peers of the same age and gender, with weight classifications judged as shown in the table.{ref}Centers for Disease Control and Prevention. Body Mass Index: Considerations for Practitioners. Available <a href="https://www.cdc.gov/obesity/downloads/bmiforpactitioners.pdf">online</a>.{/ref}</p>   <div class="wp-block-image"><figure class="aligncenter"><a href="https://ourworldindata.org/app/uploads/2017/08/BMI-classification-children.png"><img src="https://ourworldindata.org/app/uploads/2017/08/BMI-classification-children.png" alt="" class="wp-image-12825"/></a></figure></div>   <h4>Is BMI an appropriate measure of weight-related health?</h4>   <p>The merits of using BMI as an indicator of body fat and obesity are still contested. A key contention to the use of BMI indicators is that it provides a measure of body mass/weight rather than providing a direct measure of body fat. Whilst physicians continue to use BMI as a general indicator of weight-related health risks, there are some cases where its use should be considered more carefully{ref}Centers for Disease Control and Prevention. Body Mass Index: Considerations for Practitioners. Available <a href="https://www.cdc.gov/obesity/downloads/bmiforpactitioners.pdf">online</a>.{/ref}:</p>   <ul><li>muscle mass can increase bodyweight; this means athletes or individuals with a high muscle mass percentage can be deemed overweight on the BMI scale, even if they have a low or healthy body fat percentage;</li><li>muscle and bone density tends to decline as we get older; this means that an older individual may have a higher percentage body fat than a younger individual with the same BMI;</li><li>women tend to have a higher body fat percentage than men for a given BMI.</li></ul>   <p>Physicians must therefore evaluate BMI results carefully on a individual basis. Despite outlier cases where BMI is an inappropriate indicator of body fat, its use provides a reasonable measure of the risk of weight-related health factors across most individuals across the general population.</p>   <h2>Data sources</h2>   <h4>NCD Risk Factor Collaboration</h4>   <ul><li><strong>Data</strong>: Mean and distributions of body mass index (BMI), by country</li><li><strong>Geographical coverage: </strong>Global- by country</li><li><strong>Time span: </strong>1975 onwards</li><li><strong>Available at:</strong> <a rel="noopener noreferrer" href="http://www.ncdrisc.org/index.html" target="_blank">http://www.ncdrisc.org/index.html</a></li></ul>   <h4>WHO Global Database on Body Mass Index</h4>   <ul><li><strong>Data</strong>: Share of population by weight category</li><li><strong>Geographical coverage: </strong>Global – by country</li><li><strong>Time span: </strong>1960 onwards</li><li><strong>Available at:</strong> <a href="https://www.who.int/data/gho/data/themes/topics/topic-details/GHO/body-mass-index" target="_blank" rel="noreferrer noopener">https://www.who.int/data/gho/data/themes/topics/topic-details/GHO/body-mass-index</a></li></ul>   <h4>Institute of Health Metrics and Evaluation (IHME) Global Burden of Disease (GBDx) Data Tool</h4>   <ul><li><strong>Data</strong>: Number of deaths and death rates from obesity</li><li><strong>Geographical coverage: </strong>Global – by country</li><li><strong>Time span: </strong>1990 onwards</li><li><strong>Available at: </strong><a rel="noopener noreferrer" href="http://www.healthdata.org/results/data-visualizations" target="_blank">http://www.healthdata.org/results/data-visualizations</a></li></ul>

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                        "text": ".{/ref} These estimates of the annual number of deaths attributed to a wide range of risk factors are shown here. This chart is shown for the global total, but can be explored for any country or region using the \"change country\" toggle.",
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                        "text": "Obesity \u2013 defined as having a high body-mass index \u2013 is a risk factor for several of the world's leading causes of death, including heart disease, stroke, diabetes and various types of cancer.{ref}WHO (2018) \u2013 Fact sheet \u2013 Obesity and overweight. Updated February 2018. Online ",
                        "spanType": "span-simple-text"
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                    {
                        "url": "https://www.who.int/en/news-room/fact-sheets/detail/obesity-and-overweight",
                        "children": [
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                                "text": "here",
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                        "text": ".{/ref} Obesity does not directly ",
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                                "text": "cause",
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                        "text": " of any of these health impacts but can increase their likelihood of occurring. In the chart we see that it is one of the leading risk factors for death globally. ",
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                        "text": " study 4.7 million people died prematurely in 2017 as a result of obesity. To put this into context: this was close to four times the number that died in ",
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                    {
                        "url": "https://ourworldindata.org/grapher/road-deaths-by-type",
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                                "text": "road accidents",
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                    {
                        "text": ", and close to five times the number that died from ",
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                    {
                        "url": "https://owid.cloud/hiv-aids",
                        "children": [
                            {
                                "text": "HIV/AIDS",
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                    {
                        "text": " in 2017.{ref}The ",
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                    {
                        "children": [
                            {
                                "text": "Global Burden of Disease",
                                "spanType": "span-simple-text"
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                    {
                        "text": " study ",
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                    {
                        "url": "https://ourworldindata.org/grapher/annual-number-of-deaths-by-cause",
                        "children": [
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                                "text": "estimates that",
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                    {
                        "text": " around 1.2 million died in road accidents in 2017, and just under 1 million from HIV/AIDS.{/ref}",
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                "text": [
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                        "text": "The global distribution of health impacts from obesity",
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                "text": [
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                        "text": "8% of global deaths are the result of obesity",
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                "value": [
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                        "text": "Globally, ",
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                    {
                        "url": "https://ourworldindata.org/grapher/share-of-deaths-obesity?tab=chart&country=OWID_WRL",
                        "children": [
                            {
                                "text": "8% of deaths",
                                "spanType": "span-simple-text"
                            }
                        ],
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                    {
                        "text": " in 2017 were the result of obesity \u2013 this represents an increase from 4.5% in 1990.",
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                ],
                "parseErrors": []
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                "value": [
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                        "text": "This share varies significantly across the world. In the map here we see the share of deaths attributed to obesity across countries.",
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                        "text": "Across many middle-income countries \u2013 particularly across Eastern Europe, Central Asia, North Africa, and Latin America \u2013 more than 15% of deaths were attributed to obesity in 2017. This most likely results from having a high prevalence of obesity, but poorer overall health and healthcare systems relatively to high-income countries with similarly high levels of obesity. ",
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                        "text": "In most high-income countries this share is in the range of 8 to 10%. This is about half the share of many middle-income countries. The large outliers among rich countries are Japan and South Korea: there only around 5% of premature deaths are attributed to obesity. ",
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                        "text": "Across low-income countries \u2013 especially across Sub-Saharan Africa \u2013 obesity accounts for less than 5% of deaths.",
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                "parseErrors": []
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            {
                "url": "https://ourworldindata.org/grapher/share-of-deaths-obesity",
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                "text": [
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                        "text": "There is a 10-fold difference in death rates from obesity across the world",
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                "level": 3,
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                "value": [
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                        "text": "Death rates from obesity give us an accurate comparison of differences in its mortality impacts between countries and over time. In contrast to the share of deaths that we studied before, death rates are not influenced by how other causes or risk factors for death are changing.",
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                        "text": "In the map here we see differences in death rates from obesity across the world. Globally, ",
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                    {
                        "url": "https://ourworldindata.org/grapher/death-rate-from-obesity?tab=chart&country=OWID_WRL",
                        "children": [
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                                "text": "the death rate",
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                        "text": " from obesity was around 60 per 100,000 in 2017.",
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                        "text": "The overall picture does in fact match closely with the share of deaths: death rates are high across middle-income countries, especially across Eastern Europe, Central Asia, North Africa and Latin America. Rates there can be close to 200 per 100,000. This is more than ten times greater than rates at the bottom: Japan and South Korea have the lowest rates in the world at 14 and 20 deaths per 100,000, respectively.",
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                        "text": "When we look at the ",
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                        "children": [
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                                "text": "relationship between",
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                    {
                        "text": " death rates and the prevalence of obesity we find a positive one: death rates tend to be higher in countries where more people have obesity. But what we also notice is that for a given prevalence of obesity, death rates can vary by a factor of four. 23% of Russian and Norwegian are obese, yet Russia's death rate is four times higher. Clearly it's not ",
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                        "children": [
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                                "text": "only",
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                        "text": " the prevalence of obesity that plays a role but also other factors such as underlying health, other confounding risk factors (such as ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "url": "https://owid.cloud/alcohol-consumption",
                        "children": [
                            {
                                "text": "alcohol",
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                        "spanType": "span-link"
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                    {
                        "text": ", ",
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                    {
                        "url": "https://owid.cloud/drug-use",
                        "children": [
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                                "text": "drugs",
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                        "text": ", ",
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                    {
                        "url": "https://owid.cloud/smoking",
                        "children": [
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                                "text": "smoking",
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                    {
                        "text": " and other lifestyle factors) and healthcare systems.",
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                ],
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                "url": "https://ourworldindata.org/grapher/death-rate-from-obesity",
                "type": "chart",
                "parseErrors": []
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                "text": [
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                        "text": "What share of adults are obese?",
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                "text": [
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                        "text": "13% of adults in the world are obese",
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                "value": [
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                        "text": "Globally, 13% of adults aged 18 years and older were obese in 2016.{ref}WHO (2018) \u2013 Fact sheet \u2013 Obesity and overweight. Updated February 2018. Online ",
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                    {
                        "url": "https://www.who.int/en/news-room/fact-sheets/detail/obesity-and-overweight",
                        "children": [
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                                "text": "here",
                                "spanType": "span-simple-text"
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                    {
                        "text": ".{/ref} Obesity ",
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                    {
                        "url": "https://ourworldindata.org/obesity#definitions-measurement",
                        "children": [
                            {
                                "text": "is defined",
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                        "text": " as having a body-mass index equal to or greater than 30. ",
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                        "text": "In the map here we see the share of adults who are obese across countries. Overall we see a pattern roughly in line with prosperity: the prevalence of obesity tends to be higher in richer countries across Europe, North America, and Oceania. Obesity rates are much lower across South Asia and Sub-Saharan Africa. ",
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                        "text": "More than one-in-three (36%) of adults in the United States were obese in 2016. In India this share was around 10 times lower (3.9%).",
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                        "text": "The relationship between income and obesity generally holds true \u2013 as we see in the comparison ",
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                        "url": "https://ourworldindata.org/grapher/obesity-vs-gdp",
                        "children": [
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                                "text": "here",
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                        "text": ". But there are some notable exceptions. The small Pacific Island States stand out clearly: they have very high rates of obesity \u2013 61% in Nauru and 55% in Palau \u2013 for their level of income. At the other end of the spectrum, Japan, South Korea and Singapore have very low levels of obesity for their level of income.",
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            {
                "url": "https://ourworldindata.org/grapher/share-of-adults-defined-as-obese",
                "type": "chart",
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                "url": "https://ourworldindata.org/grapher/obesity-in-men-vs-obesity-in-women",
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                "text": [
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                        "text": "What share of adults are overweight?",
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                "text": [
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                        "text": "39% of adults in the world are overweight or obese",
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                "value": [
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                        "text": "Globally, 39% of adults aged 18 years and older were overweight or obese in 2016.{ref}WHO (2018) \u2013 Fact sheet \u2013 Obesity and overweight. Updated February 2018. Online ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "url": "https://www.who.int/en/news-room/fact-sheets/detail/obesity-and-overweight",
                        "children": [
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                                "text": "here",
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                    {
                        "text": ".{/ref} Being overweight ",
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                        "url": "https://ourworldindata.org/obesity#definitions-measurement",
                        "children": [
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                                "text": "is also defined",
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                        "text": " based on body-mass index: the threshold value is lower than for obesity, with a BMI equal to or greater than 25.",
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                        "text": "In the map here we see the share of adults who are overweight or obese across countries. The overall pattern is very closely aligned with the distribution of obesity across the world: the share of people who are overweight tends to be higher in richer countries and lower at lower incomes. What is of course true is that the share who are overweight (have a BMI greater than or equal to 25) is much higher than the share that are obese (a BMI of 30 or greater).",
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                        "text": "In most high-income countries, around two-thirds of adults are overweight or obese. In the US, 70% are. At the lowest end of the scale, across South Asia and Sub-Saharan Africa around 1-in-5 adults have a BMI greater than 25.",
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                "url": "https://ourworldindata.org/grapher/share-of-adults-who-are-overweight",
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                "type": "horizontal-rule",
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                "text": [
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                        "text": "Body Mass Index (BMI)",
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                        "text": "Mean BMI in adult women",
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                        "text": "Body Mass Index (BMI) is ",
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                        "text": " the share of individuals that are underweight, in the 'healthy' range, overweight and obese.",
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                        "text": "In the map here we see the distribution of mean BMI for adult women \u2013 aged 18 years and older \u2013 across the world. The ",
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                        "text": " for women in 2016 was 25 \u2013 just on the threshold from the WHO's 'healthy' to 'overweight' classification. This has increased from a mean BMI of 22 \u2013 in the mid-range of 'healthy' \u2013 in the 1970s.",
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                        "text": "Mean BMI in adult men",
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                        "text": "Body Mass Index (BMI) is ",
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                        "text": " the share of individuals that are underweight, in the 'healthy' range, overweight and obese.",
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                        "text": "In the map here we see the distribution of mean BMI for adult men \u2013 aged 18 years and older \u2013 across the world. The ",
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                        "url": "https://ourworldindata.org/grapher/mean-body-mass-index-bmi-in-adult-males?tab=chart&country=OWID_WRL",
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                        "text": " for men in 2016 was 24.5 \u2013 just on the threshold from the WHO's 'healthy' to 'overweight' classification. This has increased from a mean BMI of 21.7 \u2013 in the mid-range of 'healthy' \u2013 in the 1970s.",
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                        "text": "Childhood obesity",
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                        "text": "Share of children that are overweight",
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                        "text": "Obesity and overweight in children are also measured on the basis of body-mass-index (BMI). However, interpretation of BMI scores is treated differently for children and adolescents.\u00a0Weight categories are defined in relation to WHO Growth Standards \u2013 a child is defined as overweight if their weight-for-height is more than two standard deviations from the median of the WHO Child Growth Standards.",
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                    {
                        "text": "The World Health Organization reports that the share of children and adolescents aged 5-19 who are overweight or obese has risen from 4% in 1975 to around 18% in 2016.{ref}WHO (2018) \u2013 Fact sheet \u2013 Obesity and overweight. Updated February 2018. Online ",
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                    {
                        "url": "https://www.who.int/en/news-room/fact-sheets/detail/obesity-and-overweight",
                        "children": [
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                                "text": "here",
                                "spanType": "span-simple-text"
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                        "text": ".{/ref}",
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                        "text": "In the map here we see the share of very young children \u2013 aged 2 to 4 years old \u2013 who are overweight based on WHO Child Growth Standards. In many countries as many as every third or fourth child is overweight.",
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                "url": "https://ourworldindata.org/grapher/children-who-are-overweight-sdgs?time=1990..2016",
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                "type": "horizontal-rule",
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                "text": [
                    {
                        "text": "What are the drivers of obesity?",
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                "parseErrors": []
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                        "text": "At a basic level, weight gain \u2013 eventually leading to being overweight or obesity \u2013 is determined by a balance of energy.{ref}Hall, K. D., Heymsfield, S. B., Kemnitz, J. W., Klein, S., Schoeller, D. A., & Speakman, J. R. (2012). ",
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                        "text": "(4), 989-994.{/ref} When we consume more energy \u2013 typically measured in kilocalories \u2013 than the energy expended to maintain life and carry out daily activites, we gain weight. This is a called an energy surplus. When we consume less energy than we expend, we lose weight \u2013 this is an energy deficit. ",
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2017-08-11 14:05:14

2024-02-16 14:22:39

[
    "Hannah Ritchie"
]

When did obesity increase? How do rates vary across the world? What is the health impact?

2019-02-05 21:12:15

2023-01-09 11:17:40

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Obesity is most commonly measured using the body mass index (BMI) scale. The World Health Organization [define BMI](https://web.archive.org/web/20220219072441/https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight) as: "a simple index of weight-for-height that is commonly used to classify underweight, overweight and obesity in adults."{ref}BMI is defined as the weight in kilograms divided by the square of the height in metres (kg/m2). For example, an adult who weighs 70kg and whose height is 1.75m will have a BMI of 22.9. This is calculated as 70kg / 1.752 = 70 / 3.06 = 22.9{/ref} BMI values are used to define whether an individual is considered to be underweight, healthy, overweight or obese. The WHO defines these categories using the cut-off points: an individual with a BMI between 25.0 and 30.0 is considered to be 'overweight'; a BMI greater than 30.0 is defined as 'obese'.{ref}World Health Organization. BMI Classification. _Global Database on Body Mass Index_. Available [online](https://knoema.com/WHOGDOBMIMay/who-global-database-on-body-mass-index-bmi).{/ref} **Related research entries** [Food per person](https://owid.cloud/food-per-person) – food availability has increased significantly in most countries across the world. How does the supply of calories, protein and fats vary between countries? How has this changed over time? [Hunger and Undernourishment](https://owid.cloud/hunger-and-undernourishment) – obesity rates have now overtaken hunger rates globally. But it remains the case that high levels of obesity and hunger can occur in a country at any given time. How does undernourishment vary across the world? How has it changed over time? [Micronutrient Deficiency](https://owid.cloud/micronutrient-deficiency) – getting sufficient intake of calories (a requirement for obesity) does not guarantee an individual gets the full range of essential vitamins and minerals (micronutrients) for good health. Dietary diversity varies significantly across the world. How common is micronutrient deficiency and who is most at risk? --- # Obesity is one of the leading risk factors for early death --- ### Obesity is responsible for 4.7 million premature deaths each year Obesity is one of the world's largest health problems – one that has shifted from being a problem in rich countries, to one that spans all income levels. The _Global Burden of Disease_ is a major global study on the causes and risk factors for death and disease published in the medical journal _The Lancet_.{ref}The latest study can be found at the website of the Lancet here: [TheLancet.com/GBD](https://www.thelancet.com/gbd) The 2017 study was published as GBD 2017 Risk Factor Collaborators – "Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017" and is online [here](http://www.healthdata.org/research-article/global-regional-and-national-comparative-risk-assessment-84-behavioral-0).{/ref} These estimates of the annual number of deaths attributed to a wide range of risk factors are shown here. This chart is shown for the global total, but can be explored for any country or region using the "change country" toggle. Obesity – defined as having a high body-mass index – is a risk factor for several of the world's leading causes of death, including heart disease, stroke, diabetes and various types of cancer.{ref}WHO (2018) – Fact sheet – Obesity and overweight. Updated February 2018. Online [here](https://www.who.int/en/news-room/fact-sheets/detail/obesity-and-overweight).{/ref} Obesity does not directly _cause_ of any of these health impacts but can increase their likelihood of occurring. In the chart we see that it is one of the leading risk factors for death globally. According to the _Global Burden of Disease_ study 4.7 million people died prematurely in 2017 as a result of obesity. To put this into context: this was close to four times the number that died in [road accidents](https://ourworldindata.org/grapher/road-deaths-by-type), and close to five times the number that died from [HIV/AIDS](https://owid.cloud/hiv-aids) in 2017.{ref}The _Global Burden of Disease_ study [estimates that](https://ourworldindata.org/grapher/annual-number-of-deaths-by-cause) around 1.2 million died in road accidents in 2017, and just under 1 million from HIV/AIDS.{/ref} <Chart url="https://ourworldindata.org/grapher/number-of-deaths-by-risk-factor"/> --- # The global distribution of health impacts from obesity --- ### 8% of global deaths are the result of obesity Globally, [8% of deaths](https://ourworldindata.org/grapher/share-of-deaths-obesity?tab=chart&country=OWID_WRL) in 2017 were the result of obesity – this represents an increase from 4.5% in 1990. This share varies significantly across the world. In the map here we see the share of deaths attributed to obesity across countries. Across many middle-income countries – particularly across Eastern Europe, Central Asia, North Africa, and Latin America – more than 15% of deaths were attributed to obesity in 2017. This most likely results from having a high prevalence of obesity, but poorer overall health and healthcare systems relatively to high-income countries with similarly high levels of obesity. In most high-income countries this share is in the range of 8 to 10%. This is about half the share of many middle-income countries. The large outliers among rich countries are Japan and South Korea: there only around 5% of premature deaths are attributed to obesity. Across low-income countries – especially across Sub-Saharan Africa – obesity accounts for less than 5% of deaths. <Chart url="https://ourworldindata.org/grapher/share-of-deaths-obesity"/> ### There is a 10-fold difference in death rates from obesity across the world Death rates from obesity give us an accurate comparison of differences in its mortality impacts between countries and over time. In contrast to the share of deaths that we studied before, death rates are not influenced by how other causes or risk factors for death are changing. In the map here we see differences in death rates from obesity across the world. Globally, [the death rate](https://ourworldindata.org/grapher/death-rate-from-obesity?tab=chart&country=OWID_WRL) from obesity was around 60 per 100,000 in 2017. The overall picture does in fact match closely with the share of deaths: death rates are high across middle-income countries, especially across Eastern Europe, Central Asia, North Africa and Latin America. Rates there can be close to 200 per 100,000. This is more than ten times greater than rates at the bottom: Japan and South Korea have the lowest rates in the world at 14 and 20 deaths per 100,000, respectively. When we look at the [relationship between](https://ourworldindata.org/grapher/death-rate-vs-share-obesity) death rates and the prevalence of obesity we find a positive one: death rates tend to be higher in countries where more people have obesity. But what we also notice is that for a given prevalence of obesity, death rates can vary by a factor of four. 23% of Russian and Norwegian are obese, yet Russia's death rate is four times higher. Clearly it's not _only_ the prevalence of obesity that plays a role but also other factors such as underlying health, other confounding risk factors (such as [alcohol](https://owid.cloud/alcohol-consumption), [drugs](https://owid.cloud/drug-use), [smoking](https://owid.cloud/smoking) and other lifestyle factors) and healthcare systems. <Chart url="https://ourworldindata.org/grapher/death-rate-from-obesity"/> --- # What share of adults are obese? --- ### 13% of adults in the world are obese Globally, 13% of adults aged 18 years and older were obese in 2016.{ref}WHO (2018) – Fact sheet – Obesity and overweight. Updated February 2018. Online [here](https://www.who.int/en/news-room/fact-sheets/detail/obesity-and-overweight).{/ref} Obesity [is defined](https://ourworldindata.org/obesity#definitions-measurement) as having a body-mass index equal to or greater than 30. In the map here we see the share of adults who are obese across countries. Overall we see a pattern roughly in line with prosperity: the prevalence of obesity tends to be higher in richer countries across Europe, North America, and Oceania. Obesity rates are much lower across South Asia and Sub-Saharan Africa. More than one-in-three (36%) of adults in the United States were obese in 2016. In India this share was around 10 times lower (3.9%). The relationship between income and obesity generally holds true – as we see in the comparison [here](https://ourworldindata.org/grapher/obesity-vs-gdp). But there are some notable exceptions. The small Pacific Island States stand out clearly: they have very high rates of obesity – 61% in Nauru and 55% in Palau – for their level of income. At the other end of the spectrum, Japan, South Korea and Singapore have very low levels of obesity for their level of income. <Chart url="https://ourworldindata.org/grapher/share-of-adults-defined-as-obese"/> ### undefined undefined https://ourworldindata.org/grapher/obesity-in-men-vs-obesity-in-women --- # What share of adults are overweight? --- ### 39% of adults in the world are overweight or obese Globally, 39% of adults aged 18 years and older were overweight or obese in 2016.{ref}WHO (2018) – Fact sheet – Obesity and overweight. Updated February 2018. Online [here](https://www.who.int/en/news-room/fact-sheets/detail/obesity-and-overweight).{/ref} Being overweight [is also defined](https://ourworldindata.org/obesity#definitions-measurement) based on body-mass index: the threshold value is lower than for obesity, with a BMI equal to or greater than 25. In the map here we see the share of adults who are overweight or obese across countries. The overall pattern is very closely aligned with the distribution of obesity across the world: the share of people who are overweight tends to be higher in richer countries and lower at lower incomes. What is of course true is that the share who are overweight (have a BMI greater than or equal to 25) is much higher than the share that are obese (a BMI of 30 or greater). In most high-income countries, around two-thirds of adults are overweight or obese. In the US, 70% are. At the lowest end of the scale, across South Asia and Sub-Saharan Africa around 1-in-5 adults have a BMI greater than 25. ### undefined undefined https://ourworldindata.org/grapher/share-of-females-defined-as-overweight <Chart url="https://ourworldindata.org/grapher/share-of-adults-who-are-overweight"/> --- # Body Mass Index (BMI) --- ### Mean BMI in adult women Body Mass Index (BMI) is [used to define](https://ourworldindata.org/obesity#definitions-measurement) the share of individuals that are underweight, in the 'healthy' range, overweight and obese. In the map here we see the distribution of mean BMI for adult women – aged 18 years and older – across the world. The [global mean BMI](https://ourworldindata.org/grapher/mean-body-mass-index-bmi-in-adult-women?tab=chart&country=OWID_WRL) for women in 2016 was 25 – just on the threshold from the WHO's 'healthy' to 'overweight' classification. This has increased from a mean BMI of 22 – in the mid-range of 'healthy' – in the 1970s. <Chart url="https://ourworldindata.org/grapher/mean-body-mass-index-bmi-in-adult-women"/> ### Mean BMI in adult men Body Mass Index (BMI) is [used to define](https://ourworldindata.org/obesity#definitions-measurement) the share of individuals that are underweight, in the 'healthy' range, overweight and obese. In the map here we see the distribution of mean BMI for adult men – aged 18 years and older – across the world. The [global mean BMI](https://ourworldindata.org/grapher/mean-body-mass-index-bmi-in-adult-males?tab=chart&country=OWID_WRL) for men in 2016 was 24.5 – just on the threshold from the WHO's 'healthy' to 'overweight' classification. This has increased from a mean BMI of 21.7 – in the mid-range of 'healthy' – in the 1970s. <Chart url="https://ourworldindata.org/grapher/mean-body-mass-index-bmi-in-adult-males"/> --- # Childhood obesity --- ### Share of children that are overweight Obesity and overweight in children are also measured on the basis of body-mass-index (BMI). However, interpretation of BMI scores is treated differently for children and adolescents. Weight categories are defined in relation to WHO Growth Standards – a child is defined as overweight if their weight-for-height is more than two standard deviations from the median of the WHO Child Growth Standards. The World Health Organization reports that the share of children and adolescents aged 5-19 who are overweight or obese has risen from 4% in 1975 to around 18% in 2016.{ref}WHO (2018) – Fact sheet – Obesity and overweight. Updated February 2018. Online [here](https://www.who.int/en/news-room/fact-sheets/detail/obesity-and-overweight).{/ref} In the map here we see the share of very young children – aged 2 to 4 years old – who are overweight based on WHO Child Growth Standards. In many countries as many as every third or fourth child is overweight. <Chart url="https://ourworldindata.org/grapher/children-who-are-overweight-sdgs?time=1990..2016"/> --- # What are the drivers of obesity? --- At a basic level, weight gain – eventually leading to being overweight or obesity – is determined by a balance of energy.{ref}Hall, K. D., Heymsfield, S. B., Kemnitz, J. W., Klein, S., Schoeller, D. A., & Speakman, J. R. (2012). [Energy balance and its components: implications for body weight regulation](https://academic.oup.com/ajcn/article/95/4/989/4576902). _The American Journal of Clinical Nutrition_, _95_(4), 989-994.{/ref} When we consume more energy – typically measured in kilocalories – than the energy expended to maintain life and carry out daily activites, we gain weight. This is a called an energy surplus. When we consume less energy than we expend, we lose weight – this is an energy deficit. This means there are two potential drivers of the increase in obesity rates in recent decades: either an increase in kilocalorie intake i.e. we eat more; or we expend less energy in daily life through lower activity levels. Both elements are likely to play a role in the rise in obesity. To tackle obesity it's likely that interventions which address both components: energy intake and expenditure are necessary.{ref}Hill, J. O., Wyatt, H. R., & Peters, J. C. (2012). [Energy balance and obesity](https://www.ahajournals.org/doi/full/10.1161/circulationaha.111.087213). _Circulation_, _126_(1), 126-132.{/ref} ### Daily supply of calories Over the past century – but particularly over the past 50 years – the [supply of calories](https://owid.cloud/food-per-person) has increased across the world. In the 1960s, the global [average supply of calories](https://ourworldindata.org/grapher/daily-per-capita-caloric-supply?tab=chart&country=Asia~Europe~North+America~South+America~Africa) (that is, the availability of calories for consumers to eat) was 2200kcal per person per day. By 2013 this had increased to 2800kcal. Across most countries, energy consumption has therefore increased. If this increase was not met with an increase in energy expenditure, weight gain and a rise in obesity rates is the result. In the chart here we see the relationship between the share of men that are overweight or obese (on the y-axis) versus the daily average supply of kilocalories per person. Overall we see a strong positive relationship: countries with higher rates of overweight tend to have a higher supply of calories. If you press 'play' on the interactive timeline you can see how this has changed for each country over time. Most countries move upwards and to the right: the supply of calories has increased at the same time as obesity rates have increased. <Chart url="https://ourworldindata.org/grapher/share-of-adult-men-overweight-or-obese-vs-daily-supply-of-calories"/> --- # Definitions & Measurement --- ### How do we measure obesity in adults? The most common metric used for assessing the prevalence of obesity is the body mass index (BMI) scale. The World Health Organization [define BMI](https://web.archive.org/web/20220219072441/https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight) as: "a simple index of weight-for-height that is commonly used to classify underweight, overweight and obesity in adults. It is defined as the weight in kilograms divided by the square of the height in metres (kg/m2). For example, an adult who weighs 70kg and whose height is 1.75m will have a BMI of 22.9."{ref}This is calculated as 70kg / 1.752 = 70 / 3.06 = 22.9{/ref} Measured BMI values are used to define whether an individual is considered to be underweight, healthy, overweight or obese. The WHO defines these categories using the cut-off points in the table. For example, an individual with a BMI between 25.0 and 30.0 is considered to be 'overweight'; a BMI greater than 30.0 is defined as 'obese'.{ref}World Health Organization. BMI Classification. _Global Database on Body Mass Index_. Available [online](https://knoema.com/WHOGDOBMIMay/who-global-database-on-body-mass-index-bmi).{/ref} <Image filename="BMI-classification.png" alt=""/> ### How do we measure obesity in children and adolescents? The metric for measuring bodyweight in children and adolescents is also the body mass index (BMI) scale, measured in the same way described above. However, interpretation of BMI scores is treated differently for children and adolescents. Whilst there is no differentiation of weight categories in adults based on sex or age, these are important factors in the body composition of children. Factors such as age, gender and sexual maturation affect the BMI of younger individuals. For interpretation of individuals between the ages of 2 and 20 years old, BMI is measured relative to peers of the same age and gender, with weight classifications judged as shown in the table.{ref}Centers for Disease Control and Prevention. Body Mass Index: Considerations for Practitioners. Available [online](https://www.cdc.gov/obesity/downloads/bmiforpactitioners.pdf).{/ref} <Image filename="BMI-classification-children.png" alt=""/> ### Is BMI an appropriate measure of weight-related health? The merits of using BMI as an indicator of body fat and obesity are still contested. A key contention to the use of BMI indicators is that it provides a measure of body mass/weight rather than providing a direct measure of body fat. Whilst physicians continue to use BMI as a general indicator of weight-related health risks, there are some cases where its use should be considered more carefully{ref}Centers for Disease Control and Prevention. Body Mass Index: Considerations for Practitioners. Available [online](https://www.cdc.gov/obesity/downloads/bmiforpactitioners.pdf).{/ref}: * muscle mass can increase bodyweight; this means athletes or individuals with a high muscle mass percentage can be deemed overweight on the BMI scale, even if they have a low or healthy body fat percentage; * muscle and bone density tends to decline as we get older; this means that an older individual may have a higher percentage body fat than a younger individual with the same BMI; * women tend to have a higher body fat percentage than men for a given BMI. Physicians must therefore evaluate BMI results carefully on a individual basis. Despite outlier cases where BMI is an inappropriate indicator of body fat, its use provides a reasonable measure of the risk of weight-related health factors across most individuals across the general population. --- # Data sources --- ### NCD Risk Factor Collaboration * **Data**: Mean and distributions of body mass index (BMI), by country * **Geographical coverage: **Global- by country * **Time span: **1975 onwards * **Available at:**[http://www.ncdrisc.org/index.html](http://www.ncdrisc.org/index.html) ### WHO Global Database on Body Mass Index * **Data**: Share of population by weight category * **Geographical coverage: **Global – by country * **Time span: **1960 onwards * **Available at:**[https://www.who.int/data/gho/data/themes/topics/topic-details/GHO/body-mass-index](https://www.who.int/data/gho/data/themes/topics/topic-details/GHO/body-mass-index) ### Institute of Health Metrics and Evaluation (IHME) Global Burden of Disease (GBDx) Data Tool * **Data**: Number of deaths and death rates from obesity * **Geographical coverage: **Global – by country * **Time span: **1990 onwards * **Available at: **[http://www.healthdata.org/results/data-visualizations](http://www.healthdata.org/results/data-visualizations)

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        "rendered": "\n<p>Obesity is most commonly measured using the body mass index (BMI) scale. The World Health Organization <a rel=\"noopener noreferrer\" href=\"https://web.archive.org/web/20220219072441/https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight\" target=\"_blank\">define BMI</a> as: &#8220;<span class=\"storydeck\">a simple index of weight-for-height that is commonly used to classify underweight, overweight and obesity in adults.&#8221;{ref}BMI is defined as the weight in kilograms divided by the square of the height in metres (kg/m<sup>2</sup>). For example, an adult who weighs 70kg and whose height is 1.75m will have a BMI of 22.9.</span> This is calculated as 70kg / 1.75<sup>2</sup> = 70 / 3.06 = 22.9{/ref}</p>\n\n\n\n<p>BMI values are used to define whether an individual is considered to be underweight, healthy, overweight or obese. The WHO defines these categories using the cut-off points: an individual with a BMI between 25.0 and 30.0 is considered to be &#8216;overweight&#8217;; a BMI greater than 30.0 is defined as &#8216;obese&#8217;.{ref}World Health Organization. BMI Classification.&nbsp;<em>Global Database on Body Mass Index</em>. Available <a href=\"https://knoema.com/WHOGDOBMIMay/who-global-database-on-body-mass-index-bmi\">online</a>.{/ref}</p>\n\n\n\t<div class=\"wp-block-owid-summary\">\n\t\t<h2>Summary</h2>\n\t\t\n\n<ul><li><a href=\"https://ourworldindata.org/obesity#obesity-is-one-of-the-leading-risk-factors-for-early-death\">Obesity is one of the leading risk factors for premature death. It was linked to 4.7 million deaths globally in 2017.</a></li><li><a href=\"https://ourworldindata.org/obesity#8-of-global-deaths-are-attributed-to-obesity\">8% of global deaths were attributed to obesity in 2017.</a></li><li><a href=\"https://ourworldindata.org/obesity#there-is-a-10-fold-difference-in-death-rates-from-obesity-across-the-world\">There are large differences \u2013 10-fold \u2013 in death rates from obesity across the world.</a></li><li><a href=\"https://ourworldindata.org/obesity#what-share-of-adults-are-obese\">13% of adults in the world are obese.</a></li><li><a href=\"https://ourworldindata.org/obesity#what-share-of-adults-are-overweight\">39% of adults in the world are overweight.</a></li><li><a href=\"https://ourworldindata.org/obesity#childhood-obesity\">One-in-five children and adolescents, globally, are overweight.</a></li><li><a href=\"https://ourworldindata.org/obesity#what-are-the-drivers-of-obesity\">Obesity is determined by the balance of energy intake and expenditure. Rates have increased as the calories have become more readily available.</a></li></ul>\n\n\n\t</div>\n\n\n<p><strong>Related research entries</strong></p>\n\n\n\n<p><a href=\"https://owid.cloud/food-per-person\">Food per person</a> \u2013 food availability has increased significantly in most countries across the world. How does the supply of calories, protein and fats vary between countries? How has this changed over time?</p>\n\n\n\n<p><a href=\"https://owid.cloud/hunger-and-undernourishment\">Hunger and Undernourishment</a> \u2013 obesity rates have now overtaken hunger rates globally. But it remains the case that high levels of obesity and hunger can occur in a country at any given time. How does undernourishment vary across the world? How has it changed over time?</p>\n\n\n\n<p><a href=\"https://owid.cloud/micronutrient-deficiency\">Micronutrient Deficiency</a> \u2013 getting sufficient intake of calories (a requirement for obesity) does not guarantee an individual gets the full range of essential vitamins and minerals (micronutrients) for good health. Dietary diversity varies significantly across the world. How common is micronutrient deficiency and who is most at risk?</p>\n\n\n\n<h2>Obesity is one of the leading risk factors for early death</h2>\n\n\n\n<h4>Obesity is responsible for 4.7 million premature deaths each year</h4>\n\n\n\n<p>Obesity is one of the world&#8217;s largest health problems \u2013 one that has shifted from being a problem in rich countries, to one that spans all income levels.<br><br>The <em>Global Burden of Disease</em> is a major global study on the causes and risk factors for death and disease published in the medical journal <em>The Lancet</em>.{ref}The latest study can be found at the website of the Lancet here: <a href=\"https://www.thelancet.com/gbd\">TheLancet.com/GBD</a><br><br>The 2017 study was published as GBD 2017 Risk Factor Collaborators \u2013 &#8220;Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017&#8221; and is online <a href=\"http://www.healthdata.org/research-article/global-regional-and-national-comparative-risk-assessment-84-behavioral-0\">here</a>.{/ref} These estimates of the annual number of deaths attributed to a wide range of risk factors are shown here. This chart is shown for the global total, but can be explored for any country or region using the &#8220;change country&#8221; toggle.</p>\n\n\n\n<p>Obesity \u2013 defined as having a high body-mass index \u2013 is a risk factor for several of the world&#8217;s leading causes of death, including heart disease, stroke, diabetes and various types of cancer.{ref}WHO (2018) \u2013 Fact sheet \u2013 Obesity and overweight. Updated February 2018. Online <a href=\"https://www.who.int/en/news-room/fact-sheets/detail/obesity-and-overweight\">here</a>.{/ref} Obesity does not directly <em>cause</em> of any of these health impacts but can increase their likelihood of occurring. In the chart we see that it is one of the leading risk factors for death globally. </p>\n\n\n\n<p>According to the <em>Global Burden of Disease</em> study 4.7 million people died prematurely in 2017 as a result of obesity. To put this into context: this was close to four times the number that died in <a href=\"https://ourworldindata.org/grapher/road-deaths-by-type\">road accidents</a>, and close to five times the number that died from <a href=\"https://owid.cloud/hiv-aids\">HIV/AIDS</a> in 2017.{ref}The <em>Global Burden of Disease</em> study <a href=\"https://ourworldindata.org/grapher/annual-number-of-deaths-by-cause\">estimates that</a> around 1.2 million died in road accidents in 2017, and just under 1 million from HIV/AIDS.{/ref}</p>\n\n\n\n<iframe src=\"https://ourworldindata.org/grapher/number-of-deaths-by-risk-factor\" style=\"width: 100%; height: 600px; border: 0px none;\"></iframe>\n\n\n\n<h2>The global distribution of health impacts from obesity</h2>\n\n\n\n<h4>8% of global deaths are the result of obesity</h4>\n\n\n\n<p>Globally, <a href=\"https://ourworldindata.org/grapher/share-of-deaths-obesity?tab=chart&amp;country=OWID_WRL\">8% of deaths</a> in 2017 were the result of obesity \u2013 this represents an increase from 4.5% in 1990.</p>\n\n\n\n<p>This share varies significantly across the world. In the map here we see the share of deaths attributed to obesity across countries.</p>\n\n\n\n<p>Across many middle-income countries \u2013 particularly across Eastern Europe, Central Asia, North Africa, and Latin America \u2013 more than 15% of deaths were attributed to obesity in 2017. This most likely results from having a high prevalence of obesity, but poorer overall health and healthcare systems relatively to high-income countries with similarly high levels of obesity. <br><br>In most high-income countries this share is in the range of 8 to 10%. This is about half the share of many middle-income countries. The large outliers among rich countries are Japan and South Korea: there only around 5% of premature deaths are attributed to obesity. </p>\n\n\n\n<p>Across low-income countries \u2013 especially across Sub-Saharan Africa \u2013 obesity accounts for less than 5% of deaths.</p>\n\n\n\n<iframe src=\"https://ourworldindata.org/grapher/share-of-deaths-obesity\" style=\"width: 100%; height: 600px; border: 0px none;\"></iframe>\n\n\n\n<h4>There is a 10-fold difference in death rates from obesity across the world</h4>\n\n\n\n<p>Death rates from obesity give us an accurate comparison of differences in its mortality impacts between countries and over time. In contrast to the share of deaths that we studied before, death rates are not influenced by how other causes or risk factors for death are changing.</p>\n\n\n\n<p>In the map here we see differences in death rates from obesity across the world. Globally, <a href=\"https://ourworldindata.org/grapher/death-rate-from-obesity?tab=chart&amp;country=OWID_WRL\">the death rate</a> from obesity was around 60 per 100,000 in 2017.</p>\n\n\n\n<p>The overall picture does in fact match closely with the share of deaths: death rates are high across middle-income countries, especially across Eastern Europe, Central Asia, North Africa and Latin America. Rates there can be close to 200 per 100,000. This is more than ten times greater than rates at the bottom: Japan and South Korea have the lowest rates in the world at 14 and 20 deaths per 100,000, respectively.</p>\n\n\n\n<p>When we look at the <a href=\"https://ourworldindata.org/grapher/death-rate-vs-share-obesity\">relationship between</a> death rates and the prevalence of obesity we find a positive one: death rates tend to be higher in countries where more people have obesity. But what we also notice is that for a given prevalence of obesity, death rates can vary by a factor of four. 23% of Russian and Norwegian are obese, yet Russia&#8217;s death rate is four times higher. Clearly it&#8217;s not <em>only</em> the prevalence of obesity that plays a role but also other factors such as underlying health, other confounding risk factors (such as <a href=\"https://owid.cloud/alcohol-consumption\">alcohol</a>, <a href=\"https://owid.cloud/drug-use\">drugs</a>, <a href=\"https://owid.cloud/smoking\">smoking</a> and other lifestyle factors) and healthcare systems.</p>\n\n\n\n<iframe src=\"https://ourworldindata.org/grapher/death-rate-from-obesity\" style=\"width: 100%; height: 600px; border: 0px none;\"></iframe>\n\n\n\n<h2>What share of adults are obese?</h2>\n\n\n\n<h4>13% of adults in the world are obese</h4>\n\n\n\n<p>Globally, 13% of adults aged 18 years and older were obese in 2016.{ref}WHO (2018) \u2013 Fact sheet \u2013 Obesity and overweight. Updated February 2018. Online <a href=\"https://www.who.int/en/news-room/fact-sheets/detail/obesity-and-overweight\">here</a>.{/ref} Obesity <a href=\"https://ourworldindata.org/obesity#definitions-measurement\">is defined</a> as having a body-mass index equal to or greater than 30. </p>\n\n\n\n<p>In the map here we see the share of adults who are obese across countries. Overall we see a pattern roughly in line with prosperity: the prevalence of obesity tends to be higher in richer countries across Europe, North America, and Oceania. Obesity rates are much lower across South Asia and Sub-Saharan Africa. </p>\n\n\n\n<p>More than one-in-three (36%) of adults in the United States were obese in 2016. In India this share was around 10 times lower (3.9%).</p>\n\n\n\n<p>The relationship between income and obesity generally holds true \u2013 as we see in the comparison <a href=\"https://ourworldindata.org/grapher/obesity-vs-gdp\">here</a>. But there are some notable exceptions. The small Pacific Island States stand out clearly: they have very high rates of obesity \u2013 61% in Nauru and 55% in Palau \u2013 for their level of income. At the other end of the spectrum, Japan, South Korea and Singapore have very low levels of obesity for their level of income.</p>\n\n\n\n<iframe style=\"width: 100%; height: 600px; border: 0px none;\" src=\"https://ourworldindata.org/grapher/share-of-adults-defined-as-obese\"></iframe>\n\n\n\n<blockquote class=\"wp-block-quote\"><p><strong>Related charts \u2013 share of men and women that are obese.</strong> <a href=\"https://ourworldindata.org/grapher/share-of-men-defined-as-obese\">This map</a> allows you to explore the share of men that are obese; <a href=\"https://ourworldindata.org/grapher/share-of-females-defined-as-obese\">this map</a> allows you to explore this data for women across the world. <a href=\"https://ourworldindata.org/grapher/obesity-in-men-vs-obesity-in-women\">This chart</a> shows the comparison of obesity in men and women.</p></blockquote>\n\n\n\n<h2>What share of adults are overweight?</h2>\n\n\n\n<h4>39% of adults in the world are overweight or obese</h4>\n\n\n\n<p>Globally, 39% of adults aged 18 years and older were overweight or obese in 2016.{ref}WHO (2018) \u2013 Fact sheet \u2013 Obesity and overweight. Updated February 2018. Online <a href=\"https://www.who.int/en/news-room/fact-sheets/detail/obesity-and-overweight\">here</a>.{/ref} Being overweight <a href=\"https://ourworldindata.org/obesity#definitions-measurement\">is also defined</a> based on body-mass index: the threshold value is lower than for obesity, with a BMI equal to or greater than 25.</p>\n\n\n\n<p>In the map here we see the share of adults who are overweight or obese across countries. The overall pattern is very closely aligned with the distribution of obesity across the world: the share of people who are overweight tends to be higher in richer countries and lower at lower incomes. What is of course true is that the share who are overweight (have a BMI greater than or equal to 25) is much higher than the share that are obese (a BMI of 30 or greater).</p>\n\n\n\n<p>In most high-income countries, around two-thirds of adults are overweight or obese. In the US, 70% are. At the lowest end of the scale, across South Asia and Sub-Saharan Africa around 1-in-5 adults have a BMI greater than 25.</p>\n\n\n\n<blockquote class=\"wp-block-quote\"><p><strong>Related charts \u2013 share of men and women that are overweight</strong> <strong>or obese</strong>. <a href=\"https://ourworldindata.org/grapher/share-of-men-defined-as-overweight\">This map</a> allows you to explore the share of men that are overweight or obese; <a href=\"https://ourworldindata.org/grapher/share-of-females-defined-as-overweight\">this map</a> allows you to explore this data for women across the world.</p></blockquote>\n\n\n\n<iframe style=\"width: 100%; height: 600px; border: 0px none;\" src=\"https://ourworldindata.org/grapher/share-of-adults-who-are-overweight\"></iframe>\n\n\n\n<h2>Body Mass Index (BMI)</h2>\n\n\n\n<h4>Mean BMI in adult women</h4>\n\n\n\n<p>Body Mass Index (BMI) is <a href=\"https://ourworldindata.org/obesity#definitions-measurement\">used to define</a> the share of individuals that are underweight, in the &#8216;healthy&#8217; range, overweight and obese.</p>\n\n\n\n<p>In the map here we see the distribution of mean BMI for adult women \u2013 aged 18 years and older \u2013 across the world. The <a href=\"https://ourworldindata.org/grapher/mean-body-mass-index-bmi-in-adult-women?tab=chart&amp;country=OWID_WRL\">global mean BMI</a> for women in 2016 was 25 \u2013 just on the threshold from the WHO&#8217;s &#8216;healthy&#8217; to &#8216;overweight&#8217; classification. This has increased from a mean BMI of 22 \u2013 in the mid-range of &#8216;healthy&#8217; \u2013 in the 1970s.</p>\n\n\n\n<iframe loading=\"lazy\" style=\"width: 100%; height: 600px; border: 0px none;\" src=\"https://ourworldindata.org/grapher/mean-body-mass-index-bmi-in-adult-women\" width=\"300\" height=\"150\"></iframe>\n\n\n\n<h4>Mean BMI in adult men</h4>\n\n\n\n<p>Body Mass Index (BMI) is <a href=\"https://ourworldindata.org/obesity#definitions-measurement\">used to define</a> the share of individuals that are underweight, in the &#8216;healthy&#8217; range, overweight and obese.</p>\n\n\n\n<p>In the map here we see the distribution of mean BMI for adult men \u2013 aged 18 years and older \u2013 across the world. The <a href=\"https://ourworldindata.org/grapher/mean-body-mass-index-bmi-in-adult-males?tab=chart&amp;country=OWID_WRL\">global mean BMI</a> for men in 2016 was 24.5 \u2013 just on the threshold from the WHO&#8217;s &#8216;healthy&#8217; to &#8216;overweight&#8217; classification. This has increased from a mean BMI of 21.7 \u2013 in the mid-range of &#8216;healthy&#8217; \u2013 in the 1970s.</p>\n\n\n\n<iframe loading=\"lazy\" style=\"width: 100%; height: 600px; border: 0px none;\" src=\"https://ourworldindata.org/grapher/mean-body-mass-index-bmi-in-adult-males\" width=\"300\" height=\"150\"></iframe>\n\n\n\n<h2>Childhood obesity</h2>\n\n\n\n<h4>Share of children that are overweight</h4>\n\n\n\n<p>Obesity and overweight in children are also measured on the basis of body-mass-index (BMI). However, interpretation of BMI scores is treated differently for children and adolescents.&nbsp;Weight categories are defined in relation to WHO Growth Standards \u2013 a child is defined as overweight if their weight-for-height is more than two standard deviations from the median of the WHO Child Growth Standards.</p>\n\n\n\n<p>The World Health Organization reports that the share of children and adolescents aged 5-19 who are overweight or obese has risen from 4% in 1975 to around 18% in 2016.{ref}WHO (2018) \u2013 Fact sheet \u2013 Obesity and overweight. Updated February 2018. Online <a href=\"https://www.who.int/en/news-room/fact-sheets/detail/obesity-and-overweight\">here</a>.{/ref}</p>\n\n\n\n<p>In the map here we see the share of very young children \u2013 aged 2 to 4 years old \u2013 who are overweight based on WHO Child Growth Standards. In many countries as many as every third or fourth child is overweight.</p>\n\n\n\n<iframe src=\"https://ourworldindata.org/grapher/children-who-are-overweight-sdgs?time=1990..2016\" style=\"width: 100%; height: 600px; border: 0px none;\"></iframe>\n\n\n\n<h2>What are the drivers of obesity?</h2>\n\n\n\n<p>At a basic level, weight gain \u2013 eventually leading to being overweight or obesity \u2013 is determined by a balance of energy.{ref}Hall, K. D., Heymsfield, S. B., Kemnitz, J. W., Klein, S., Schoeller, D. A., &amp; Speakman, J. R. (2012). <a href=\"https://academic.oup.com/ajcn/article/95/4/989/4576902\">Energy balance and its components: implications for body weight regulation</a>.&nbsp;<em>The American Journal of Clinical Nutrition</em>,&nbsp;<em>95</em>(4), 989-994.{/ref} When we consume more energy \u2013 typically measured in kilocalories \u2013 than the energy expended to maintain life and carry out daily activites, we gain weight. This is a called an energy surplus. When we consume less energy than we expend, we lose weight \u2013 this is an energy deficit. </p>\n\n\n\n<p>This means there are two potential drivers of the increase in obesity rates in recent decades: either an increase in kilocalorie intake i.e. we eat more; or we expend less energy in daily life through lower activity levels. Both elements are likely to play a role in the rise in obesity.</p>\n\n\n\n<p>To tackle obesity it&#8217;s likely that interventions which address both components: energy intake and expenditure are necessary.{ref}Hill, J. O., Wyatt, H. R., &amp; Peters, J. C. (2012). <a href=\"https://www.ahajournals.org/doi/full/10.1161/circulationaha.111.087213\">Energy balance and obesity</a>.&nbsp;<em>Circulation</em>,&nbsp;<em>126</em>(1), 126-132.{/ref}</p>\n\n\n\n<h4>Daily supply of calories</h4>\n\n\n\n<p>Over the past century \u2013 but particularly over the past 50 years \u2013 the <a href=\"https://owid.cloud/food-per-person\">supply of calories</a> has increased across the world. In the 1960s, the global <a href=\"https://ourworldindata.org/grapher/daily-per-capita-caloric-supply?tab=chart&amp;country=Asia~Europe~North+America~South+America~Africa\">average supply of calories</a> (that is, the availability of calories for consumers to eat) was 2200kcal per person per day. By 2013 this had increased to 2800kcal.</p>\n\n\n\n<p>Across most countries, energy consumption has therefore increased. If this increase was not met with an increase in energy expenditure, weight gain and a rise in obesity rates is the result. </p>\n\n\n\n<p>In the chart here we see the relationship between the share of men that are overweight or obese (on the y-axis) versus the daily average supply of kilocalories per person. Overall we see a strong positive relationship: countries with higher rates of overweight tend to have a higher supply of calories. </p>\n\n\n\n<p>If you press &#8216;play&#8217; on the interactive timeline you can see how this has changed for each country over time. Most countries move upwards and to the right: the supply of calories has increased at the same time as obesity rates have increased.</p>\n\n\n\n<iframe loading=\"lazy\" style=\"width: 100%; height: 600px; border: 0px none;\" src=\"https://ourworldindata.org/grapher/share-of-adult-men-overweight-or-obese-vs-daily-supply-of-calories\" width=\"300\" height=\"150\"></iframe>\n\n\n\n<h2>Definitions &amp; Measurement</h2>\n\n\n\n<h4>How do we measure obesity in adults?</h4>\n\n\n\n<p>The most common metric used for assessing the prevalence of obesity is the body mass index (BMI) scale. The World Health Organization <a rel=\"noopener noreferrer\" href=\"https://web.archive.org/web/20220219072441/https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight\" target=\"_blank\">define BMI</a> as: &#8220;<span class=\"storydeck\">a simple index of weight-for-height that is commonly used to classify underweight, overweight and obesity in adults. It is defined as the weight in kilograms divided by the square of the height in metres (kg/m<sup>2</sup>). For example, an adult who weighs 70kg and whose height is 1.75m will have a BMI of 22.9.&#8221;</span>{ref}This is calculated as 70kg / 1.75<sup>2</sup> = 70 / 3.06 = 22.9{/ref}</p>\n\n\n\n<p>Measured BMI values are used to define whether an individual is considered to be underweight, healthy, overweight or obese. The WHO defines these categories using the cut-off points in the table. For example, an individual with a BMI between 25.0 and 30.0 is considered to be &#8216;overweight&#8217;; a BMI greater than 30.0 is defined as &#8216;obese&#8217;.{ref}World Health Organization. BMI Classification.&nbsp;<em>Global Database on Body Mass Index</em>. Available <a href=\"https://knoema.com/WHOGDOBMIMay/who-global-database-on-body-mass-index-bmi\">online</a>.{/ref}</p>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter\"><a href=\"https://ourworldindata.org/app/uploads/2017/08/BMI-classification.png\"><img loading=\"lazy\" width=\"494\" height=\"373\" src=\"https://ourworldindata.org/app/uploads/2017/08/BMI-classification.png\" alt=\"\" class=\"wp-image-12788\" srcset=\"https://owid.cloud/app/uploads/2017/08/BMI-classification.png 494w, https://owid.cloud/app/uploads/2017/08/BMI-classification-150x113.png 150w, https://owid.cloud/app/uploads/2017/08/BMI-classification-400x302.png 400w\" sizes=\"(max-width: 494px) 100vw, 494px\" /></a></figure></div>\n\n\n\n<h4>How do we measure obesity in children and adolescents?</h4>\n\n\n\n<p>The metric for measuring bodyweight in children and adolescents is also the body mass index (BMI) scale, measured in the same way described above. However, interpretation of BMI scores is treated differently for children and adolescents. Whilst there is no differentiation of weight categories in adults based on sex or age, these are important factors in the body composition of children. Factors such as age, gender and sexual maturation affect the BMI of younger individuals. For interpretation of individuals between the ages of 2 and 20 years old, BMI is measured relative to peers of the same age and gender, with weight classifications judged as shown in the table.{ref}Centers for Disease Control and Prevention.&nbsp;Body Mass Index: Considerations for Practitioners. Available <a href=\"https://www.cdc.gov/obesity/downloads/bmiforpactitioners.pdf\">online</a>.{/ref}</p>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter\"><a href=\"https://ourworldindata.org/app/uploads/2017/08/BMI-classification-children.png\"><img loading=\"lazy\" width=\"474\" height=\"113\" src=\"https://ourworldindata.org/app/uploads/2017/08/BMI-classification-children.png\" alt=\"\" class=\"wp-image-12825\" srcset=\"https://owid.cloud/app/uploads/2017/08/BMI-classification-children.png 474w, https://owid.cloud/app/uploads/2017/08/BMI-classification-children-150x36.png 150w, https://owid.cloud/app/uploads/2017/08/BMI-classification-children-400x95.png 400w\" sizes=\"(max-width: 474px) 100vw, 474px\" /></a></figure></div>\n\n\n\n<h4>Is BMI an appropriate measure of weight-related health?</h4>\n\n\n\n<p>The merits of using BMI as an indicator of body fat and obesity are still contested. A key contention to the use of BMI indicators is that it provides a measure of body mass/weight rather than providing a direct measure of body fat. Whilst physicians continue to use BMI as a general indicator of weight-related health risks, there are some cases where its use should be considered more carefully{ref}Centers for Disease Control and Prevention.&nbsp;Body Mass Index: Considerations for Practitioners. Available <a href=\"https://www.cdc.gov/obesity/downloads/bmiforpactitioners.pdf\">online</a>.{/ref}:</p>\n\n\n\n<ul><li>muscle mass can increase bodyweight; this means athletes or individuals with a high muscle mass percentage can be deemed overweight on the BMI scale, even if they have a low or healthy body fat percentage;</li><li>muscle and bone density tends to decline as we get older; this means that an older individual may have a higher percentage body fat than a younger individual with the same BMI;</li><li>women tend to have a higher body fat percentage than men for a given BMI.</li></ul>\n\n\n\n<p>Physicians must therefore evaluate BMI results carefully on a individual basis. Despite outlier cases where BMI is an inappropriate indicator of body fat, its use provides a reasonable measure of the risk of weight-related health factors across most individuals across the general population.</p>\n\n\n\n<h2>Data sources</h2>\n\n\n\n<h4>NCD Risk Factor Collaboration</h4>\n\n\n\n<ul><li><strong>Data</strong>: Mean and distributions of body mass index (BMI), by country</li><li><strong>Geographical coverage: </strong>Global- by country</li><li><strong>Time span:&nbsp;</strong>1975 onwards</li><li><strong>Available at:</strong>&nbsp;<a rel=\"noopener noreferrer\" href=\"http://www.ncdrisc.org/index.html\" target=\"_blank\">http://www.ncdrisc.org/index.html</a></li></ul>\n\n\n\n<h4>WHO Global Database on Body Mass Index</h4>\n\n\n\n<ul><li><strong>Data</strong>: Share of population by weight category</li><li><strong>Geographical coverage: </strong>Global \u2013 by country</li><li><strong>Time span:\u00a0</strong>1960 onwards</li><li><strong>Available at:</strong>\u00a0<a href=\"https://www.who.int/data/gho/data/themes/topics/topic-details/GHO/body-mass-index\" target=\"_blank\" rel=\"noreferrer noopener\">https://www.who.int/data/gho/data/themes/topics/topic-details/GHO/body-mass-index</a></li></ul>\n\n\n\n<h4>Institute of Health Metrics and Evaluation (IHME) Global Burden of Disease (GBDx) Data Tool</h4>\n\n\n\n<ul><li><strong>Data</strong>: Number of deaths and death rates from obesity</li><li><strong>Geographical coverage: </strong>Global \u2013 by country</li><li><strong>Time span: </strong>1990 onwards</li><li><strong>Available at:&nbsp;</strong><a rel=\"noopener noreferrer\" href=\"http://www.healthdata.org/results/data-visualizations\" target=\"_blank\">http://www.healthdata.org/results/data-visualizations</a></li></ul>\n",
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        "rendered": "When did obesity increase? How do rates vary across the world? What is the health impact?",
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    "date_gmt": "2017-08-11T14:05:14",
    "modified": "2023-01-09T11:17:40",
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    "authors_name": [
        "Hannah Ritchie"
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