India, China and the United States are projected to have the highest numbers of people who are overweight or live with obesity by 2050, according to a new study published in the journal The Lancet.
The study, based on 2021 estimates and 2050 projections, indicated that Indian women aged 25 and above are likely to bear a higher burden of overweight and obesity compared to their male counterparts.
In 1990, an estimated 15 million men and 21 million women in India were overweight or lived with obesity. By 2021, these figures had risen to 81 million and 98 million, respectively. By 2050, 218 million men and 232 million women in India are expected to be overweight or live with obesity.
This rise is linked to the increasing consumption of ultra-processed foods and beverages. Between 2009 and 2019, India was among the top three countries with the largest annual growth in per capita sales of these products.
“In view of the devastating subsequent rise in a variety of serious, potentially fatal, comorbidities — with type 2 diabetes, hypertension, and cardiovascular diseases being the most prominent—the results of both the historical and forecasted trends are concerning and urgent challenges to global public health,” Thorkild I A Sørensen from the Department of Public Health and the Novo Nordisk Foundation Centre for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark in a comment published in The Lancet.
The study warned that in low- and middle-income countries (LMICs) like India, the rising obesity epidemic, combined with persistent childhood malnutrition and pervasive infectious diseases, is placing immense pressure on healthcare systems. These countries, particularly those in sub-Saharan Africa, south Asia, southeast Asia, and in the Pacific, face a dual problem: High childhood undernutrition rates alongside the growing prevalence of adult obesity.
In India, the prevalence of obesity was estimated at 4 per cent for males, compared to 8 per cent among women. A previous study also found that obesity among ever-married women (women who has been married at least once in their live, even if they are not currently married) of reproductive age in India has tripled from 5 per cent in 1998-99 to 16 per cent in 2019-21.
This pattern aligns with global trends. The prevalence of obesity in China is estimated at 9 per cent for men and 10.8 per cent for women, while in the US, it stands at 42 per cent for men and 46 per cent for women.
However, the study also highlights that the prevalence of obesity has been rising more rapidly among men in recent decades. The global prevalence of adult obesity has increased by 105 per cent among women (from 10 per cent in 1990 to 21 per cent in 2021), but by an even higher 155.1 per cent among men (from 6 per cent to 15 per cent in the same period).
In 2021, an estimated 2.11 billion adults aged 25 years and older worldwide were overweight or living with obesity — nearly 50 per cent of the global adult population. More than half of these cases were concentrated in eight countries: China, India, the US, Brazil, Russia, Mexico, Indonesia and Egypt. China (402 million individuals), India (180 million), and the US (172 million) topped the list.
By 2050, the global number of individuals who are overweight and live with obesity is projected to reach 3.8 billion, with over half classified as live with obesity. China is expected to have 627 million cases, followed by India with 450 million and the US with 214 million. They “would continue to be the three countries with the largest numbers of people with overweight and obesity,” the researchers wrote in the study.
Sørensen highlighted that the rise in obesity began before World War II and has since expanded to more countries. “Multiple reports have documented this continued rise, indicating that efforts to abate this increasing prevalence have been ineffective,” he added.
For this study, researchers collected information on body mass index (BMI) from available pre-existing data sources for adults (aged 25 years and above) from 1,350 sources in 184 areas for males and females. They analysed data for 30 years from 1990-2021 and used this data to make forecasts of the national, regional, and global trends to 2050.
A separate The Lancet study examined overweight and obesity trends among children and adolescents (aged 5–24 years). It found that the combined prevalence of overweight and obesity in these age groups had doubled between 1990 and 2021.
By 2021, an estimated 93.1 million children aged 5-14 years and 80.6 million adolescents aged 15-24 years were living with obesity worldwide. These figures are expected to rise further, with projections estimating that by 2050, 186 million children aged 5-14 years and 175 million adolescents aged 15-24 years will be living with obesity globally.
India ranked second globally in overweight and obesity cases among children aged 5-14 years. In 1990, India had 4.6 million boys and 5.4 million girls with obesity, rising to 13 million boys and 12 million girls by 2021. By 2050, these figures are expected to reach 16 million boys and 14 million girls.
For adolescents aged 15-24, India had 4 million males and 3.3 million females living with obesity in 1990. This number grew to 17 million males and 13 million females in 2021 and is projected to increase to 23 million young men and 17 million young women by 2050.
Notably, the largest rise in obesity among younger populations has been observed in males, a contrast to the trend seen in adults, where women are more affected.
While factors such as excessive food supply and increasingly sedentary lifestyles contribute to obesity, the precise causes remain unclear, Sørensen cautioned. He called for a deeper understanding of its underlying mechanisms to inform more effective prevention strategies.