Globally, overweight and obesity is a major public health concern, and there are more overweight or obese than underweight adults. In 2022, 43% men and 44% of women aged 18 and over, accounting for nearly 2.5 billion adults, were overweight, and about 16% of adult population, over 890 million adults, were obese worldwide. Both overweight and obesity have shown a marked increase over the past four decades. Once considered a high-income country problem, overweight is also on the rise in low- and middle‑income countries (WHO, 2024[1]).
Obesity is a known risk factor for numerous health problems, including hypertension, high cholesterol, diabetes, cardiovascular diseases, respiratory problems (asthma), musculoskeletal diseases (arthritis) and some forms of cancer, and mortality also increases progressively once the overweight threshold is crossed (OECD, 2019[2]; WHO, 2020[3]). In addition, childhood and adolescent obesity harms immediate health, is associated with higher risk of early-onset non-communicable diseases (NCDs) like type 2 diabetes and heart disease, It also can lead to mental health issues, compounded stigma, and bullying reducing quality of life and affecting school performance. Obese children are also more likely to become obese adults with a higher risk of NCDs (WHO, 2024[1]). The economic impacts of the obesity epidemic are also important. If nothing is done, the global costs of overweight and obesity are predicted to reach USD 3 trillion per year by 2030 and more than USD 18 trillion by 2060 (Okunogbe et al., 2022[4]).
A key driver of the increasing obesity epidemic is a changing food environment, in which nutrient poor and energy dense processed foods are aggressively marketed, readily available and often cheaper than healthier alternatives. The economic priorities and policies that promote consumption-based growth, and the regulatory policies that promote market and trade liberalisation are increasingly regarded as contributing to the global rise of obesity too (OECD, 2019[2]; UNICEF, 2019[5]). At the same time, it is common to find undernutrition and obesity co‑existing within the same country.
At the 75th World Health Assembly in 2022, Member States adopted new recommendations for the prevention and management of obesity and endorsed the WHO Acceleration Plan to Stop Obesity. The plan is designed to stimulate and support multi-sector country level action across the globe (WHO, 2023[6]).
In Asia-Pacific, the obesity rate among children and adolescents varied widely between the high of 22.1% in Brunei Darussalam, followed by 17.8% in New Zealand, and the low of 1.9% in Bangladesh and Nepal, where the prevalence of thinness was high among adolescents (see indicator “Adolescent health” in Chapter 4). On average across high- and upper-middle-income Asia-Pacific countries and territories, about 14% of children and adolescents were obese in 2022, twice the prevalence observed across lower-middle- and low-income Asia-Pacific countries and territories. In Brunei Darussalam the prevalence of overweight was the highest in the region at more than 40%, whereas in India with one of the lowest obesity rates, the prevalence of overweight was lowest at less than 7% (Figure 4.11, right panel).
Among adults, obesity prevalence was high in Australia, Brunei Darussalam, Fiji and New Zealand in 2022 where more than 30% of adults were obese. In these countries and territories, the prevalence of overweight adults was also high at more than 60%. On the other hand, obesity rate was low in Bangladesh, Cambodia and Viet Nam at 5% or less, and in Japan and Viet Nam, overweight prevalence among adults was also the lowest in Asia-Pacific, at less than 25%. In high- and upper-middle-income countries and territories, 19% of adults were obese and 49% of adults were overweight, whereas the average prevalence for lower-middle- and low-income countries and territories was lower at 12% and 37%, respectively (Figure 4.11, left panel). Across countries and territories, the prevalence of obesity and overweight among children and adolescents was positively associated with the prevalence among adults.
Between 2010 and 2022, the increase in the prevalence of obesity was fast particularly in lower-middle- and low-income countries and territories in Asia-Pacific. This increase was higher among children and adolescents in most countries and territories. In lower-middle- and low-income countries and territories, the prevalence of obesity increased more than doubled (+120%)among children and adolescents (from 3.1% to 6.8%) and by 63% among adults (from 7.1% to 11.6%). The average increase was lower in higher-income countries and territories – by 42% among children and adolescents (from 10.5% to 15%) and by 36% among adults (from 15% to 20%). The increase was particularly high in Pakistan, by 4 times among children and adolescents (from 2.1% to 8.5%) and by 2 times among adults (from 11.2% to 23%). The obesity prevalence also tripled in Viet Nam among children and adolescents (from 2.0% to 6.3%) and among adults (from 0.7% to 2.0%) (Figure 4.12, left panel).
Since 2010, the prevalence of overweight has increased in almost all Asia-Pacific countries and territories. The increase was again faster in lower-middle- and low-income countries and territories – 68% for children and adolescents (from 10.3% to 17.4%) and 42% for adults (from 26.3% to 37.2%) – than in high-income countries and territories – 21% (from 28.2% to 34%) and 15% (from 43.8% to 50.3%), respectively. Between 2010 and 2022, the prevalence of overweight grew rapidly in Viet Nam among children, adolescents and adults. The prevalence also grew fast by 2.5 times among children and adolescents in Pakistan (from 7.5% to 18.9%) and Indonesia (from 10.4% to 23.6%), and a large increase was also observed among adults in Bangladesh (97%, from 13.7% to 27%), Cambodia (78%, from 14.2% to 25.1%) and Nepal (73%, from 17.9% to 30.9%) in the same period (Figure 4.12, right panel). In developing countries obesity is more common among people with a higher socio‑economic status, those living in urban regions and middle‑aged women. In developed countries, obesity is associated with lower socio‑economic status, especially among women (OECD, 2010[7]).
