Editor's note: The obesity epidemic has become a major public health challenge globally and in China. In recent years, the mainland government and society have paid more and more attention to the prevention and control of obesity and chronic diseases, but there is still an urgent need to strengthen existing measures and action plans to control the rapid growth trend of obesity. It is urgent for the mainland to strengthen the prevention and control of chronic diseases, and obesity intervention is a "good starting point". Based on this, the Chinese Journal of Preventive Medicine and the team of Professor Wang Youfa of the Institute of Global Health of Xi'an Jiaotong University planned and organized the "Obesity Prevention and Control" key issue, which includes a total of 10 papers, focusing on important issues related to obesity from different perspectives from global and Chinese perspectives, including epidemiology, disease burden, prevention and control, and treatment, and reporting the new progress and important results of related research, in order to provide reference for future actions.
Prof. Youfa Wang
He is a national leading talent, a second-level professor of Xi'an Jiaotong University, a leading scholar, deputy director of the Department of Medicine, the president of the Institute of Global Health, the director of the International Research Center for Obesity and Metabolic Diseases, the chairman of the Obesity Prevention and Control Branch of the Chinese Nutrition Society, the chief expert of the Chinese nutrition science community, the vice chairman of the Global Health Branch and the Behavioral Health Branch of the Chinese Preventive Medicine Association, and the deputy editor-in-chief of the Chinese Journal of Preventive Medicine. His research interests include obesity and chronic disease prevention and control, nutritional epidemiology, and global health.
1. The global and Chinese obesity problem is a serious challenge that requires effective interventions and actions
According to the International Obesity Federation (WOF), the global prevalence of overweight/obesity among people over 5 years old will increase from 38% in 2020 to 51% by 2035. Projection studies show that if effective prevention and control measures are not implemented in the mainland, the rate of overweight/obesity in adults will reach about 70% by 2030, and about 30% among children and adolescents. Overweight/obesity increases the risk of many chronic diseases, and obesity-related chronic diseases such as hypertension and diabetes continue to increase rapidly in mainland China, and projection studies suggest that the prevalence of overweight obesity, hypertension and diabetes among adults in 2030 can reach 70.5%, 35.4% and 18.5%, respectively.
Professor Wang Youfa pointed out that the global and Chinese obesity problem is a serious challenge and requires effective interventions and actions. The mainland needs to actively explore effective new measures for obesity prevention and control to help achieve the strategic goal of "Healthy China". It is expected that this issue will help promote relevant research and practice in the future, including promoting interdisciplinary and international cooperation, supporting the continuous improvement and implementation of relevant national policies and regulations, helping to promote the implementation of national healthy weight management, and contributing China's strength and experience to the global efforts to combat the epidemic of obesity and related chronic diseases.
2. Interpretation of the World Obesity Report 2024 and its implications for China's related work
In this journal, Professor Wang's collaborative team interprets the World Obesity Report 2024 released by WOF, revealing the trend characteristics of overweight and obesity in low- and middle-income countries, and the close relationship between obesity and chronic diseases. Combined with the latest evidence of overweight and obesity research in China, this paper discusses the enlightenment of the Report and the World Obesity Day to China's obesity prevention and control work, and calls for building guidelines and consensus, promoting China-related activities on World Obesity Day, strengthening multi-sectoral cooperation and international cooperation, etc., to address the challenge of obesity in China and contribute to the construction of a healthy China and a community with a shared future for human health.
WOF established World Obesity Day in 2015. World Obesity Day encourages people to take action to address global health challenges through education, public policy initiatives and health promotion campaigns. The theme for World Obesity Day 2024 is "Let's Talk About Obesity and ......", with a special focus on obesity as a preventable risk factor for chronic diseases and its associated diseases. On March 4, 2024, WOF released the World Obesity Atlas 2024 for the sixth time, guiding the whole society to continue to pay attention to the global obesity problem.
The report is divided into four main parts: (1) Global overweight and obesity epidemic trend prediction and risk. (2) Overweight and obesity in adults and the risk of chronic diseases. and (3) the risk of overweight and obesity and chronic diseases in children. (4) Multi-sectoral cooperation to address the problem of overweight and obesity. In addition, the report provides obesity scorecards for 186 countries and territories, showing the status of obesity and chronic diseases based on current data from each country, which is intended to support policymakers in advancing their efforts to prevent and control obesity.
1. The global obesity crisis and its impact on chronic diseases are increasing year by year
The report shows that the global obesity crisis and its impact on chronic diseases (such as diabetes, stroke, heart disease and cancer) are increasing year by year, and that there is a strong link between overweight and obesity and multiple chronic diseases (Figure 1, Figure 2), and there is great potential to prevent chronic diseases through obesity management.
Figure 1. The trend of the global mortality rate of chronic diseases caused by overweight and obesity from 1990~2019
Figure 2. The annual proportion of disability-adjusted life (ADLY) for chronic diseases and obesity in the world due to overweight and obesity in 1990~2019
2. Global environmental and socioeconomic factors have a profound impact on obesity
According to the report, the higher the gross domestic product (GDP) per capita, the higher the prevalence of overweight and obesity among adults and children. At the same time, there is a positive correlation between the annual growth rate of GDP per capita of adults and children and the annual growth rate of the prevalence of overweight and obesity, and the global spread of overweight and obesity to low- and middle-income countries. The report dispels the common misconception that obesity is confined to economically developed and ageing regions, and that obesity can be easily prevented and controlled by calling on individuals to reduce their intake and increase exercise. In fact, as of 2020, more than 65% of the world's obese adults lived in low- and middle-income countries, and this proportion is projected to rise to 70% by 2030.
The data show that there is a strong link between overweight and obesity and the global environmental crisis, with climate change, urbanization, plastic waste, physical inactivity, and consumption of animal products constituting an unhealthy environment that contributes to overweight and obesity, as shown in Table 1.
Table 1. Correlation of overweight and obesity in adults and children with environmental indicators
3. There is a clear trend of younger people in obesity around the world
The report provides a range of evidence that overweight and obesity not only affect both rich and poor countries around the world, but also that there is a growing trend towards younger people, including the number of children with early symptoms of chronic diseases such as hyperglycemia, hypertension and low HDL cholesterolemia, and the proportion of these children who have a high BMI that causes these conditions, as shown in Figure 3.
Figure 3. The estimated number of children at risk of chronic diseases due to high overweight and obesity globally
4. Comprehensive cooperation is needed to address the global problem of obesity
Overweight and obesity have become a global public health problem and one of the core agendas of the United Nations, and it is impossible for one country or a few countries to meet the global challenge of overweight and obesity and achieve the goal of "halting" the rise in obesity by 2030 set by the World Health Organization (WHO). There are still many difficulties in tackling obesity and climate change, including a lack of coordination and resource allocation between sectors, and a lack of a strong framework to deal with it. Lasting success in obesity prevention and control can only be achieved if comprehensive, integrated and fully supported measures are taken.
The report clearly presents the grim situation and impact of global overweight and obesity. As a developing country, China and the international community face common challenges, and the obesity rate in China has increased significantly over the past few decades, which not only affects the health status of Chinese citizens, but also places a huge burden on the public health system. Obesity-related chronic diseases, such as hypertension and diabetes, continue to increase rapidly in mainland China, while awareness and management rates are low. It is urgent for the mainland to strengthen the prevention and control of chronic diseases, and the prevention and control of obesity is a good starting point. In recent years, the mainland government and society have paid more and more attention to the prevention and control of obesity and chronic diseases. However, there is an urgent need to intensify existing measures and action programmes to control their rapid growth. The report brings enlightenment to China's future obesity prevention and control work and the construction of "Healthy China".
In the future, we will combine the healthy weight management work promoted by the National Health Commission and the annual "World Obesity Day" to promote the prevention and control of obesity and other chronic diseases, and help build a "Healthy China". The mainland should vigorously promote all-round healthy weight management, carry out effective integration of medical treatment and prevention and serve patients, promote a healthy lifestyle and a supportive environment for the whole society, integrate relevant health resources, optimize the health service system, realize the whole chain of health management and chronic disease management, and strengthen the implementation and evaluation of early diagnosis, early treatment, early rehabilitation, and everyone's autonomy and self-discipline. Obesity prevention and control, especially childhood obesity prevention and control, is an important starting point for the construction of "Healthy China".