The World Obesity Federation updates us on how countries are doing to meet the 2025 WHO obesity targets. Sadly, it doesn’t look good.
World Obesity Day – 4 March
Obesity organisations around the world came together on 4 March 2020 to mark World Obesity Day and call for more comprehensive solutions, treatment, and shared accountability for addressing the global epidemic that is obesity1.
Obesity is a chronic relapsing disease affecting a rapidly increasing number of people worldwide3. A new report, published by the World Obesity Federation, shines a spotlight on the rise in obesity levels around the world and highlights that all countries are worryingly off track to meet the 2025 global targets to which they have committed, despite just five years to go2.
By 2025, global obesity prevalence is predicted to reach 18% in men and surpass 21% in women4, with many countries experiencing much higher levels. Five countries, US, China, Brazil, India and Russia, account for around a third of all cases of obesity in adults globally.
Low- and middle-income countries
Once seen as a health concern in high-income countries only, the greatest rise and highest numbers of obesity are now seen in low- and middle-income countries. Countries such as Vietnam, Indonesia and Bangladesh are experiencing some of the most rapid rises.
Table 2: Countries with the most rapid rise in obesity prevalence 1995-2016 
CAGR* as %
CAGR* as %
In many of these countries, undernutrition still prevails, and they are now experiencing the double burden of malnutrition. This is especially true for countries in Africa where rates vary substantially, with Algeria and South Africa showing the highest proportion of adults with obesity.
Table 3: Countries in Africa with the largest proportion of adults over 20 living with obesity 
|Country||% men with
|Country||% women with
Increased risk of other non-communicable diseases
Left untreated, the consequences of obesity are likely to escalate. This includes an increased risk of other non-communicable diseases (NCDs), such as diabetes, heart disease and some cancers. Thus putting the other WHO NCD targets in jeopardy as well.
A high BMI has been linked to 217,6 million cases of diabetes5, 307 million cases of hypertension6, 11.7 million cases of cardiovascular disease7and almost 500 000 cases of certain cancers8, needing more extensive and costly interventions.
Healthcare expenditure attributable to obesity
Obesity also has staggering financial and social impacts, as well as an impact on future generations. It has been estimated that the total cost of high BMI to health services globally is US$990 billion per year9,10, with the highest costs in the Eastern Mediterranean and America regions.
Table 5: Estimated national healthcare expenditure attributable to overweight and obesity: global and regional ($US) [9,10]
|WHO region||Total health care expenditure ($US)||Expenditure attributed to high BMI ($US)||High BMI expenditure as % of total healthcare expenditure|
|Region of the Americas||3,784.3bn||669.2bn||17.7%|
|South-East Asian Region||141.9bn||4.8bn||3.4%|
|Eastern Mediterranean Region||147.8bn||20.1bn||13.6%|
|Western Pacific Region||1,402.0bn||70.6bn||5.0%|
In Organisation for Economic Co-operation and Development (OECD) countries, obesity is estimated to cost 3,3% of total GDP, with the highest cost seen in countries, such as Mexico (5,3%) and Brazil5.
Map: Cost of obesity as percent GDP in OECD countries – provided by RTI International, based on 
Stigma and misunderstanding around obesity
Furthermore, obesity has significant impact on employment, education and mental well-being, exacerbated by the stigma and misunderstanding around obesity.
When it comes to a disease like obesity, there is more complexity than meets the eye. Many people, including healthcare professionals, policymakers, and others are guilty of seeing it as a simple lack of personal responsibility. But like all chronic diseases, the root causes of obesity run much deeper. They can be genetic, psychological, sociocultural, economic, and environmental.
Organisations around the world are calling for this cycle of shame and blame to be broken and to re-evaluate our approach for addressing this complex, chronic disease that affects over 650 million adults and more than 125 million children worldwide.
Declaration for obesity targets
Professor Donna Ryan, President of the World Obesity Federation, said, “Despite government commitments, not a single country is on track to meet the WHO goals and there is far too much inertia instead of action. There is no excuse for this inaction. People with obesity require respectful and equitable access to treatment or opportunities for prevention. This requires action from policymakers around the world to address the underlying roots of obesity.”
To mark the first unified World Obesity Day, a Declaration has been drawn up by obesity groups to highlight the five areas, the roots, in which action must be taken by policymakers to achieve the targets on obesity to which they have committed.
Signatories to the Declaration are some of the world’s largest obesity organisations, and the Declaration is now open for individual supporters to add their voices to this urgent call for a comprehensive and effective government response to obesity in their own countries12.
According to Johanna Ralston, Chief Executive Officer of the World Obesity Federation, “The absence of a comprehensive view of obesity has translated into fragmented health systems, weak policies and poor translation of medical knowledge into widely available prevention and care. Obesity does not occur in silos and it will not be solved in them either. That is why we are launching a Declaration on obesity, calling on governments and policymakers to join civil society organisations around the world in supporting greater collective action and to further raise awareness about this serious, chronic disease.”
Countries with the best chance of meeting the 2025 target for obesity4
|3||China (Hong Kong)||3%||Latvia||20%|
|5||Mauritius||3%||China (Hong Kong)||18%|
 See www.worldobesity.org for more information about World Obesity Day
 These targets include a zero increase in obesity prevalence between 2010 and 2025. See: http://apps.who.int/gb/ebwha/pdf_files/WHA66/A66_R10-en.pdf (see pages 43-44)
 Bray, B.A et al. (2017) See: https://www.ncbi.nlm.nih.gov/pubmed/28489290
 NCD Risk Factor Collaboration. (2017) Visit http://ncdrisc.org/
 International Diabetes Federation (2019) See: https://www.diabetesatlas.org/en/
 World Health Organization (2019) See: http://apps.who.int/gho/data/
 Roth GA et al. (2017) See: https://www.ncbi.nlm.nih.gov/pubmed/28527533
 Pearson-Stuttard J et al. (2018) See: https://www.thelancet.com/journals/landia/article/PIIS2213-8587(18)30150-5/fulltext
 World Health Organization (2019) See: https://www.who.int/gho/publications/world_health_statistics/2019/EN_WHS_2019_Main.pdf
 World Obesity Federation (2017) See: https://www.worldobesity.org/resources/resource-library/calculating-the-costs-of-the-consequences-of-obesity
 World Obesity Day declaration available at: Declaration
The summary report Obesity: missing the 2025 targets is available here.