The global burden of disease attributable to high body mass index in 195 countries and territories, 1990–2017: An analysis of the Global Burden of Disease Study

Autoři: Haijiang Dai aff001;  Tariq A. Alsalhe aff003;  Nasr Chalghaf aff004;  Matteo Riccò aff006;  Nicola Luigi Bragazzi aff002;  Jianhong Wu aff002
Působiště autorů: Department of Cardiology, Third Xiangya Hospital, Central South University, Changsha, China aff001;  Laboratory for Industrial and Applied Mathematics, Centre for Disease Modelling, Department of Mathematics and Statistics, York University, Toronto, Ontario, Canada aff002;  College of Sport Sciences and Physical Activity, King Saud University, Riyadh, Saudi Arabia aff003;  Group for the Study of Development and Social Environment, Faculty of Letters and Human Sciences of Sfax, University of Sfax, Sfax, Tunisia aff004;  Higher Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia aff005;  Occupational Health and Safety Services, Department of Public Health, AUSL-IRCCS di Reggio Emilia, Reggio Emilia, Italy aff006
Vyšlo v časopise: The global burden of disease attributable to high body mass index in 195 countries and territories, 1990–2017: An analysis of the Global Burden of Disease Study. PLoS Med 17(7): e32767. doi:10.1371/journal.pmed.1003198
Kategorie: Research Article
doi: 10.1371/journal.pmed.1003198



Obesity represents an urgent problem that needs to be properly addressed, especially among children. Public and global health policy- and decision-makers need timely, reliable quantitative information to develop effective interventions aimed at counteracting the burden generated by high body mass index (BMI). Few studies have assessed the high-BMI-related burden on a global scale.

Methods and findings

Following the methodology framework and analytical strategies used in the Global Burden of Disease Study (GBD) 2017, the global deaths and disability-adjusted life years (DALYs) attributable to high BMI were analyzed by age, sex, year, and geographical location and by Socio-demographic Index (SDI). All causes of death and DALYs estimated in GBD 2017 were organized into 4 hierarchical levels: level 1 contained 3 broad cause groupings, level 2 included more specific categories within the level 1 groupings, level 3 comprised more detailed causes within the level 2 categories, and level 4 included sub-causes of some level 3 causes. From 1990 to 2017, the global deaths and DALYs attributable to high BMI have more than doubled for both females and males. However, during the study period, the age-standardized rate of high-BMI-related deaths remained stable for females and only increased by 14.5% for males, and the age-standardized rate of high-BMI-related DALYs only increased by 12.7% for females and 26.8% for males. In 2017, the 6 leading GBD level 3 causes of high-BMI-related DALYs were ischemic heart disease, stroke, diabetes mellitus, chronic kidney disease, hypertensive heart disease, and low back pain. For most GBD level 3 causes of high-BMI-related DALYs, high-income North America had the highest attributable proportions of age-standardized DALYs due to high BMI among the 21 GBD regions in both sexes, whereas the lowest attributable proportions were observed in high-income Asia Pacific for females and in eastern sub-Saharan Africa for males. The association between SDI and high-BMI-related DALYs suggested that the lowest age-standardized DALY rates were found in countries in the low-SDI quintile and high-SDI quintile in 2017, and from 1990 to 2017, the age-standardized DALY rates tended to increase in regions with the lowest SDI, but declined in regions with the highest SDI, with the exception of high-income North America. The study’s main limitations included the use of information collected from some self-reported data, the employment of cutoff values that may not be adequate for all populations and groups at risk, and the use of a metric that cannot distinguish between lean and fat mass.


In this study, we observed that the number of global deaths and DALYs attributable to high BMI has substantially increased between 1990 and 2017. Successful population-wide initiatives targeting high BMI may mitigate the burden of a wide range of diseases. Given the large variations in high-BMI-related burden of disease by SDI, future strategies to prevent and reduce the burden should be developed and implemented based on country-specific development status.

Klíčová slova:

Age groups – Body Mass Index – Cardiovascular diseases – Death rates – diabetes mellitus – Global health – Obesity – Public and occupational health


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