Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight
Maria LC Iurilli, Bin Zhou, James E Bennett, Rodrigo M. Carrillo‐Larco, Marisa K. Sophiea, Andrea Rodriguez‐Martinez, Honor Bixby, Bethlehem Solomon, Cristina Taddei, Goodarz Danaei, Mariachiara Di Cesare, Gretchen A Stevens, Leanne M Riley, Stefan Savin, Melanie Cowan, Pascal Bovet, Albertino Damasceno, Adela Chiriță-Emandi, Alison J. Hayes, Nayu Ikeda, Rod T Jackson, Young‐Ho Khang, Avula Laxmaiah, Jing Liu, J. Jaime Miranda, Olfa Saidi, Sylvain Sebert, Maroje Sorić, Gregor Starc, Edward W. Gregg, Leandra Abarca-Gómez, Ziad Abdeen, Shynar Abdrakhmanova, Suhaila Abdul Ghaffar, Hanan F Abdul Rahim, Niveen Abu-Rmeileh, Jamila Abubakar Garba, Benjamín Acosta-Cázares, Robert J. Adams, Wichai Aekplakorn, Kaosar Afsana, Shoaib Afzal, Imelda Angeles‐Agdeppa, Javad Aghazadeh-Attari, Carlos A Aguilar-Salinas, Charles Agyemang, Mohamad Hasnan Ahmad, Noor Ani Ahmad, Ali Ahmadi, Naser Ahmadi, Soheir H. Ahmed, Wolfgang Ahrens, Gulmira Aitmurzaeva, Kamel Ajlouni, Hazzaa M. Al-Hazzaa, Badreya Al‐Lahou, Rajaa Al‐Raddadi, Monira Alarouj, Fadia AlBuhairan, Shahla AlDhukair, Mohamed M Ali, Abdullah Alkandari, Ala’a Alkerwi, Kristine H. Allin, Mar Álvarez‐Pedrerol, Eman Aly, Deepak Amarapurkar, Parisa Amiri, Norbert Amougou, Philippe Amouyel, Lars Bo Andersen, Sigmund A. Anderssen, Lars Ängquist, Ranjit Mohan Anjana, Alireza Ansari‐Moghaddam, Hajer Aounallah-Skhiri, Joana Araújo, Inger Ariansen, Tahir Aris, Raphael E. Arku, Nimmathota Arlappa, Krishna K Aryal, Thor Aspelund, Félix Assah, Maria Cecília F Assunção, May Soe Aung, Juha Auvinen, Mária Avdičová, Avi Shina, Ana Azevedo, Mohsen Azimi–Nezhad, Fereidoun Azizi, Mehrdad Azmin, Bontha V. Babu, Maja Bæksgaard Jørgensen, Azli Baharudin, Suhad Bahijri, Jennifer L. Baker, Nagalla Balakrishna, Mohamed Bamoshmoosh
Abstract
From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions.