Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight


Maria L.C. Iurilli, Imperial College London
Bin Zhou, Imperial College London
James E. Bennett, Imperial College London
Rodrigo M. Carrillo-Larco, Imperial College London
Marisa K. Sophiea, Imperial College London
Andrea Rodriguez-Martinez, Imperial College London
Honor Bixby, Imperial College London
Bethlehem D. Solomon, Imperial College London
Cristina Taddei, Imperial College London
Goodarz Danaei, Harvard T.H. Chan School of Public Health
Mariachiara Di Cesare, Middlesex University
Gretchen A. Stevens, Imperial College London
Leanne M. Riley, Organisation Mondiale de la Santé
Stefan Savin, Organisation Mondiale de la Santé
Melanie J. Cowan, Organisation Mondiale de la Santé
Pascal Bovet, Ministry of Health Seychelles
Albertino Damasceno, Universidade Eduardo Mondlane
Adela Chirita-Emandi, Universitatea de Medicina si Farmacie Victor Babes din Timisoara
Alison J. Hayes, The University of Sydney
Nayu Ikeda, National Institutes of Biomedical Innovation, Health and Nutrition
Rod T. Jackson, The University of Auckland
Young Ho Khang, Seoul National University
Avula Laxmaiah, National Institute of Nutrition India
Jing Liu, Beijing Anzhen Hospital, Capital Medical University
J. Jaime Miranda, Universidad Peruana Cayetano Heredia
Olfa Saidi, Université de Tunis El Manar
Sylvain Sebert, Oulun Yliopisto
Maroje Sorić, University of Zagreb
Gregor Starc, Univerza v Ljubljani
Edward W. Gregg, Imperial College London
Leandra Abarca-Gómez, Caja Costarricense de Seguro Social
Ziad A. Abdeen, Al-Quds University
Shynar Abdrakhmanova, National Center of Public Health Care

Article Type

Research Article

Publication Title



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.



Publication Date



Open Access, Gold, Green

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