Half of Nepal’s adult population will be overweight or obese by 2050, in what is a looming health crisis characterised by premature deaths, diseases, and additional burden to healthcare systems, according to a new study.

The report published in The Lancet, a leading international medical journal, on Monday, highlights a growing health crisis driven by obesity and overweight globally, including in developing countries like Nepal, which is still grappling with challenges like hunger and undernutrition.

“No doubt, cases of overweight and obesity have increased alarmingly in our country,” said Ashok Bhurtyal, a public health practitioner. “Without immediate intervention, problems could exacerbate, and we will have to at once deal with twin, if contradictory, challenges—hunger and obesity.”

According to the World Health Organisation, overweight is classified as having a Body Mass Index (BMI) equal to or greater than 25, while obesity is defined as having a BMI equal to or greater than 30.

The prevalence of overweight and obesity has surged at both global and regional levels, affecting all nations between 1990 and 2021, says the report.

In Nepal, the obesity rate in males increased from 11.7 percent in 1990 to 29.5 percent in 2021, and from 13.9 percent to 28.1 percent in females. Without any intervention, by 2050, these figures are projected to increase to 52.2 percent in males and 47.8 percent in females.

Obesity and underweight are both forms of malnutrition and are also detrimental to people’s health in multiple ways. Nepal has been struggling to cope with both.

The 2024 report on hunger also paints a bleak picture of Nepal’s hunger level. The country ranks 68th out of 127 countries in the 2024 Global Hunger Index, with a score of 14.7, which indicates that the country has a moderate level of hunger. The GHI score is based on four components—undernourished population, stunted children, wasting problems, and child mortality under five years of age.

The Lancet report estimated that 2.11 billion adults aged 25 years and older are overweight or obese and they account for nearly half (45.1 percent) of the total adult population worldwide.

In 2021 alone, 3.71 million deaths and 129 million disability-adjusted life-years were attributed to overweight and obesity. The increase in these figures over the past two decades is striking—global age-standardised disability-adjusted life years rates associated with overweight and obesity rose by over 15 percent, as they became one of the top global risk factors for health.

As obesity rates continue to surge, particularly among children and adolescents, adult obesity is projected to rise as well. The repercussions will be felt in the form of an escalating burden of non-communicable diseases—most notably type 2 diabetes, cardiovascular diseases, and cancer, the report warns.

These diseases are already on the rise globally, and as obesity rates increase, so too will the prevalence of these costly and debilitating conditions.

The report emphasises the close link between adult and childhood obesity. The global prevalence of obesity in children and adolescents has rocketed by 244 percent over the past 30 years. It is predicted to increase by an additional 121 percent in the next 30 years.

Without drastic intervention, 3·80 billion adults over the age of 25 will be overweight or obese by 2050, the report stated. “Urgent, bold, and comprehensive initiatives are imperative to enable multisectoral collaboration and propel structural reforms to address drivers of overweight and obesity at individual and population levels.”

The report stated that this shift has profound implications for public health, economic productivity, and quality of life.

The World Health Organisation said that many low- and middle-income countries like Nepal are now facing a ‘double burden’—under-nutrition as well as a rapid upsurge in obesity-related cases, particularly in the urban areas.

The UN health agency said children in low- and middle-income countries are more susceptible to inadequate nutrition of prenatal, infant, and young children. At the same time, it said that children are being exposed to high-fat, high-sugar, high-salt, energy-dense, and micronutrient-poor foods, which tend to be cheap but also poor in nutrient quality.

These dietary patterns, in conjunction with lower levels of physical activity, result in sharp increases in childhood obesity.

“More people are becoming aware of the risk of lifestyle diseases, including the risk of overweight and obesity of late,” said Bhurtyal. “What we need is a collective effort of all agencies concerned and individuals to combat this crisis driven by changing lifestyles and eating habits.”