Increasing Obesity Rates: Why More People Are Struggling with Weight Gain
World Obesity Day 2025 emphasizes the critical necessity for systemic reforms to address the obesity epidemic. Dr. Zhang Peng, director of metabolic and bariatric surgery at Capital Medical University Beijing Friendship Hospital and a key figure behind China's most recent national obesity diagnosis and treatment guidelines, shares his perspectives on the factors contributing to the obesity crisis and the increasing strain on healthcare systems.
TroibNews 
**Editor's Note:** World Obesity Day 2025 underscores the urgent need for systemic change to address the obesity crisis. In response, China has intensified its policy initiatives to enhance public awareness and establish standardized clinical guidelines for the diagnosis and treatment of obesity. Dr. Zhang Peng, director of metabolic and bariatric surgery at Capital Medical University Beijing Friendship Hospital and a lead contributor to China's latest national obesity diagnosis and treatment guidelines, shares insights into the factors contributing to the obesity crisis and the increasing strain on healthcare systems.
The global obesity crisis ranks among the most significant public health challenges of the 21st century.
Data from the World Health Organization in 2022 indicates that more than one billion people worldwide, approximately one in eight individuals, are living with obesity. This figure continues to grow and is expected to reach 1.9 billion by 2035.
Obesity significantly increases the risk of non-communicable diseases such as type 2 diabetes, cardiovascular issues, and specific cancers. The World Obesity Federation warns that obesity-related illnesses could impose a cost of $4 trillion on the global economy annually by 2035.
In China, as of 2020, over 50 percent of adults are categorized as overweight or obese, amounting to an astonishing 600 million people—the highest number globally.
Body mass index (BMI) serves as a common measure to evaluate whether an individual’s weight is appropriate for their height. It is calculated by dividing weight by height squared. In China, a BMI between 24.0 and 27.9 kg/m² is classified as overweight, while a BMI of 28.0 kg/m² or higher is considered obese.
"If all these people were to seek treatment at hospitals, it would pose a significant challenge to the healthcare system," said Dr. Zhang Peng.
"Projections indicate that by 2030, 22 percent of the country's healthcare expenditures will be linked to obesity," he added.
**Drivers of the Crisis**
"Obesity can stem from a variety of factors, including family clustering of obesity, stress-related eating, a sedentary lifestyle, high-calorie food choices, and the traditional perception associating excess weight with wealth," acknowledged Zhang.
He pointed out that hormonal medications, underlying diseases, and genetic mutations can also contribute to obesity, although this form of secondary obesity is relatively rare.
The factors driving the crisis differ across regions, necessitating multifaceted actions that include re-evaluating food production and healthcare systems. Zhang emphasized the need for community-level integration of obesity prevention strategies.
"We must guide the public to adopt a healthy lifestyle to prevent obesity, help those who have already gained weight to avoid developing diseases, and encourage those who have developed diseases due to obesity to actively seek medical treatment," he said.
**Responses in China**
In recent years, China has intensified its multifaceted approach to combating the obesity crisis through a combination of top-down policies, healthcare innovations, and cultural transformations.
Under the national health initiative Healthy China 2030, launched in 2016, the country has prioritized obesity prevention by enhancing nutrition, increasing physical activity, and fostering public education. Key objectives include halting the rise in obesity rates among children and adolescents by 2030.
A follow-up plan released in 2019 outlined the complete implementation and assessment of the blueprint, offering technological support through expert teams and delineating essential tasks.
China has revised its dietary guidelines to encourage reduced consumption of salt, oil, and sugar, while advocating for greater intake of whole grains, vegetables, and plant-based proteins.
To encourage physical activity, the government has expanded public sports infrastructure, resulting in a total of 4.6 million sports venues across China by the end of 2023, averaging 2.9 square meters of sports area per person.
For combating childhood obesity, China has implemented strict measures such as restricting junk food advertising aimed at children and prohibiting the sale of high-sugar snacks in schools. All students are now required to engage in at least one hour of exercise per school day.
As obesity rates climb, many public hospitals have established specialized obesity clinics to cater to the increasing demand for medical interventions. Furthermore, China has introduced several clinical guidelines to standardize obesity diagnosis and treatment while creating multidisciplinary care pathways.
**Challenges Ahead**
Zhang mentioned that the forthcoming 2024 National Obesity Diagnosis and Treatment Guideline will detail specific grading criteria for diagnosis and treatment, which include lifestyle modifications, medications, and surgical interventions.
"We increasingly recognize the critical role of multidisciplinary collaboration in obesity treatment. At the same time, doctors must shift their mindset and work with patients to develop personalized plans, which should be based upon shared decision-making between physicians and patients—only those that patients can adhere to will be effective," he explained.
Zhang also pointed out systemic deficiencies in China's healthcare system.
"A key issue is the lack of specialized obesity training. Medical schools and residency programs do not offer dedicated courses and programs, leading to inconsistent advice from doctors," he stated.
"In hospitals, multiple departments run their own weight-loss clinics without a unified strategy. Patients receive conflicting treatment plans, leaving them unsure whose advice to follow," he added.
He further noted that obesity-related stigma often starts at home, where overweight individuals may face criticism from family members.
"Overweight students may encounter discrimination from teachers and peers, especially if they struggle academically. These students need support, not judgment," he emphasized.
Ramin Sohrabi for TROIB News
The global obesity crisis ranks among the most significant public health challenges of the 21st century.
Data from the World Health Organization in 2022 indicates that more than one billion people worldwide, approximately one in eight individuals, are living with obesity. This figure continues to grow and is expected to reach 1.9 billion by 2035.
Obesity significantly increases the risk of non-communicable diseases such as type 2 diabetes, cardiovascular issues, and specific cancers. The World Obesity Federation warns that obesity-related illnesses could impose a cost of $4 trillion on the global economy annually by 2035.
In China, as of 2020, over 50 percent of adults are categorized as overweight or obese, amounting to an astonishing 600 million people—the highest number globally.
Body mass index (BMI) serves as a common measure to evaluate whether an individual’s weight is appropriate for their height. It is calculated by dividing weight by height squared. In China, a BMI between 24.0 and 27.9 kg/m² is classified as overweight, while a BMI of 28.0 kg/m² or higher is considered obese.
"If all these people were to seek treatment at hospitals, it would pose a significant challenge to the healthcare system," said Dr. Zhang Peng.
"Projections indicate that by 2030, 22 percent of the country's healthcare expenditures will be linked to obesity," he added.
**Drivers of the Crisis**
"Obesity can stem from a variety of factors, including family clustering of obesity, stress-related eating, a sedentary lifestyle, high-calorie food choices, and the traditional perception associating excess weight with wealth," acknowledged Zhang.
He pointed out that hormonal medications, underlying diseases, and genetic mutations can also contribute to obesity, although this form of secondary obesity is relatively rare.
The factors driving the crisis differ across regions, necessitating multifaceted actions that include re-evaluating food production and healthcare systems. Zhang emphasized the need for community-level integration of obesity prevention strategies.
"We must guide the public to adopt a healthy lifestyle to prevent obesity, help those who have already gained weight to avoid developing diseases, and encourage those who have developed diseases due to obesity to actively seek medical treatment," he said.
**Responses in China**
In recent years, China has intensified its multifaceted approach to combating the obesity crisis through a combination of top-down policies, healthcare innovations, and cultural transformations.
Under the national health initiative Healthy China 2030, launched in 2016, the country has prioritized obesity prevention by enhancing nutrition, increasing physical activity, and fostering public education. Key objectives include halting the rise in obesity rates among children and adolescents by 2030.
A follow-up plan released in 2019 outlined the complete implementation and assessment of the blueprint, offering technological support through expert teams and delineating essential tasks.
China has revised its dietary guidelines to encourage reduced consumption of salt, oil, and sugar, while advocating for greater intake of whole grains, vegetables, and plant-based proteins.
To encourage physical activity, the government has expanded public sports infrastructure, resulting in a total of 4.6 million sports venues across China by the end of 2023, averaging 2.9 square meters of sports area per person.
For combating childhood obesity, China has implemented strict measures such as restricting junk food advertising aimed at children and prohibiting the sale of high-sugar snacks in schools. All students are now required to engage in at least one hour of exercise per school day.
As obesity rates climb, many public hospitals have established specialized obesity clinics to cater to the increasing demand for medical interventions. Furthermore, China has introduced several clinical guidelines to standardize obesity diagnosis and treatment while creating multidisciplinary care pathways.
**Challenges Ahead**
Zhang mentioned that the forthcoming 2024 National Obesity Diagnosis and Treatment Guideline will detail specific grading criteria for diagnosis and treatment, which include lifestyle modifications, medications, and surgical interventions.
"We increasingly recognize the critical role of multidisciplinary collaboration in obesity treatment. At the same time, doctors must shift their mindset and work with patients to develop personalized plans, which should be based upon shared decision-making between physicians and patients—only those that patients can adhere to will be effective," he explained.
Zhang also pointed out systemic deficiencies in China's healthcare system.
"A key issue is the lack of specialized obesity training. Medical schools and residency programs do not offer dedicated courses and programs, leading to inconsistent advice from doctors," he stated.
"In hospitals, multiple departments run their own weight-loss clinics without a unified strategy. Patients receive conflicting treatment plans, leaving them unsure whose advice to follow," he added.
He further noted that obesity-related stigma often starts at home, where overweight individuals may face criticism from family members.
"Overweight students may encounter discrimination from teachers and peers, especially if they struggle academically. These students need support, not judgment," he emphasized.
Ramin Sohrabi for TROIB News
