Obesity prevalence in the long-term future in 18 European countries and in the USA

Introduction: Obesity constitutes a major public health problem in Europe, but how the obesity epidemic in European countries will evolve remains unknown. Most previous obesity projections considered the short-term future only, focused on single non-European countries, and projected ongoing increases foremost. We comparatively project obesity prevalence into the long-term future for 18 European countries and the USA. Data: We used national age-specific (20–84 years) and sex-specific obesity prevalence estimates (1975–2016) from the NCD Risk Factor Collaboration (NCD-RisC) 2017 study, which are based on available measured height and weight data, supplemented with estimates from a Bayesian hierarchical model. Methods: We projected age- and sex-specific obesity prevalence up to the year 2100 by integrating the notion of a wave-shaped obesity epidemic into conventional age-period projections. Results: In 1990–2016, the increasing trends in obesity prevalence were decelerating. Obesity is expected to reach maximum levels between 2030 and 2052 among men, and between 2026 and 2054 among women. The maximum levels will likely be reached first in The Netherlands, USA, and UK, and last in Switzerland; and are expected to be highest in the USA and UK, and lowest in The Netherlands for men and Denmark for women. In 2060, obesity prevalence is expected to be lowest among Dutch men and highest among Swiss men. The projected age-specific obesity prevalence levels have an inverse U-shape, peaking at around the age of 60–69 years. Discussion: Applying our novel approach to the NCD-RisC 2017 data, obesity prevalence is expected to reach maximum levels between 2026 and 2054, with the USA and UK reaching the highest maximum levels first, followed by other European countries.