Prevalence and inequalities of obesity and associated complications in China: A multicentre nationwide survey

Objectives: Obesity is a risk factor for chronic diseases. The prevalence of obesity is rapidly increase and a significant social inequality exists. This study aimed to analyse obesity prevalence and complications in different regions and occupations in China.

Study design: Multicentre cross-sectional study.

Methods: Data from 62,893 adults in 10 Chinese provinces were collected in 2022. Measures included body mass index (BMI), metabolic status and complications. Analysis was stratified by gender, age, region and occupation, with results adjusted for age and gender.

Results: The average BMI was 23.81 ± 3.42 kg/m², with overweight and obesity prevalence at 34.29 % and 11.24 %, respectively. North China had the highest obesity rate (27.93 %), followed by West (26.64 %), South (25.37 %) and East China (20.06 %). Functionaries (e.g. as civil servants, corporate executives) had higher BMI than employees or intellectual professionals, while workers had higher BMI than farmers. Intellectual professionals had the lowest rates of metabolically healthy obesity (MHO) at 4.90 % and metabolically unhealthy obesity (MUO) at 3.47 %, followed by employees (MHO 6.63 %, MUO 4.45 %) and functionaries (MHO 6.74 %, MUO 4.94 %). Workers had the highest MHO prevalence rate at 8.51 %, while farmers had the highest MUO rate at 6.16 %. Obesity-associated complications were 1.5-3 times more common among obese individuals than those in the normal BMI category, with inequality observed across different occupational groups.

Conclusions: In China, a large number of adults with obesity have poor metabolic health, highlighting the importance of considering metabolic status when addressing obesity-related chronic diseases. Addressing the inequality in obesity rates can inform public health strategies to tackle the increasing problem of obesity and its associated complications in China.