Current situation and management strategies of childhood obesity: Challenges and responses in China_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

ZHAO Li ¹ , XIONG Zhihan ¹ , FAN Linlin ¹ , JIANG Lihua ² , SONG Geyang ^1,3 , TANG Qi ¹ , PAN Xiongfei ^3,4 , LI Sheyu ² ,  CHEN Yi ²

1. West China School of Public Health/West China Fourth Hospital of Sichuan University, Chengdu 610041, P. R. China;
2. West China Hospital of Sichuan University, Chengdu 610041, P. R. China;
3. Sichuan University HI-TECH Group Co., Ltd, Chengdu 610065, P. R. China;
4. West China Second University Hospital of Sichuan University, Chengdu 610041, P. R. China;

Corresponding author：

CHEN Yi, Email: toddy@scu.edu.cn

Keywords：

obesity; children; health promotion; health policy

DOI：

10.7507/1007-9424.202506026

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To systematically review the current prevalence, key determinants, and prevention strategies of childhood obesity in China. Method A retrospective review of recent domestic and international literature and policy documents related to the epidemiological trends, health impacts, risk factors, and intervention strategies for childhood obesity was conducted, supplemented by national surveillance data and clinical practice updates. Results The prevalence of childhood obesity in China had been rising continuously over the past four decades, with particularly high rates observed among primary school children and boys. Recent trends showed a “provincial reversal” and an “urban-rural reversal”. The complex interplay of factors at the family, school, and societal levels contributed to the high-risk environment for obesity. China had developed a relatively comprehensive policy framework for obesity prevention and control and was promoting a three-tier prevention strategy. Clinically, pharmacological and surgical interventions were being gradually adopted, and traditional Chinese medicine also showed potential. However, challenges remain, including limited health insurance coverage. Conclusions Childhood obesity has become a significant public health issue in China, threatening national health and social development. Future efforts should focus on enhancing intersectoral governance, improving early intervention capabilities, expanding health insurance support, and standardizing clinical practices. A multi-level, multi-pathway integrated prevention and control system is essential for effectively curbing childhood obesity under the Healthy China strategy.

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3. Xing X, Hu L, Guo Y, et al. Interactions between ambient air pollution and obesity on lung function in children: the Seven Northeastern Chinese Cities (SNEC) Study. Sci Total Environ, 2020, 699: 134397. doi: 10.1016/j.scitotenv.2019.134397.
4. Yuan S, Ruan X, Sun Y, et al. Birth weight, childhood obesity, adulthood obesity and body composition, and gastrointestinal diseases: a Mendelian randomization study. Obesity (Silver Spring), 2023, 31(10): 2603-2614.
5. Wang S, Sun Q, Zhai L, et al. The prevalence of depression and anxiety symptoms among overweight/obese and non-overweight/non-obese children/adolescents in China: a systematic review and meta-analysis. Int J Environ Res Public Health, 2019, 16(3): 340. doi: 10.3390/ijerph16030340.
6. Liu D, Hao YX, Zhao TZ, et al. Childhood BMI and Adult Obesity in a Chinese Sample: A 13-Year Follow-up Study. Biomed Environ Sci, 2019, 32(3): 162-168.
7. Wang J, Freire D, Knable L, et al. Childhood and adolescent obesity and long-term cognitive consequences during aging. J Comp Neurol, 2015, 523(5): 757-768.
8. Ma G, Meyer CL, Jackson-Morris A, et al. The return on investment for the prevention and treatment of childhood and adolescent overweight and obesity in China: a modelling study. Lancet Reg Health West Pac, 2023, 43: 100977. doi: 10.1016/j.lanwpc.2023.100977.
9. Dennett CC, Simon J. The role of polycystic ovary syndrome in reproductive and metabolic health: overview and approaches for treatment. Diabetes Spectr, 2015, 28(2): 116-120.
10. 董彦会, 陈力, 刘婕妤, 等. 1985–2019年中国7~18岁儿童青少年超重与肥胖的流行趋势及预测研究. 中华预防医学杂志, 2023, 57(4): 461-469.
11. 国务院新闻办就《中国居民营养与慢性病状况报告(2020年)》有关情况举行发布会(2020-12-24)[2025-05-01].
12. 马淑婧, 张艳青, 羊柳, 等. 1991–2015年中国9个省份儿童青少年超重和肥胖率的变化趋势分析. 中华预防医学杂志, 2020, 54(2): 133-138.
13. Ma S, Hou D, Zhang Y, et al. Trends in abdominal obesity among Chinese children and adolescents, 1993-2015. J Pediatr Endocrinol Metab, 2020, 34(2): 163-169.
14. Zhang L, Chen J, Zhang J, et al. Regional disparities in obesity among a heterogeneous population of Chinese Children and adolescents. JAMA Netw Open, 2021, 4(10): e2131040. doi: 10.1001/jamanetworkopen.2021.31040.
15. Pan XF, Wang L, Pan A. Epidemiology and determinants of obesity in China. Lancet Diabetes Endocrinol, 2021, 9(6): 373-392.
16. 董彦会, 陈力, 刘婕妤, 等. 1985–2019年中国7~18岁儿童青少年超重与肥胖的流行趋势及预测研究. 中华预防医学杂志, 2023, 57(4): 461-469.
17. 袁金娜, 金冰涵, 斯淑婷, 等. 2009至2019年6~15岁中国儿童超重和肥胖趋势分析. 中华儿科杂志, 2021, 59(11): 935-941.
18. Shah B, Tombeau Cost K, Fuller A, et al. Sex and gender differences in childhood obesity: contributing to the research agenda. BMJ Nutr Prev Health, 2020, 3(2): 387-390.
19. Jia P, Ma S, Qi X, et al. Spatial and temporal changes in prevalence of obesity among Chinese children and adolescents, 1985–2005. Prev Chronic Dis, 2019, 16: E160. doi: 10.5888/pcd16.190290.
20. Zhang L, Chen J, Zhang J, et al. Regional disparities in obesity among a heterogeneous population of Chinese Children and adolescents. JAMA Netw Open, 2021, 4(10): e2131040. doi: 10.1001/jamanetworkopen.2021.31040.
21. Dang J, Shi D, Li X, et al. Artificial light-at-night exposure and overweight and obesity across GDP levels among Chinese children and adolescents. Nutrients, 2023, 15(4): 939. doi: 10.3390/nu15040939.
22. 马军, 蔡赐河, 王海俊, 等. 1985–2010年中国学生超重与肥胖流行趋势. 中华预防医学杂志, 2012, 46(9): 776-780.
23. Yuan C, Dong Y, Chen H, et al. Determinants of childhood obesity in China. Lancet Public Health, 2024, 9(12): e1105-e1114. doi: 10.1016/S2468-2667(24)00246-9.
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