仅凭毅力瘦身99%终告负？《柳叶刀》权威提醒：全球廿亿人体重隐患，迫在眉睫，健体势在必为！

Core Viewpoint - The article highlights the alarming global obesity crisis, projecting that by 2050, over half of adults (3.8 billion) and one-third of children and adolescents (746 million) will be overweight or obese without immediate policy reforms and actions [6][9]. Global Obesity Status - A comprehensive assessment of overweight and obesity from 1990 to 2021 across 204 countries reveals a dramatic increase in obesity rates, with adult obesity rising from 731 million in 1990 to 2.11 billion in 2021, and childhood obesity increasing from 198 million to 493 million [7]. - The study utilized Body Mass Index (BMI) as a standard, defining overweight as a BMI of 25-30 kg/m² and obesity as a BMI of 30 kg/m² or higher for adults, while using specific standards for children [7]. Global Distribution of Obesity - Eight countries—China (402 million), India (180 million), the USA (172 million), Brazil (88 million), Russia (71 million), Mexico (58 million), Indonesia (52 million), and Egypt (41 million)—account for over half of the global adult overweight or obese population [8]. Future Trends - Projections indicate that by 2050, approximately 60% of adults (3.8 billion) and 31% of children and adolescents (746 million) will face overweight or obesity issues, with the growth rate of childhood obesity expected to surpass that of overweight individuals [9]. - The male population aged 5-14 is predicted to experience a higher obesity rate (16.5%) than the overweight rate (12.9%) for the first time by 2050 [10]. Causes of Obesity - The complexity of obesity is emphasized, involving genetic, environmental, and lifestyle factors, with only 1% of obese individuals successfully losing weight through diet and exercise alone [11]. - The article notes that East Asian genetic traits lead to higher abdominal fat accumulation, which is exacerbated by carbohydrate-rich diets and sedentary lifestyles, increasing the risk of metabolic diseases [12]. Response Strategies - The medical community advocates for a "lifetime management" approach to obesity, suggesting tiered interventions based on severity, including dietary adjustments for overweight individuals, medication for mild obesity, and surgical options for severe cases [13]. - Recommendations include enhancing public education to shift perceptions of obesity from personal responsibility to a broader societal issue, improving policy support for community exercise facilities, and promoting nutritional labeling [13].