仅靠意志力减肥成功率不足1%？《柳叶刀》指出：全球超20亿人迫切需要减脂

Core Viewpoint - The article emphasizes the urgent need for policy reforms and effective measures to combat the rising obesity crisis globally, predicting that by 2050, over half of adults (approximately 3.8 billion) and one-third of children and adolescents (around 746 million) will face overweight or obesity issues if no action is taken [5][8]. Summary by Sections Global Obesity Trends - A recent analysis published in The Lancet indicates that the prevalence of overweight and obesity among adults aged 25 and above has surged from 731 million in 1990 to 2.11 billion in 2021. Similarly, the number of overweight and obese children and adolescents aged 5-24 has increased from 198 million to 493 million during the same period [8]. - The distribution of weight gain is highly uneven globally, with eight countries—China (402 million), India (180 million), the United States (172 million), Brazil (88 million), Russia (71 million), Mexico (58 million), Indonesia (52 million), and Egypt (41 million)—accounting for over half of the world's overweight or obese adults in 2021 [8]. Future Projections - If decisive measures are not implemented, it is projected that by 2050, approximately 60% of adults (3.8 billion) and one-third (31%) of children and adolescents (746 million) will be overweight or obese [8][10]. - The growth rate of obesity among children and adolescents is expected to outpace that of overweight individuals, particularly among boys, with obesity rates for boys aged 5-14 projected to reach 16.5% by 2050 [10]. Health and Economic Implications - The rising obesity rates will impose significant health, economic, and social burdens, especially in regions like North Africa, the Middle East, and Latin America, which are expected to become hotspots for adolescent obesity [10]. - By 2050, nearly one-quarter of obese adults will be aged 65 and older, further straining healthcare systems, particularly in resource-limited countries [10]. Causes and Management Strategies - The complexity of obesity is highlighted, involving genetic, environmental, and lifestyle factors. The success rate of weight loss through diet and exercise alone is only about 1% [11]. - The article advocates for a multi-tiered intervention approach, suggesting that overweight individuals can adjust through diet and exercise, while those with severe obesity or metabolic diseases may require medication or surgical options [11]. Recommendations for Action - Public education should be enhanced to correct misconceptions about obesity being solely a result of personal willpower [12]. - Policy support is necessary, including the establishment of community exercise facilities and mandatory nutritional labeling on food products [12]. - Improving access to quality healthcare resources through telemedicine and training for primary care physicians is essential to increase the availability of scientific weight management services [12].