- ➔ Increased availability of foods of high energy density and minimal nutritional value, including ultra-processed foods, can be associated with an increasing prevalence of overweight and obesity. Trade can contribute to this availability.
- ➔ By lowering import tariffs and harmonizing sanitary and phytosanitary measures and technical barriers to trade, regional trade agreements have a significant impact on food trade because they reduce trade obstacles and increase consumer trust.
- ➔ Deep regional trade agreements with a focus on sanitary and phytosanitary measures and technical barriers to trade could facilitate imports of ultra-processed foods. These foods are generally subject to a larger number of regulatory measures than unprocessed or minimally processed foods.
- ➔ Income affects the demand for food imports. As incomes grow, a country would rapidly increase the demand for imports of ultra-processed foods. A 10 percent increase in income results in a 11 percent increase in the demand for imports of ultra-processed foods but only a 7 percent increase in the demand for imports of unprocessed and minimally processed foods.
The prevalence of obesity in the world
While overweight is a condition of excessive fat deposits, obesity is a chronic complex disease defined by excessive fat deposits that can impair health. Obesity is associated with an increased risk of developing non-communicable diseases such as hypertension, type 2 diabetes mellitus and cardiovascular disease.173 It can also affect bone health and reproduction and increases the risk of certain cancers. Since the 1990s, the World Health Organization (WHO) has strengthened the focus on obesity and on the impacts that rapid economic growth and social transition have on nutrition, considering the political, economic, cultural and physical factors that would give rise to obesogenic environments.
In 2022, 2.5 billion adults aged 18 years and older were overweight, including 890 million adults who were living with obesity, a share of 43 percent worldwide. Since the 1990s, the worldwide prevalence of obesity increased from 6.6 percent in 1990 to 15.8 percent in 2022.174 Obesity has now reached epidemic proportions and it is estimated that by 2030 more than one billion adults globally will be obese.175 Once associated with high-income countries, obesity is now also prevalent in low- and middle-income countries (see Figure 4.1 and the discussion on the multiple burdens of malnutrition in Part 1).
FIGURE 4.1Prevalence of obesity among adults in the world, percent, 2022

Refer to the disclaimer on the copyright page for the names and boundaries used in this map. Dotted line represents approximately the Line of Control in Jammu and Kashmir agreed upon by India and Pakistan. The final status of Jammu and Kashmir has not yet been agreed upon by the parties. Final boundary between the Republic of Sudan and the Republic of South Sudan has not yet been determined.
SOURCES: Adapted from WHO. 2024. The Global Health Observatory: Prevalence of obesity among adults. [Accessed on 27 May 2024]. https://www.who.int/data/gho/data/indicators/indicator-details/GHO/prevalence-of-obesity-among-adults-bmi-=-30-(age-standardized-estimate)-(-)
The prevalence of obesity also grew in every region in the world and in most countries over the 1990–2022 period (Figure 4.2). In many high-income countries the prevalence of obesity more than doubled. For example, in the United States, the prevalence of obesity increased from 18.6 percent in 1990 to 42.0 percent in 2022. In Australia in 1990, the prevalence was 12.7 percent, increasing to 30.2 percent in 2022. In the Republic of Korea, a country that experienced rapid economic growth and nutrition transition (see Part 1), although the prevalence of obesity more than quadrupled from 1.5 percent in 1990 to 7.3 percent in 2022, it remained at relatively low levels.
FIGURE 4.2Prevalence of obesity among adults in the world, selected countries, 1990 and 2022

SOURCE: Authors’ own elaboration based on WHO. 2024. The Global Health Observatory: Prevalence of obesity among adults. [Accessed on 27 May 2024]. https://www.who.int/data/gho/data/indicators/indicator-details/GHO/prevalence-of-obesity-among-adults-bmi-=-30-(age-standardized-estimate)-(-)
Middle-income countries and emerging economies also show significant increases. In Brazil, the prevalence of obesity more than tripled from 8.6 percent in 1990 to 28.1 percent in 2022. During the same period in Egypt, the prevalence of obesity increased from 19.4 percent to 44.3 percent.
The highest levels of obesity in the world are consistently found in the Small Island Developing States, especially in the Pacific region. In 2022, the prevalence of obesity in American Samoa and Tonga was 75.2 and 71.6 percent, respectively. In the same year, the prevalence of obesity in the Cook Islands, Nauru, Niue, Samoa, Tokelau and Tuvalu, was over 62 percent. Obesity is also prevalent in the Caribbean, for example in Saint Kitts and Nevis and Puerto Rico, the prevalence of obesity in 2022 was 45.6 and 41.1 percent, respectively.