The problems could cost the equivalent of US$57 billion, around 22 per cent of the total national health budget
Jane Caiin, Beijing
Published: 12:00pm, 6 Apr 2025Updated: 8:41pm, 6 Apr 2025
China, plagued with famine six or seven decades ago, is facing an obesity crisis, prompting warnings that more than 65 per cent of adults could be overweight or obese by 2030.
Beijing is racing against time before chronic diseases such as hypertension, diabetes and cardiovascular problems place further pressure on the country’s healthcare system.
Last year, the National Health Commission (NHC) and other government departments launched a three-year plan to tackle the problem, which includes diet and exercise recommendations.
Last month it stepped up its efforts, by announcing a plan to introduce multidisciplinary “weight management clinics” at hospitals across the nation.
According to a study published in The Lancet last month, by 2021 the number of overweight or obese adults in China had passed the 400 million mark – compared with 180 million in India or 172 million in the United States. This figure is projected to rise to 630 million by 2050.
The study used the World Health Organization’s definition, which classes people with a body mass index (BMI) – a person’s weight divided by the square of their height – of over 30 as obese.
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However, the Chinese government has its own definition of obesity, which classifies a BMI over 24 as overweight and a reading exceeding 28 as obese – and the NHC warned that an official study had predicted that 65 per cent of Chinese adults would be overweight or obese by 2030.
The study also calculated that treating overweight and obese patients by then would cost 418 billion yuan (US$57 billion), the equivalent of 22 per cent of the annual national health budget, compared with 8 per cent in 2022.
During last month’s meeting of the national legislature and top political advisory body, Zhang Wenhong, an infectious disease expert, said the health system would be “targeting big bellies”.
“We want to help people lose weight,” he added.
But some people said making lifestyle changes was a challenge.
Wang Xiaoni, 33, a bank employee in Shanghai, said she often ate and drank more when she was feeling stressed and unhappy and often did not have time to exercise.
“I eat snacks when I’m unhappy with my boss or work long hours, which is quite often,” Wang said. “I also eat a lot when I’m worried about being laid off. The economy is not good and many banks have cut staff or frozen hires.
“My university classmates can hardly recognise me. I used to be quite slim. Now I’m approaching the threshold of obesity.”
Wang said she was “motivated to make some changes” but express delivery services meant it was “hard to resist” unhealthy snacks such as chips, sweets and milk tea.
Nearly one third of Chinese children aged over seven could be overweight or obese by 2030, compared with 19 per cent in 2018, according to the NHC.
The Ministry of Education has announced a range of measures to tackle the problem, including adding BMI to pupils’ physical education assessments and asking schools to set aside at least one hour a day for outdoor activities, reduce the amount of homework and expand break times from 10 minutes to 15.
But Chen Yiyang, a schoolboy in Beijing, said he ate to “reward myself” as he struggled with exam pressures, heavy loads of homework and limited break time at school.
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“I always feel hungry,” Chen said. “I have to sit at least two exams per week. I do homework till 11pm every night, including weekends, which is relatively early compared with my hardworking classmates. I study hard but I’m ranked below average in almost every subject in my class. I eat to reward myself. It seems to be the only way I can get rewarded.”
He also said that despite the education ministry’s appeal to schools, homework was never reduced in his school and the break time had been cut from 15 minutes to 10.
The only change after the NHC’s guidelines were released last year was that food in the school canteen was getting blander. “There are less spicy, [or] salty dishes, to my disappointment,” he said. “So I eat less from the canteen, but more at home as compensation.”
Xu Naizhang, 76, a retired engineer in the northern city of Tianjin who is overweight, said he was eager to lead a healthier life but was worried that weight loss medication might prove too expensive for ordinary people. He is also worried about the side effects.
“Now I eat more vegetables. I do tai chi for an hour every morning. When I go to the supermarket, I stand on the weight scale. Hopefully I can lose some weight in a year so that I can recover from hypertension,” he said.
“I think the key is self-discipline,” he added. “In most cases, I can discipline myself well. But when there’s a gathering with relatives or friends, it’s difficult to refrain from eating, eating and eating.
“I had to struggle hard with the memory of famine and starvation in my childhood when food supplies were scarce. When I’m overwhelmed by that sense of lack, I can’t help eating meat, big chunks of pork, beef or mutton.”
Jane Cai, CFA, is the Beijing Bureau Chief of the Post. She has been covering China’s economic, financial, business and political news since the early 2000s.
