The National and Subnational Burden Attributable to High Body Mass Index in Iran From 1990 to 2021: A Systematic Analysis of the Global Burden of Disease Study Publisher



Najafi M ; Kheirabady MM ; Fallahzadeh A ; Golestani A ; Mousavi SM ; Khanmohammadi S ; Ghasemi H ; Tabatabaeimalazy O ; Rashidi MM ; Rezaei N ; Asadilari M ; Larijani B
Source: Journal of Diabetes and Metabolic Disorders Published:2025

Abstract

Background: High body mass index (BMI) remains a critical public health issue, significantly burdening healthcare systems. This study aimed to evaluate the burden of high BMI and its related causes in Iran from 1990 to 2021. Methods: Data from the Global Burden of Disease (GBD) 2021 project were used to assess the burden attributable to high BMI in Iran. Measures included years lived with disability (YLDs), years of life lost (YLLs), disability-adjusted life years (DALYs), and deaths, presented by cause, age, sex, province, and sociodemographic index (SDI). Summary exposure values (SEVs) were also analyzed to indicate exposure levels. All estimates were reported with 95% uncertainty intervals (UIs). Results: The age-standardized DALYs per 100,000 population attributable to high BMI increased by 39.3% (17.4 to 55.9), from 1570.8 (95% UI: 801.5 to 2356.3) in 1990 to 2188.4 (1020.5 to 3231.0) in 2021. Similarly, the age-standardized death rate rose by 28.2% (6.55 to 46.07), from 55.9 (32.4 to 81.7) in 1990 to 71.6 (39.2 to 106.8) in 2021. For both sexes, the premature death rate (under 70 years) rose from 14.05 (7.66–20.36) in 1990 to 26.42 (13.78–37.97) in 2021. Cardiovascular diseases (CVDs) and diabetes and kidney disorders remained the leading causes of high BMI-related deaths. From 2010 to 2021, low SDI provinces saw greater increases in BMI-attributed death rates compared to 1990–2010. SEV values rose across all age groups from 1990 to 2021, particularly among females aged 60–69. Between 2019 and 2021, SEV changes accelerated compared to 2010–2019. Conclusion: The burden of high BMI and related diseases in Iran has increased substantially over the past three decades. This trend highlights the urgent need for targeted public health initiatives to mitigate the health and economic impacts of obesity, particularly addressing disparities related to sex, age, and provincial SDI levels, while focusing on CVDs and diabetes prevention. © The Author(s), under exclusive licence to Tehran University of Medical Sciences 2025.