Obesity is a common metabolic disease that has become a serious public health problem worldwide. In recent decades, with the rapid development of China's economy and the acceleration of globalization and urbanization, the rate of overweight and obesity in China has shown a rapid rise, and it is urgent to carry out the prevention and control of obesity in the whole population.

To analyze the status quo and changing trend of disease burden due to high BMI in China from 1990 to 2019, and to predict the Disability-Adjusted Life Years (DALY) normalization rate of high BMI in China in the next decade, providing reference for formulating obesity prevention and control strategies in China.

The data of DALY number and DALY normalization rate attributed to high BMI in China from 1990 to 2019 were extracted from the global Burden of Disease database, and the burden of disease due to high BMI in China was analyzed from the aspects of gender, age and the burden of disease attributable to high BMI. Using the estimated annual percentage change (EAPC) to represent the change trend, a grey prediction model GM (1, 1) was established to predict the DALY normalization rate attributed to high BMI in China from 2020 to 2030.

From 1990 to 2019, the number of deaths and DALY attributable to high BMI in China increased by 225% and 215%, respectively. The standardized mortality rate (EAPC=1.21%, P<0.001) and the standardized DALY rate showed an increasing trend (EAPC=1.41%, P<0.001). The burden of DALY attributed to high BMI and its growth rate was significantly higher in men than in women over the same period. The burden of DALY caused by high BMI increased with the increase of age, and the burden of <5-19 years old increased rapidly, and the increase trend of males at all ages was increasing, and the increase trend of females at 20-54 years old was unstable, and the increase rate was accelerated at 55 years old and above. In 1990 and 2019, the top four diseases with the greatest burden of DALY attributed to high BMI were stroke, ischemic heart disease, diabetes and hypertensive heart disease, and the diseases with rapid increase of DALY normalization rate were mainly tumor and musculoskeletal diseases. The number of DALY caused by high BMI in 2019 accounted for 6.50% of the total number of DALY in 2019, ranking fifth among 69 risk factors. GM (1, 1) forecast shows that the DALY normalization rate of high BMI in China will continue to rise from 2020 to 2030. In 2030, the DALY normalization rate of high BMI in China will be 1 452.52/ 100 000, among which 1 845.81/ 100 000 for males and 1 106.74/ 100 000 for females.

The burden of diseases caused by high BMI increased significantly in China from 1990 to 2019, and targeted intervention measures should be taken for people of different genders and different age groups, focusing on the prevention of diseases and cancers caused by high BMI. The disease burden of high BMI will increase further in the next decade, and a nationwide community obesity prevention and control effort is urgently needed.

肥胖是目前常见的代谢疾病，现已成为全球范围内危害严重的公共卫生问题。近几十年来随着中国经济的快速发展、全球化和城镇化进程加快，中国超重肥胖率呈现快速上升的趋势，开展全人群肥胖防控工作亟不可待。

分析1990—2019年中国归因于高BMI的疾病负担现状及变化趋势，并预测未来十年高BMI的伤残调整寿命年（DALY）标化率，为我国制定肥胖防控策略提供参考依据。

提取全球疾病负担数据库中1990—2019年中国归因于高BMI的DALY数、DALY标化率等数据，从性别、年龄、高BMI的归因疾病负担等方面分析中国高BMI疾病负担，用年估计变化百分比（EAPC）表示变化趋势，建立灰色预测模型GM（1，1）预测2020—2030年中国归因于高BMI的DALY标化率。

1990—2019年中国归因于高BMI的死亡例数、DALY数分别增长225%、215%，标化死亡率（EAPC=1.21%，P<0.001）与DALY标化率呈上升趋势（EAPC=1.41%，P<0.001）。男性归因于高BMI的DALY负担及其增长速度明显高于同时期的女性。高BMI导致的DALY负担随着年龄的增加而增加，<5~19岁的负担快速增长，男性全年龄均呈上升趋势，女性20~54岁增长趋势不稳定，55岁及以上加速增长。1990年与2019年高BMI的归因DALY负担最大的前4种疾病均是脑卒中、缺血性心脏病、糖尿病、高血压性心脏病，DALY标化率增长较快的疾病主要为肿瘤与肌肉骨骼疾病。2019年高BMI所致的DALY数占该年总DALY数的6.50%，在69个危险因素中顺位第五。GM（1，1）预测显示，2020—2030年中国高BMI的DALY标化率持续上升，2030年中国高BMI的DALY标化率为1 452.52/10万，其中男性1 845.81/10万，女性1 106.74/10万。

1990—2019年中国高BMI导致的疾病负担明显增加，应针对不同性别、不同年龄段的人群采取针对性的干预措施，重点关注与预防高BMI导致的相关疾病与癌种。未来十年高BMI的疾病负担将进一步加重，开展全国范围的社区肥胖防治工作已亟不可待。