Eli Lilly and Company

Executive Summary

Obesity represents a critical public health challenge in China, contributing to a wide range of chronic conditions, elevated mortality risk, and a growing national health and social burden. Widely recognized as a chronic disease, obesity is an important risk factor for more than 200 other conditions, including diabetes, hypertension, dyslipidemia, cardiovascular diseases, respiratory diseases, and reproductive disorders. Obesity also significantly increases mortality risk. Studies show that each one-unit increase in Body Mass Index (BMI) is associated with on average 9% higher risk of mortality among individuals with obesity. At present, obesity has become the sixth leading risk factor for death and disability in China, exerting a profound impact on the country’s future disease burden and healthy life expectancy.

China has the world’s largest population who suffer from overweight or obesity, and the prevalence continues to rise with earlier onset and widening urban–rural disparities. According to the latest statistics, China’s prevalence of overweight and obesity among adults stood at 50.7% in 2024, affecting approximately 532 million people and ranking first globally. If the trend continues, by 2030, this figure will reach 70.5% (approximately 811 million adults). Among adolescents, the prevalence is projected to rise from 19.8% to 31.8%, while that of rural adults would reach 73% by 2030. There is a pressingneed to prioritize resources to address the rising trends, particularly in primary care settings.

Overweight and obesity have inevitably become a major healthcare and economic burden due to high medical costs and reduced labor productivity. A study conducted by multinational business intelligence firm GlobalData based on official public databases and multivariable regression models shows that, the total economic costs related to overweight and obesity in China reached approximately CNY 1 trillion in 2025, accounting for 0.7% of China’s national GDP, roughly equivalent to the 2025 GDP of Chinese cities like Wenzhou or Dalian. Of these costs, 40% came from the direct medical costs of obesity and its comorbidities and 60% from the incurred productivity losses. If no action is taken, the figure will rise by 30% to about CNY 1.3 trillion within a decade. As labor quality and supply gradually weaken, such trend will exert sustained pressure on China’s economic growth potential and pose risks to development resilience over the medium and long term.

From international perspective, clinical intervention and evidence-based treatment have become widely recognized as cornerstones of effective obesity management, bringing both health benefits and long-term economic value. An international leading journal has suggested a clear distinction between pre-clinical obesity and clinical obesity, and proposed systematic medical treatment for patients with clinical obesity. The World Health Organization (WHO) guideline on the use of glucagon-like peptide-1 (GLP-1) therapies for the treatment of obesity in adults published in December 20252 also note that pharmacotherapy is an important component of comprehensive interventions for obesity. It is therefore evident that integrating obesity into the clinical care system has become a key global approach to obesity management. Studies further show that timely treatment with innovative drugs can not only deliver significant and sustained health benefits, but also generate substantial long-term economic returns by reducing the burden ofcomorbidities, slowing labor force decline, and increasing labor force participation. This yields multiple benefits: improving health, enhancing productivity, reducing premature deaths, and boosting economic growth.

It is encouraging to note that, through a series of policy documents such as Healthy China 2030 and the Implementation Plan for the Year of Weight Management Initiative, China has been progressively elevating the importance of weight management in terms of both policy level and dimension. However, implementation still faces uncertainties, particularly in primary care and rural settings and at the healthcare security level. In primary care institutions and rural areas, practical challenges remain prominent: significant improvements are needed in clinical capacity, standardized management, and equitable access to medications. Furthermore, although obesity is widely recognized as a chronic disease within the medical community, it has not yet been incorporated into the healthcare security system. A clear scientific distinction between clinical weight management and cosmetic weight loss has yet to be established at the policy level, which limits insurance coverage for innovative therapies with proven clinical value. These gaps in healthcare security and service delivery hinder the development of a fully integrated, closed-loop management system for obesity, and ultimately restrict the overall effectiveness of national obesity governance.

China is now at a critical turning point, and immediate action is needed. While China has prioritized weight management on the national agenda, more proactive, scientific and systematic efforts should be made to effectively curb the rising prevalence of obesity: 

1. Elevate weight management in the 15th Five‑Year Plan for National Health with long‑term implementation plans and sustained investment, creating synergy between health promotion and economic growth.

Weight management shall be integrated into the National Health Plan for the 15th Five-Year Plan period, with a Healthy Weight campaign and clear national obesity control targets. A cross-departmental collaboration mechanism and a holistic assessment mechanism (for instance, by drawing on assessment indicators forconditions like hypertension and diabetes) shall be established. We should also incorporate weight management services such as BMI and waist circumference measurements into the basic public health service system, thereby promoting the systematization of resource investment and policy support. 

2. Recognize the value of pharmacotherapy for obesity and expand access to evidence‑based solutions, including evaluating the inclusion of innovative obesity management medications (OMMs) on the National Essential Drug List to achieve broader access.

Current interventions focus primarily on lifestyle change, underestimating the value of pharmacotherapy for weight management. The newly released WHO Guidelines provide a holistic and standardized model for weight management, with focus on pharmacotherapy. By aligning with the WHO Guidelines and Lancet’s definition of clinical obesity, weight management and obesity treatment capacity should be strengthened at primary care level and innovative OMMs should be scientifically evaluated to be included on the National Essential Drug List (NEDL) to expand access, particularly in rural areas.

3. Comprehensively reduce the disease burden by gradually covering clinical obesity treatment in the basic medical insurance and exploring innovative payment schemes.

Clinical obesity treatments remain excluded from reimbursement due to being grouped with cosmetic weight‑loss products. With the consensus of obesity as a complex, relapsing, chronic disease, weight management for clinical purposes should be clearly differentiated from lifestyle‑related treatments such as cosmetic weight loss. By adopting health technology assessment and cost-effectiveness analysis, medium-to high-risk populations (e.g., patients with moderate to severe obesity) should be gradually covered by basic medical insurance, supplemented by innovative payment schemes and a sustainable and equitable healthcare financing system to comprehensively reduce the economic burden of obesity.

Download the full report：From Healthy Weight to Healthy Economy:  Upgrading Weight Management and Affordability for Long-term Socio-economic Resilience