Multisectoral workshop on obesity in China brings together key experts from across the system

A core theme throughout the workshop was the need to look beyond individual behaviour to the biological, environmental, societal, and cultural factors which shape health. In China, participants noted that obesity is still frequently attributed to personal choice or lack of willpower, and often intervention approaches are overly narrow. 

Instead, it was felt that achieving measurable progress in obesity prevention and care will require strong leadership and cross-sectoral coordination, improved public awareness and professional capacity, as well as adequate resources, sustainable financing mechanisms and institutional support. This requires coordinated action, with a need to break down institutional barriers and establish a mechanism for regular collaborative governance. Additionally, there is a need to strengthen inter-departmental collaboration, clarify responsibilities and authorities, and better enable higher-level leadership to take the lead in integrating the efforts of relevant departments to promote the weight loss initiative.

“Obesity is a systemic social project that cannot be accomplished by the health department alone”

Meng Zhang, Tongzhou Health Commission

“The next step is not to build more clinics, but to truly connect resources- from population-level prevention, to early identification, risk stratification, proper management, and long-term follow-up and complication prevention. In other words, to expand one clinic into a service network”

Zhenping Zhao, Chinese Center for Disease Control and Prevention
 

Participants noted the importance of addressing the early developmental origins of obesity. It is now widely recognised that risk factors for obesity can be present from the preconception period, making early intervention during pregnancy essential to break intergenerational transmission. Despite this, current clinical trial populations are predominantly over 50 years of age, with limited evidence for younger age groups. There is a need to include a wide range of life stages and age groups  to provide corresponding evidence for effective interventions. 

Each stage of the life course has different critical windows and stakeholders, requiring specific strategies. For example, ensuring that guidelines for weight loss still ensure growing children get enough protein, or paying special attention to the co-occurence of obesity and sarcopenia in the elderly population. Participants advocated for a family-centred co-prevention and co-management model, with schools playing a key role through health education, balanced meals, and active living programmes that ripple out to families and communities. 

“Adopting a life course strategy for obesity control places life-stage-specific early intervention at the core, with pregnancy, early childhood and adolescence serving as irreplaceable critical windows to curb obesity and related chronic diseases in China. Preventive interventions starting from gestational weight management can effectively block the intergenerational transmission of obesity, far more cost-effective than treating established obesity in adulthood. We should integrate early-life obesity prevention into routine maternal, child and adolescent healthcare systems to consolidate long-term metabolic health across the whole lifespan.” 

Mi Jie, Beijing Children's Hospital, Capital Medical University 

Social and cultural norms and intergenerational beliefs around food and eating significantly shape dietary behaviours, underscoring the need for community-level nutrition education that reflects these contexts. Along with this, clearer, more accessible dietary guidelines for the general public are key to improving uptake of guidance. China's dietary guidelines have evolved to reflect an integrated approach to obesity prevention and management, incorporating both nutritional science and traditional dietary concepts. Participants suggested a need to go further to ensure clarity in guidelines, such as through separating fruit and vegetables.

With ultra-processed food and sugar-sweetened beverage intake among children remaining high, experts called for stronger action on the food environment  including marketing regulation, improved nutrition labelling, controls on food delivery services, and government-led fiscal measures. Innovations like the CDC-Baidu mapping tool was given as an example of what a supportive environment can look like in practice.

Obesity receives substantial policy attention, but there remains room to strengthen implementation at the primary care and community levels. There is a need for greater use of primary care, as people often bypass it and go directly to tertiary services, but participants highlighted a lack of proactive engagement from community health centres. 

Accessibility and affordability remain important barriers to obesity prevention, treatment, and care, and there are notable urban-rural disparities in specialised resources. Specialised weight management services are often concentrated in cities and better-resourced workplaces, where professional weight services are more available to those with better employee benefits. Participants stated that real progress should be measured through breadth of population coverage, improvement in health outcomes, and enhancement of health equity and accessibility. 

Participants suggested that community health institutions need to shift from passive to active engagement, with capacity building and training as key enablers. There is an opportunity to promote the application of digital technology at the community level to extend high-quality weight management services beyond hospitals. Local governments should also fully utilise surveillance data for precision intervention, recognising that each province in China has different demographic structures, obesity levels, and primary drivers. Equity, accessibility, and anti-discrimination should be core principles across all actions. 

“Real progress should mean that every community has a supportive environment for weight management, every school has scientific nutrition and physical activity education, and every workplace has a health management mechanism for employees”

Juan Xu, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology 

“Obesity is a chronic, progressive, and relapsing disease of biology—not a behavioral failure. As physicians, we must treat it as a primary disease, not merely a symptom. Furthermore, just as we define remission in other chronic conditions—such as cancer or type 2 diabetes—we must establish clear, biologically anchored criteria for obesity remission that integrate adiposity, physical functions, metabolic biomarkers, and psychological and social well-beings.”

Peng (Charles) Zhang, Executive President, China Obesity Federation (COF)

Participants highlighted the need to improve public understanding of obesity. Language around obesity is layered and matters.  Weight stigma is not only a social justice issue but also a practical barrier to prevention and extends beyond the individual to affect family and social networks. People with lived experience of obesity report that public perceptions affect multiple aspects of their lives, causing harm through emotional eating, avoidance of physical activity, and delayed care-seeking. Stigma is a long-standing cultural phenomenon that requires cultural reframing to address. Experts called for de-stigmatisation through public communication, using more person-first language, and helping the public understand that obesity is the result of multiple complex factors. 

Participants also suggested that progress in obesity prevention and care should not be assessed solely by weight or BMI reduction. Instead, there needs to be a shift from a focus on weight to a comprehensive health-oriented management model. Effective implementation requires systematic training for healthcare professionals, more inclusive healthcare environments, and the integration of mental health and social factors into the prevention system. Healthcare professionals need better training to feel confident raising weight management conversations and addressing their own biases. Lessons can be drawn from how other chronic diseases, such as diabetes, have been integrated into clinical practice. 

“Weight change is certainly an important clinical indicator, but we also need to pay attention to improvements in physical function and quality of life, whether healthy behaviours can be sustained over the long term, and whether people in need can access stigma-free medical services”

Yunyi Cheng, Xi’an Jiaotong-Liverpool University