Over 1.6 billion adults and 340 million children are overweight or obese globally, and nearly one-half of those live in Asia. People of Asian origin are considered to be more susceptible than Europeans to obesity-associated noncommunicable diseases (NCD), including insulin resistance and metabolic syndrome, cardiovascular disease, stroke, kidney disease, and related mortality.

The factors contributing to the obesity-NCD relationship are complex, ranging from maternal malnutrition and periconceptual influences to environmental exposures during early childhood and adulthood, leading to phenotypic body types with higher total body fat content in Asians.

The World Health Organization (WHO) recommends a lower threshold of body mass index (BMI) and waist circumference (WC) for defining obesity in Asians, largely driven by evidence showing stronger magnitude of an obesity-NCD relationship in this population. However, there may be additional factors (e.g., epigenetic changes, microbiomes, impairment of liver, and pancreatic beta cells) that play a role, independent of obesity, in NCDs in Asian populations.

Furthermore, Asian populations are ethnically and racially diverse, and socioeconomic and health systems disparities exist within and between Asian countries.

Strategies for combating obesity require investment in focused research in Asian populations to better understand the factors involved in both the obesity risk and the obesity-independent-NCD risk factors. Furthermore, evidence-based efforts for changes in behaviors on the individual level that are challenging to sustain in the long term are needed. Actions on a policy and population level hold promise, though these need to be backed by good research and substantial political commitment. These efforts, however, may run counter to the vested interests of industry and tax revenue generated for the government from sales of unhealthy products.

Potential topics include but are not limited to the following:

• Evidence supporting or refuting lower thresholds to define obesity in Asian ethnic populations
• Evidence suggesting unique actors other than obesity that may be at play in the heightened risk of NCDs in Asians
• Gender differences in obesity and predisposing factors
• Novel advances in factors mediating enhanced susceptibility of Asians to vascular disease in both obese and nonobese individuals
• Studies on how presence of obesity alters diagnosis of NCDs and modifies the therapeutic benefit of interventions targeting other NCD risk factors
• Research on factors associated with obesity in Asian populations, especially social (education, income, wealth index), and life style factors (diet, physical activity, sleep, and stress) in low- and middle-income countries
• Evidence for behavioral and lifestyle interventions including incentives and Nudge strategies on weight loss (especially using digital technology and task-shifting), long term adherence to interventions, and outreach of such interventions to marginalized populations
• Studies on legislative and policy interventions targeting obesity, and their impact on NCD outcomes
• Qualitative studies on facilitators and barriers to sustainable public health interventions for combating obesity
• Economic evaluation including modeling studies on cost of obesity and related interventions