Recommendation: Expert Consensus and Call on Actions for Weight Management in China: Advancing Healthy China Initiative Through Strategic Actions

In support of China’s national weight management initiative, this consensus outlines 10 strategic recommendations across five key domains: 1) strategic policy and guideline implementation, 2) strengthening healthcare systems and public awareness, 3) collaborative and international engagement, 4) building health-conducive environments, and 5) data-driven approaches and technological solutions. These recommendations provide a comprehensive framework for addressing obesity prevention and control while fostering a healthier society across China. Through the integration of diverse strategies and multi-sectoral engagement, the Initiative establishes a robust and evidence-based approach to weight management. Each strategic domain targets specific aspects of the obesity challenge, ensuring comprehensive coverage and measurable outcomes. The following sections detail these 10 strategic recommendations.

Obesity prevention and control must be strategically integrated into China’s comprehensive public health agenda, particularly within the framework of the Healthy China initiative. This initiative, encompassing health promotion, disease prevention, and healthcare reform, provides an established platform for addressing the escalating obesity epidemic. By incorporating targeted obesity interventions within the 15 key actions of the “Healthy China” initiative, policymakers and stakeholders can enhance the prioritization and implementation of evidence-based interventions.

For instance, implementing price-tilting policies to improve access to nutritious foods can significantly influence dietary choices and reduce obesity prevalence. Evidence from Mexico demonstrates that taxes on sugar-sweetened beverages led to a 12% reduction in consumption within the first year (15). Similarly, comprehensive food labeling systems, such as the UK’s “traffic light” scheme, enhance consumer nutritional literacy and promote healthier purchasing decisions (16). Beyond dietary interventions, infrastructure improvements through pedestrian and cycling pathway construction have been shown to increase physical activity levels, as evidenced in the Netherlands, where targeted investments in cycling infrastructure yielded improved public health outcomes (17). Furthermore, integrating obesity prevention into health insurance frameworks facilitates access to essential health services while emphasizing preventative care, ultimately reducing long-term healthcare costs and improving population health outcomes. Evidence from the United States indicates that health insurance coverage type and availability significantly correlate with BMI and healthcare utilization patterns (18).

The development and implementation of comprehensive, age-specific professional guidelines for obesity prevention and control is essential for systematically addressing rising obesity rates across diverse populations. Such guidelines enable standardized healthcare delivery and public health initiatives, ensuring consistent and effective interventions tailored to specific nutritional and physical needs of different demographic groups.

The incorporation of obesity prevalence, awareness, treatment, and control rates as key performance indicators into evaluation systems, such as those employed in “Healthy City” programs and the “National Comprehensive Prevention and Control of Non-communicable Diseases,” facilitates objective assessment of health policy effectiveness. These metrics provide crucial data to guide policymakers and health professionals in optimizing dietary regulations and physical activity programs. Recent years have seen significant progress, with institutions including the National Health Commission (NHC), the National Disease Control and Prevention Administration (NDCPA), the Chinese Center for Disease Control and Prevention (China CDC), The Chinese Preventive Medicine Association (CPMA), and the Chinese Nutrition Society (CNS) developing and releasing comprehensive professional guidelines for dietary education and exercise in weight management. These initiatives reflect China’s commitment to establishing professional technical standards and robust evaluation mechanisms, representing crucial steps toward achieving the “Healthy China Action Plan (2019–2030)” and the “National Healthy Lifestyle Action Plan (2017−2025).” Domestic organizations and institutions must continue collaborating to advance these initiatives. Campaigns such as “National Healthy Lifestyle Month” provide valuable platforms for mobilizing academic associations, foundations, enterprises, communities, and healthcare institutions to collectively refine and disseminate obesity prevention and control guidelines and evaluation systems throughout China.

The cornerstone of effective obesity control lies in robust, integrated nutrition and exercise management systems within primary healthcare institutions. These systems ensure healthcare providers can deliver evidence-based interventions tailored to individual needs, thereby optimizing health outcomes and promoting sustainable weight management. Research demonstrates that incorporating structured nutrition and exercise programs into primary care significantly improves weight management outcomes and reduces obesity-related comorbidities (19).

A critical component of this strategy is the development and implementation of standardized nutrition prescriptions and comprehensive guidelines for food, diet, and exercise interventions. These guidelines should seamlessly integrate clinical care with public health priorities, ensuring consistent, high-quality care delivery from initial diagnosis through ongoing management and treatment.

The establishment of a professional system for dietitians, aligned with international best practices, represents another crucial element. This includes formalizing dietitian roles in primary care, implementing structured training programs, and empowering dietitians to design and deliver effective food, dietary, and exercise prescriptions. To ensure sustainability, an appropriate fee structure must be established that reflects the value of dietitian-led services. Specifically, dietary and exercise prescriptions should be incorporated as reimbursable services within the healthcare system, promoting financial sustainability while expanding access to essential nutrition and exercise management interventions, particularly for underserved populations.

Optimizing service delivery requires establishing clear referral pathways and integrated linkages between clinical facilities, community-based programs, and self-management initiatives. This integration reduces care fragmentation and fosters a comprehensive approach to obesity management, ultimately enhancing patient outcomes. Furthermore, reforming health insurance policies to cover obesity prevention and treatment services expands access to essential care, particularly for vulnerable populations. Such coverage not only facilitates early intervention but also mitigates the long-term healthcare burden associated with untreated obesity, promoting a more equitable healthcare system.

Public engagement initiatives, such as National Nutrition Week, serve as valuable platforms for integrating and promoting food therapy, dietary prescriptions, and exercise prescriptions. These initiatives raise awareness about professional nutrition care’s importance, empower communities with evidence-based strategies for obesity prevention, and highlight dietitians’ crucial role in achieving sustainable health outcomes.

The Weight Management Initiative emphasizes the critical importance of enhancing public health literacy through targeted dissemination of evidence-based nutritional knowledge. This comprehensive approach aims to empower individuals and families to make informed decisions about their health behaviors. By delivering scientifically grounded health information through culturally appropriate educational content, populations become better equipped to implement sustainable lifestyle modifications that promote healthy weight management.

Health literacy extends beyond mere information acquisition; it encompasses the development of practical skills necessary for individuals to effectively navigate the healthcare system, critically evaluate health information, and make informed decisions about their well-being. The initiative’s approach to health communication emphasizes both theoretical knowledge and practical application, ensuring that weight management principles are not only understood but can be meaningfully integrated into daily life. This comprehensive strategy aims to create a sustainable framework for lifelong health maintenance by fostering an environment where evidence-based weight management practices are both accessible and actionable across diverse population groups.

Effective weight management requires a comprehensive, systems-based approach that integrates multiple sectors and stakeholders, as obesity’s complex etiology extends beyond individual behaviors to encompass societal, economic, and environmental factors. This multi-sectoral strategy necessitates coordinated action across education, economics, commerce, agriculture, and urban planning sectors to create an environment that naturally promotes balanced nutrition and regular physical activity. Educational initiatives can enhance health literacy and reshape attitudes toward healthy behaviors, while economic and commercial policies can incentivize the availability and accessibility of nutritious food options. Agricultural policies can strengthen local food systems and improve access to fresh, affordable produce, while urban planning can integrate physical activity opportunities through thoughtful design of public spaces, pedestrian-friendly infrastructure, and accessible recreational facilities.

International collaboration among government agencies, academic institutions, and social organizations enables the synthesis of diverse perspectives and evidence-based strategies, leading to more robust and effective obesity management approaches. The “Belt and Road” initiative provides a unique platform for bilateral and multilateral cooperation, facilitating the exchange of successful interventions while showcasing China’s innovative approaches to obesity prevention and control. This strategic framework allows for the development of culturally-adapted interventions that address local needs while maintaining scientific rigor.

Moreover, international knowledge exchange enhances understanding of global obesity trends and intervention effectiveness across different populations and contexts. Such collaborations can advance research methodologies, deepen mechanistic insights into obesity development and progression, and inform evidence-based policy development at both local and global levels. This shared learning environment accelerates the identification and implementation of best practices while avoiding the duplication of unsuccessful approaches.

The promotion of effective weight management necessitates a comprehensive environmental framework operating at macro-, meso-, and micro-environmental levels, with each stratum playing a distinct yet interconnected role in fostering sustainable health behaviors.

At the macro-environmental level, structural and systemic interventions are paramount. Strategic policies must ensure equitable access to affordable, nutritious foods, while urban planning initiatives should prioritize active transportation infrastructure, including integrated networks of pedestrian pathways, dedicated cycling lanes, and accessible public recreational spaces. These structural elements create a foundation that naturally encourages physical activity within daily routines.

At the meso-environmental level, institutions serve as critical implementation platforms for health-promoting behaviors. Educational institutions and workplaces should establish comprehensive wellness programs incorporating structured physical activity opportunities and nutritious meal options. Healthcare institutions must develop and implement tiered diagnostic and treatment systems that deliver personalized interventions based on evidence-based protocols. These institutional frameworks should be complemented by community-based programs that normalize and reinforce active living and balanced dietary practices.

At the micro-environmental level, households function as the primary arena for establishing lifelong health behaviors. Through targeted education and support, families can create environments that nurture positive health practices. When parents and caregivers model health-conscious behaviors and engage in shared wellness activities, they establish sustainable foundations for long-term healthy lifestyle patterns.

The imperative for society-wide engagement in youth health promotion demands comprehensive strategies that foster the early development of proper dietary and exercise habits, thereby preventing obesity and associated health complications. Educational institutions must implement evidence-based nutritional standards, ensuring the provision of balanced meals while restricting access to ultra-processed foods and sugar-sweetened beverages. Systematic approaches to promote adequate physical activity should emphasize both structured exercise programs and spontaneous outdoor activities, addressing both physical health outcomes and psychological well-being crucial for youth development.

Furthermore, interventions must address sedentary behavior patterns and establish appropriate sleep hygiene practices, recognizing their fundamental roles in cognitive function and metabolic health. Regular weight monitoring within family settings enables early identification of potential health concerns, facilitating timely family intervention when necessary. The integration of comprehensive health education into school curricula, encompassing nutrition science, physical activity principles, and weight management strategies, provides students with the knowledge base required for informed health decisions throughout their lives.

The implementation of robust weight monitoring and information-sharing mechanisms at district and county levels is fundamental to advancing evidence-based obesity management strategies. By leveraging interdisciplinary research that incorporates big data analytics and innovative technological approaches, healthcare providers and policymakers can develop nuanced insights into obesity patterns and trends across diverse populations. This data-driven approach enables the development of targeted interventions tailored to specific demographic and geographic contexts, thereby maximizing their effectiveness. The initiative emphasizes the importance of implementing and evaluating evidence-based interventions in key settings such as schools and workplaces, which serve as critical environments for establishing and maintaining healthy behaviors.

Furthermore, the integration of advanced technologies into obesity monitoring, management, and evaluation systems facilitates real-time data collection and analysis. This continuous assessment process not only enhances the precision of health interventions but also enables comprehensive cost-benefit analyses, ensuring optimal resource allocation toward the most effective strategies.

The initiative emphasizes technological innovation as a crucial driver for advancing equitable weight management across both rural and urban populations. Through the strategic deployment of smart healthcare systems, telemedicine platforms, wearable devices, and social media networks, healthcare providers can overcome geographical barriers that traditionally limit access to high-quality healthcare services and health information. These technological solutions enable the delivery of personalized health guidance and continuous health monitoring, significantly enhancing health literacy and promoting sustainable behavioral changes among diverse populations.

The integration of wearable technology provides individuals with immediate biometric feedback and activity metrics, empowering them to make evidence-based decisions about their health behaviors. Additionally, strategic utilization of social media platforms facilitates community engagement and peer support networks, creating sustainable ecosystems for health promotion across diverse demographic groups. This comprehensive technological framework not only democratizes access to health resources but also ensures that all population segments, regardless of geographic location or socioeconomic status, have equitable access to tools and support systems necessary for maintaining optimal weight and overall health outcomes.

The successful implementation of these recommendations faces several significant challenges that must be systematically addressed. Primary among these is the financial constraint, particularly acute in resource-limited settings such as rural and less developed areas (19–20). This necessitates enhanced government investment coupled with innovative financing mechanisms and robust public-private partnerships to ensure sustainable funding for programs, technologies, and professional training. Cultural considerations present another critical challenge, as traditional dietary practices and lifestyle norms may conflict with evidence-based health interventions. Success requires developing culturally sensitive interventions that meaningfully engage local leaders and integrate traditional practices with contemporary health strategies (21). Furthermore, limited public health literacy regarding obesity risks and management strategies constitutes a substantial barrier. Research demonstrates that inadequate health literacy correlates strongly with poorer health outcomes and reduced adherence to preventive measures (18). Addressing this requires coordinated public health campaigns utilizing both traditional and digital platforms to enhance understanding of obesity-related health risks while promoting actionable prevention and management strategies (22).

Addressing these implementation barriers demands robust cross-sectoral collaboration among government agencies, healthcare providers, community organizations, and educational institutions. This collaboration must focus on optimizing resource allocation, ensuring intervention scalability, and implementing effective outcome monitoring systems. Success requires seamless integration of these strategies into existing healthcare infrastructure while maintaining alignment with national guidelines for nutrition and weight management. Additionally, strategic deployment of technological innovations — including telemedicine platforms, mobile health applications, and data-driven monitoring tools — can effectively bridge care delivery gaps, particularly for underserved populations.

The Initiative’s framework extends beyond providing practical weight management solutions for Chinese residents; it offers valuable insights for nations facing similar public health challenges. Through systematic attention to financial, cultural, and awareness-related barriers, coupled with implementation of scalable, evidence-based strategies through coordinated efforts, this comprehensive approach has significant potential to enhance public health outcomes, advance health equity, and achieve sustainable long-term health objectives.

Obesity represents a complex public health challenge that demands coordinated action across all sectors of society. The Initiative provides comprehensive strategic guidance for China’s weight management efforts through multiple interconnected dimensions: individual behavioral interventions, societal influences, policy frameworks, healthcare system strengthening, and educational strategies. By positioning obesity prevention and healthy weight management as integral components of the “Healthy China” initiative, this framework emphasizes the critical need for evidence-based policy implementation, cross-sector collaboration, and international engagement. The Initiative’s particular emphasis on children and adolescent health, coupled with its promotion of healthy lifestyle adoption across all demographics, establishes a robust foundation for sustainable public health improvement.

Expert Author Group including Chun Chang, Wei Cui, Zijian Feng, Linong Ji, Hongjuan Li, Ailing Liu, Yingying Luo, Yanan Ma, Bingyin Shi, Yi Song, Deliang Wen, Qingli Xu, Juhong Yang, Yinkun Yan, Qian Zhang, Yaling Zhao, Zhirong Zeng.