BackgroundGastrointestinal (GI) cancers collectively account for over 30% of global cancer-related mortalities. Obesity is a well-established risk factor for GI cancers. We aim to investigate the temporal trends of GI cancer attributable to high BMI between 1990 to 2021 on global, regional and national levels.MethodsData was obtained from the Global Burden of Disease Study 2021. Deaths, Disability-adjusted life years (DALYs), and age-standardized rates (ASRs) were used to measure disease burden. Estimated annualized percent change (EAPC) were used to assess the temporal trend. We explored the association between SDI with high BMI-attributed GI cancer burden across 21 regions, 204 countries over the three decades.ResultsGlobally, between 1990 and 2021, all GI cancers had rising trends of deaths and DALYs attributable to high BMI. Colorectal cancer constituted the largest disease burden, with 99,268 (95% UI: 42,596-157,948) deaths and 1.17 (95% UI: 0.51-1.87)...