How should the world tackle obesity?

Cartoon of fast food and junk food

Picture credit: beastfromeast/DigitalVision Vectors via Getty Images

While the world has focused on COVID-19, another pandemic has been taking its toll, in the global north and south, on men and women. And the statistics demand action:

  • 2 billion adults live with excess weight
  • nearly 3 times as many people are living with obesity than in 1975
  • obesity is preventable and treatable – but without action can cause cancer, heart disease and diabetes

We asked the experts how they would help the world be a healthier weight.

Industry interference

Kate Oldridge-Taylor, Head of Policy and Public Affairs at WCRF: “The pandemic has shone a bright spotlight on why population health is so important – from the diets we eat to how active we are. This spotlight provides us with an opportunity to reduce obesity.

“But regardless of pandemics, now and in the future, we need to get the message through that obesity and many non-communicable diseases can be preventable.

“We know that certain strategies are effective at helping people to make healthier choices:

  • fiscal measures, such as taxing sugary drinks
  • restricting where and when unhealthy products are marketed – especially to children
  • and labelling food clearly to show whether it’s a healthy choice.

“Managing conflict of interest and industry interference in policy development is vital and requires strong political will.

“All too easily, industry is able to exploit regulatory loopholes and capitalise on situations such as the pandemic to push unhealthy products.

“Lastly, we need to change the incentives – right now, disease and disaster attract the cash, but prevention doesn’t. Global funding of prevention is tiny. Health investment focuses on treatment, and that needs to change. And unlike a disease outbreak, obesity is not a one-off event.

“Obesity measures are criticised as an overreaction or there is a lack of acknowledgement that the ‘bad thing’ ever happened. If we learn one thing from COVID-19 in our management of obesity, we need to put prevention at the heart of decision-making.”

Multitude of barriers

A woman visits a nutritionist

Marie Spreckley, Senior Nutritionist, NHS: “Patients with overweight and obesity face a multitude of environmental, social, psychological and biological barriers that need to be addressed comprehensively.

“Environmental barriers include continuous, excessive access to hypercaloric, ultraprocessed foods at low cost. This is particularly problematic when social circumstances result in financial hardship combined with a lack of food preparation skills and time.

“Psychological aspects include conditions leading to excessive food intake, medications that increase hunger levels and psychological conditions as a result of weight gain and stigma.

“Biological aspects include both genetic and epigenetic aspects that make weight management significantly more difficult.

“In order to address this comprehensively, taking into account the complexity of this disease, we need to devise strategic treatment protocols. They should draw on the support of a multitude of disciplines including behavioural therapists, dietitians, nutritionists and doctors. Solutions need to be scalable yet individual treatment requirements differ significantly.

“Research is increasingly looking into the perspectives of individuals with obesity trying to achieve long-term weight loss maintenance, which is likely the key to successful treatment as it provides wide-ranging insights from the perspectives of patients.

“Emerging pharmacotherapies that help regulate appetite and hunger – including semaglutide – are also showing promising results when used alongside comprehensive behavioural interventions. This will likely be the most promising, scalable approach going forward.”

Exercise a luxury?

Young people fist-pump after exercising

We also surveyed experts who subscribe to our e-newsletter about the factors driving obesity. Responses included:

  • big business lobbying
  • stress
  • diets too high in carbohydrates or too low in plant-based foods
  • and junk food marketing.

Others highlighted the need to learn from populations where obesity is less prevalent and the importance of educating children and adults about what a healthy diet looks like. A selection of the responses are included below:

“Treat people as individuals who do not conform to the concept of one size fits all. Teach people that they can get natural carbs from veg choices, especially when going through perimenopause, and they do not need to have a third of their plate loaded with starchy carbs. Give people quality advice and help guide them to make their choices within that advice.” – Sasha Skentelbery, Nursing Clinical Supervisor

“We don’t talk about socio-demographic factors enough – the difficulty in exercising and eating well for people who experience financial and social hardship, eg the difficulties in finding time to exercise or cook for people who have to work multiple jobs to make ends meet, or difficulty in accessing healthy, nutritious food for people who have limited financial means, poor education and limited health literacy*”

“We need to be stronger, create more opportunity and help people by reducing barriers to exercise. It is seen as a luxury, it should be a necessity.” – Dr Athalie Redwood-Mills, Senior Lecturer at Nottingham Trent University
and Owner of FiiT for Life

How do you think the world should tackle obesity? Let us know on Twitter.

*Respondent requested to remain anonymous