Of all the fault lines Covid-19 has exposed in global health, the need to address obesity has emerged as an unexpected but urgently important one. A new report from the World Obesity Federation shows that a shocking 2.2 million of the 2.5 million (or 90%) of global deaths were in countries with high levels of obesity. It is estimated that around 800 million people are living with obesity, and billions more are at risk. The 2019 Lancet Commission report The Global Syndemic of Obesity, Undernutrition and Climate Change demonstrated how obesity is also a pandemic, but one that has been neglected by global health… until now?
Obesity affects all parts of the world and is now rising fastest in emerging economies. Obesity is an issue in rapidly urbanizing contexts, but it is also now occurring in rural communities across the Global South. For example, in Mexico rising obesity represents a challenge among indigenous groups, people living in poverty and rural communities. In little more than half a decade the prevalence of obesity in Mexico’s adult population increased by nearly 10%.
For other health issues, such a rapid increase in prevalence would trigger an urgent public health response. Yet this is not the case for obesity, a disease of pandemic proportions but one currently omitted from the Global Burden of Disease study. As the global health mantra goes: if it doesn’t get counted it doesn’t get changed, which is one the reasons why World Obesity and partners around the world are advocating that in addition to being recognised as a risk factor, obesity also be recognised as a disease.
No country is on track to meet the 2025 WHO and UN Global Targets on childhood and adult obesity, jeopardising the achievement of the SDGs. As WHO knows all too well, the 2023 Triple Billion target that focuses on 1 billion people living healthier lives will not be met if obesity levels continue to rise in LMICs. Obesity is a global development issue that can no longer be ignored. However, the roots of obesity are complex and addressing it is hard, especially in countries where undernutrition remains a challenge and donors still default to the 20th century ‘feed the world’ development paradigm.
The UN Food System Summit later this year is a key opportunity to change the narrative on obesity and fast-track global action. There are, however, concerns that the private sector’s dominance in the Summit’s preparations may undermine human rights and limit the impact of the ‘game changing’ solutions called for. When it comes to addressing obesity, we know what needs to be done – the challenge is implementation. The tactics of some actors in the food industry to resist regulation around the marketing and sale of ultra-processed foods are well documented. We also know how some companies obstruct public health nutrition policies by lobbying, funding professional health organizations, discrediting scientific evidence, and interfering in governmental decision-making processes. In Mexico, recently, there were attempts by representatives of the food industry to block the approval of a new front-of-pack warning label system, and the industry used Covid-19 as an excuse to delay the implementation of the new labelling.
Despite the clear links between obesity and Covid-19, parts of the food industry have exploited the pandemic as a new marketing strategy. From the UK over Mexico to India, fast food companies are promoting home delivery and drive-through services to adults, and bombarding children with advertising for unhealthy products while they learn online. There are also thousands of examples of ‘Covid-washing’: where companies attempt to clean their reputation through ‘good’ deeds such as the donation of ultra-processed food to healthcare workers and food banks.
Covid-19 has shone a spotlight on obesity as a neglected global health issue, as well as the challenges of addressing it in a world where corporate power remains unchecked. But the tide is turning: a new coalition is forming with stakeholders including WHO, UNICEF and World Obesity Federation and its network to coordinate action globally. Covid-19 has shown how inexorable the links between communicable and non-communicable diseases are. The theme of World Obesity Day 2021 is ‘everybody needs everybody’. And when it comes to tackling obesity – we need everyone in global health to play their part. *
*For more information on what global health advocates can do now to help address obesity, there are resources on the website, or contact Rachel Thompson.