Calling it “the greatest threat to human and planetary health, affecting most people in every country and region”, The Lancet Commission on Obesity has sounded the alarm to combat the dire consequences for people and the planet of the health impacts of obesity, undernutrition and climate change. Noting that for the past two decades the three issues have been treated separately, the commission added that, “policy responses have been unacceptably slow.”
The commission describes the interplay among the issues as the “Global Syndemic” (a syndemic is the presence of two or more disease states that adversely interact with one other, negatively affecting the mutual course of each disease trajectory). The study analyzes the major problems with our current responses and sets out bold and far reaching prescriptions to address them. For the full report, visit thelancet.com
The commission says that powerful vested interests and misplaced economic incentives are the major drivers of the joint pandemics of obesity, undernutrition and climate change. The three-year project, undertaken by 43 experts from 14 countries, looks at how they are linked through common drivers, and then proposes shared solutions.
“Malnutrition in all its forms (undernutrition and obesity) is by far the biggest cause of ill health and premature death globally. Both undernutrition and obesity are expected to be made significantly worse by climate change.”
scale of the problem:
excess body weight affects two billion people globally, causes four million deaths and costs $2 billion annually in health care costs and lost economic productivity.
obesity is increasing in every region of the world and efforts to combat it have been largely ineffective.
stunting and wasting affect 155 million people and 52 million children globally.
two billion people suffer from micro-nutrient deficiency.
815 million people are chronically undernourished.
The study argues the predominant business model of large international food and beverage companies focuses on “maximizing short-term profits leading to over-consumption of nutrient-poor foods and beverages in both high-income and increasingly in low and middle income countries.”
The commission says part of the challenge is to overcome the “powerful commercial engineering of over-consumption”, and showcases examples of food deserts and food swamps (ubiquitous fast food outlets) in low income areas. The study went on to say, “low and middle income countries need to be protected from exploitation and predation by food and beverage companies and supported to achieve sustainable and healthy economic growth.”
“Powerful opposition by vested interests, lack of political leadership and insufficient demand for change are preventing action on the Global Syndemic, with rising rates of obesity and greenhouse gas emissions and stagnating rates of undernutrition.”
The commission recommends a wide range of solutions for food and agricultural systems, transportation systems, health care policy and urban design. For example:
1) Establishing a new global treaty to limit the political influence of Big Food — a proposed Framework Convention on Food Systems (FCFS) — modelled on the UN global conventions on tobacco and climate change. A FCFS would restrict the influence of the food industry in policy making and mobilize national action for healthy, equitable and sustainable food systems.
2) Creating sustainable and health-promoting business models to shift emphasis from a short-term profit-only focus to sustainable profitable models that include benefits to society and the environment.
3) Redirecting US$5 trillion in government subsidies away from fossil fuel and animal agriculture products towards sustainable alternatives. There were almost US$500 billion in global agricultural subsidies (mostly to beef and dairy), as well as grains used for animal feed or ultra-processed foods, in the top 21 food producing countries in 2015.
4) Creating stronger advocacy from civil society to demand action and break decades of political inertia.
5) Reducing red meat consumption through taxes, redirecting subsidies, health and environmental labelling and social marketing, “would lead to healthier diets for cancer and obesity prevention, more land for efficient sustainable agriculture, providing opportunities to reduce undernutrition and lower GHG emissions from agriculture.”
The commission argues that to address the Global Syndemic requires “a radical rethink of how we eat, live, consume and move ...”.
It is proposing “urgent sustainable solutions to achieve both a healthy body weight for people and a healthy ecosystem for the survival of our planet.”
Our future depends on filling this prescription.