Despite being on the political agenda for many years now, Europe is still struggling with rising obesity rates. Prevalence has tripled in many European countries since the 1980s and up to 70 percent of the European population is overweight, with 10 percent of those classified as obese.
In January 2020, I flagged up the issue and asked the European Commission about the need and urgency to update the only EU document on obesity - the White Paper on a Strategy for Europe on Nutrition, Overweight and Obesity-related health issues. Updating the strategy to fight obesity is of the utmost importance, as this is an issue we need to take seriously. Obesity is associated with reduced life expectancy and is a gateway to other health issues, such as heart disease and diabetes, that affect the wellbeing of individuals and society as a whole.
“People with obesity are at greater risk from Coronavirus infection because of underlying medical conditions such as heart disease and type 2 diabetes”
Also in 2020, the world had to face an unprecedented crisis - the COVID- 19 pandemic. A few months later, a meta-analysis of many studies from around the world, published in the journal ‘Obesity Reviews’, concluded that obesity leads to a 48 percent increase in the risk of dying from COVID- 19. The study showed that people with obesity are at greater risk from Coronavirus infection because of underlying medical conditions such as heart disease and type 2 diabetes. In addition, obesity can cause metabolic changes which make it harder for the body to fight off infections. If we add to the information provided by this study, and the fact that obesity is also considered an epidemic, we find ourselves at a crossroads of two major public health challenges that overlap and increase the burden on both people and Health Care Systems.
It is therefore crucial to treat obesity as a serious public health problem and, as such, we need concrete political measures that help prevent and provide treatment for it. The European Commission’s answer to my question was insufficient, essentially repeating the line that this public health problem should mainly be tackled through prevention, and that obesity is an issue of personal choice and responsibility. However, the solution to this public health problem lies primarily in health promotion activities that seek to change health-related dietary and physical activity behaviour. Policymakers have to address this health problem through public information, consumer education and the support of increased participation in sport and exercise. But, this is not enough. We need more.
There are millions of people already struggling with being obese or overweight. For those who are already obese the reasons are often complex, so any approach to tackle their excess weight requires considerable nuance and understanding of the issue. The World Health Organization considers obesity as a global epidemic, and recognises that its increasing prevalence must be attributed to several biopsychosocial processes, in which the political, economic, social, and cultural ‘environment’, and not only the individuals and their choices, assumes a strategic place in the analysis of the problem and in the proposals for interventions aimed at solving it.
Numerous studies have illustrated that higher levels of food insecurity and obesity persist in the most vulnerable communities, reflecting that the problem that food scarcity is linked to factors contributing to obesity-related risk factors. The consequences of promoting and advertising ultra-processed foods and their lower prices compared to nonprocessed and locally produced food should not be overlooked.
“The prevention and treatment of obesity requires political choices. Choices that influence the availability, production and dissemination of food products”
One of the EU Farm to Fork Strategy’s objectives - to reverse obesity rates by 2030 - is a testament to the increased awareness of this issue across the European Union. But the objective will not be achieved without real action. The Farm to Fork Strategy’s policy proposals are focused, as usual, on improving food information to consumers, which alone is not enough to tackle the growing issue of obesity.
The prevention and treatment of obesity requires political choices. Choices that influence the availability, production and dissemination of food products. Public interests must prevail over profit maximisation on food commodities, as well as over the food industry lobby’s influence on decision- making.
We need to take into account the impact of food production and the support given to sustainable agricultural practices, distribution models, the right to healthy food, and the integrity of the environment. Healthy habits that are affordable and accessible to all cannot be dissociated from countries’ food sovereignty, market availability of fresh and local food products, as well as short food circuits to improve their access.
Meaningful change will require policymaking processes aimed at prioritising universal and quality public health services to all citizens, without exclusion, as a solid and fundamental background to a more explicit engagement with the social, economic and political drivers of obesity.