Obesity & Systems
Systems are driving the global rise in obesity and non-communicable diseases (NCDs)
The global rise in obesity and non-communicable diseases (NCDs) is being driven by failing systems.
Health systems are often ill-equipped to care for people living with obesity and may perpetuate bias and stigma. Food systems are shaped by commercial interests, where unhealthy products are widely produced, heavily marketed and readily available. Many planning and transport systems discourage physical activity, making active travel and movement less accessible.
People living with obesity are leading calls for change - and progress will require action across multiple sectors.
No single intervention can halt the rise in obesity. Addressing obesity requires a comprehensive approach across health and food systems, our environments, and wider society.
Taking action on obesity is also a critical step in reducing the global burden of chronic diseases including diabetes, cardiovascular disease and cancer.
Priorities for change
Lasting progress requires coordinated action across three key areas:
Health Systems
Providing compassionate, accessible obesity care
Health systems around the world are not equipped to effectively address obesity. Many systems perpetuate bias and stigma, with healthcare providers lacking the training to offer appropriate, people-centred obesity care. Limited integration of obesity services within primary healthcare and inadequate insurance coverage for obesity treatment leave many without the support they need.
The challenge
People living with obesity often experience judgement and discrimination in healthcare settings. This can discourage people from seeking care and can affect the quality of care they receive.
Many health systems focus on conditions such as diabetes and cardiovascular disease without addressing obesity as a disease and a root cause of other NCDs.
High costs, limited coverage and a lack of available services create significant barriers to effective treatment and management.
Priorities for action
To strengthen health systems, we need:
Recognition of obesity as a disease
- Recognise obesity as a disease and establish monitoring and surveillance systems to better understand and manage obesity at the population level
Integration of obesity into NCD programmes
- Integrate and scale up obesity prevention and management services within NCD programmes, with a focus on primary health care
- Ensure comprehensive and continuous care across the life course
Improved accessibility and coverage
- Include obesity services across all levels of the health system (primary, secondary and tertiary) in insurance and universal health coverage packages
- Ensure equitable access to treatment and long-term support
Training for the health workforce
- Resource and train the health workforce to deliver people-centred obesity care
- Provide education and tools to deliver compassionate, stigma-free and effective care
Person-centred and holistic care
- Services should address the medical, psychological and social aspects of obesity
- Care should be respectful, supportive and tailored to individual needs
Health systems that treat obesity as a chronic disease, prioritise prevention, and deliver holistic, people-centred care can reduce the burden of obesity-related diseases and improve quality of life for millions.
Food Systems
Building a healthier future through better food environments
Our current food systems are failing us. Multinational corporations dominate, producing unhealthy foods that are highly profitable, heavily marketed and widely accessible. These products - often ultra-processed and high in sugar, salt and unhealthy fats - contribute to rising obesity rates.
Power imbalances between commercial and public health actors create food environments that promote unhealthy consumption, while healthier options can be less desirable, less accessible and less affordable.
The challenges
Billions of dollars are spent every year advertising unhealthy food and beverage products, often targeting children and vulnerable communities.
Healthy food can be less accessible, particularly for low-income households. Ultra-processed foods are engineered to be highly palatable, contributing to overconsumption and poor diet quality.
Priorities for action
To transform food systems, we need action that reduces exposure to unhealthy products and improves access to healthier options.
Stronger government regulations
Stronger government regulation is needed to reduce the consumption of unhealthy foods and beverages, including:
- Fiscal policies such as taxes on sugar-sweetened beverages
- Front-of-pack nutrition labelling and mandatory nutrient declarations
- Marketing restrictions on unhealthy products, particularly where children are targeted
Government regulation can also encourage healthier products by supporting reformulation and accountability across the food and beverage industry.
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Equitable access to healthy food across the life course
Food systems must also support healthier diets by ensuring everyone can access nutritious food, including:
- Protection, promotion and support for breastfeeding
- Healthy public food procurement and service policies in schools, workplaces and public institutions
- Reformulation of food and beverage products to support healthier diets
By creating healthier food environments, we can improve diet quality, reduce obesity-related harms, and build systems where nutritious food is the easy choice for everyone.
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Our Environments
Creating supportive spaces for healthier lives
Our environments play a crucial role in shaping health. Many towns and cities discourage active lifestyles, with limited green space and unsafe walking and cycling routes. In wider society, social norms reinforced by the media can perpetuate obesity stigma, while workplaces do not always prioritise the health and wellbeing of staff.
The challenges
A lack of safe and accessible spaces for physical activity contributes to sedentary lifestyles.
When walking, cycling and public transport are not prioritised, communities become car-dependent and less active.
Media narratives can perpetuate stigma around obesity, affecting mental health and reducing the effectiveness of obesity interventions.
Priorities for action
To create healthier environments and shift societal attitudes, we need:
Urban planning and local government action
- Local governments creating public green spaces for active recreation and sport for people of all ages and abilities
Supportive transport systems
- Transport systems that promote walking and cycling routes
- Safer, more accessible active travel and public transport options
Incentives for physical activity
- Fiscal measures to encourage physical activity, such as reduced tax on sporting goods and subsidies for extracurricular physical activity programmes
Ending stigma in the workplace
- Employers proactively addressing obesity stigma and prioritising the health and wellbeing of all staff
New media narratives
- Media playing an active role in addressing stigma and changing the narrative around obesity
- Greater focus on systemic drivers of obesity rather than individual blame
By transforming built environments, workplaces and media narratives, we can support physical and mental health, reduce obesity stigma, and create communities where everyone can thrive.
The systems approach to obesity and NCD prevention
The rise in obesity and NCDs is not inevitable - but it will not be solved through individual action alone. Obesity is shaped by the systems around us: the healthcare we can access, the food environments we live in, and the communities and societies that influence our opportunities to live healthy lives.
To reduce obesity and the wider burden of NCDs, governments, health systems, industry, employers, media, and communities must act together- creating supportive environments where healthier choices and better care are accessible to all.