Obesity is a global problem. It is estimated that by 2035, more than 2 billion people will be overweight. Global initiatives under development include the MAPPS II project, led by the World Obesity Federation (WOF), … which attempts to identify how local, national and global health systems can improve obesity care, a project in which Spain is participating. ABC Salud spoke with Magdalena Wetzel, Director of Policy and Security of (WOF) during her participation in the Congress of the Spanish Obesity Society (Seedo).
Evidence Shows the Relationship Between Ultra-Processed Foods and Chronic Disease…Why Are They Driving the “Obesity Pandemic”?
‘The Lancet’ has just published a new series of studies on ultra-processed foods showing that dietary habits high in these products are consistently associated with an increased risk of obesity, type 2 diabetes, cardiovascular disease and other chronic diseases. Ultra-processed foods are replacing diets based on fresh foods and home-prepared meals, deteriorating overall diet quality and making it easier to have excess energy. UNICEF’s Feeding Profit report also documents how girls and boys are exposed to a constant supply of cheap, heavily advertised ultra-processed products, while nutritious options are less accessible. This was also a central topic at the MAPPS intersectoral table in Toledo, where it was discussed how these dynamics particularly affect children and households with fewer resources.
How does the influence of the food industry affect the regulation and control of the consumption of ultra-processed foods?
The influence of the food industry can be seen in the way food environments and policies are designed. Children and adolescents are exposed to an avalanche of marketing and the availability of cheap, ultra-processed products, while healthy options are less visible and accessible. Large companies use political pressure and communication strategies to end measures such as front-of-house labeling, restrictions on advertising aimed at children or favorable taxes. Organizations like GHAI have documented similar trends in several countries. All of this means that, even when the evidence is clear, regulation is moving more slowly than would be desirable from a public health perspective.
Do ultra-processed foods pose a threat to public health comparable to other major risk factors?
The first article in The Lancet series on ultra-processed foods and human health concludes that the replacement of diets based on fresh foods with models focused on ultra-processed foods is a “key driver” of the growing global burden of chronic diseases – an increased risk of obesity, type 2 diabetes, cardiovascular disease, depression and premature mortality. At the same time, children and adolescents are particularly exposed to these products, which amplifies their impact throughout life. Given their prevalence in the diet and the magnitude of the negative effects associated with them, many experts consider ultra-processed foods to pose a threat to public health of a magnitude comparable to other major risk factors.
“Obesity is a reflection of social inequality as well as a health problem”
Why is there such a strong relationship between obesity and socioeconomic inequality?
Neighborhoods with fewer resources tend to have more difficult access to fresh food, fewer safe spaces for physical activity, and greater exposure to products of low nutritional quality. The Gasol Foundation’s PASOS 2022 study shows that one in three children and adolescents aged 8 to 16 lives with overweight or obesity in Spain, and that the situation is worse in low-income contexts, where worse sleeping, eating and physical activity habits are also observed. All of this makes obesity, in addition to a health problem, a reflection of social inequalities and opportunities.
What is the main objective of the World Obesity Federation project?
The goal of MAPPS II is to understand how health systems respond to obesity as a chronic disease and what barriers prevent adequate care. The project analyzes everything from access to diagnosis and treatment to professional training, including stigma and territorial and socio-economic inequalities. It also studies how social and commercial determinants determine the prevention and management of obesity, beyond individual responsibility. Their results will help countries integrate obesity into universal health coverage.
How will they influence public policies?
We want to transform our conclusions into national reports, results sheets and concrete recommendations for decision-makers. These documents will inform the 2027 Global Obesity Atlas and World Obesity Day activities, providing robust data to justify reforms in primary care, financing and equity.
What results, recommendations or interventions should be obtained?
We hope to have clear national profiles, gap analysis and concrete proposals to improve comprehensive obesity care. Recommendations will include strengthening care pathways, improving professional training, reducing stigma and the link between obesity and non-communicable diseases and universal health coverage strategies. Impact will be measured by the use of this evidence in national policies and plans, by the inclusion of obesity in social benefits and by the consolidation of multi-sectoral networks involving scientific societies, organizations such as the Gasol Foundation and people with lived experience.
“The message ‘eat less and move more’ reinforces the stigmatization of obese people”
What are the limitations of traditional interventions (diet, exercise) and why do many people regain lost weight?
The message “eat less and move more” is a simplification that does not do justice to the complexity of obesity and reinforces stigma. Interventions based solely on diet and exercise typically result in modest losses and are difficult to maintain when not accompanied by ongoing clinical support and environmental changes. Many people live surrounded by cheap, high-calorie produce, have little time for cooking or physical activity, and face economic barriers to accessing professional support. In this context, holding only the individual responsible is unfair and ineffective; That’s why we talk about the need for models of chronic care integrated into health systems and policies that transform environments, not just behaviors.
“Anti-obesity treatments must be included in universal coverage so as not to widen the access gap”
What is the emerging role of new pharmacological treatments in the management of obesity?
Treatments based on GLP-1 and its analogues (of the ozempic type) have emerged as an emerging tool for certain adults suffering from obesity and who need additional support to change their habits in order to improve their health. Evidence indicates that they can help reduce weight and improve certain risk factors, always under medical supervision and as part of chronic care programs. World Obesity advocates for these therapies to be included safely, appropriately and equitably in health systems, ideally as part of universal coverage. At the same time, without deliberate equity and affordability strategies, their introduction can widen access gaps between those who can afford them and those who cannot.
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