The Weight of the World: Global Approaches To Tackle Obesity

There are now 2.1 billion people who are overweight in the world. China and India are number one and two in the world in sheer number of type 2 diabetics. In the Middle East, rates of type 2 diabetes are reaching 40 percent of the population. The World Economic Forum estimates we will spend $47 trillion over the next 20 years on lifestyle preventable chronic disease—more than the annual GDP of the six largest economies combined. This makes obesity and its related diseases among the greatest threats to economic development. America has created the worst diet in the world and is exporting it to every country on the planet. North Korea and Cuba are the only nations on the planet without Coca Cola.

Given this tsunami of obesity threatening to cripple health care systems, burden economies, and damage productivity, nations are exploring innovative strategies to reverse the tide.

Mexico is the best example of a country attempting to seek out proven practices and implement them aggressively. Soda consumption is tracked against the increasing epidemic in Mexico of obesity and type 2 diabetes. As soda hit 20 percent of calories consumed, rates of obesity and type 2 diabetes tracked perfectly. A few countries in Europe, including some in Scandinavia, have implemented taxes on sugar, soda, or junk food. But Mexico has gone much farther and much faster, implementing a broad range of synergistic policies.

Mexico’s President Enrique Pena Nieto has become the leader in innovation and policy change to fight obesity and type 2 diabetes. And none too soon, because almost 10 percent of children in Mexico have type 2 diabetes, once called adult onset diabetes.

Here are the interventions Mexico implemented and which we should learn from, however politically unpopular.

1. A soda (and sugary beverage) tax of one peso per liter. Mexicans drink an average of 43 gallons of soda per person per year. Studies have documented the benefits of a sugar or soda tax but only a few countries have implemented it. They have also levied a tax on junk food.
2. Clear front of package food labeling for healthy and unhealthy foods. Current food labeling confounds and confuses most people. Other efforts, including stoplight labeling—green good, yellow caution and red danger—are being explored in other countries.
3. Ending sugar and junk marketing to children. The rationale and data behind this are clear. Over 50 countries have limited junk food marketing to children. America is one of the few that has not.
4. Providing only healthy foods in schools. No food that promotes disease should be provided in publicly-funded institutions. It is an area where governments have significant leverage.

Other countries have tested various policies to attempt to change behavior. Norway levies duties on sugary drinks, sugar, and chocolate. Samoa, the fattest nation on earth, has taxed sugary drinks since 1984. And in 2000, Australia implemented a 10 percent tax on soda, candy, and white flour bakery products. France, Spain, Greece, and Belgium have implemented successful community based interventions.

Obesity and its related diseases—heart disease, stroke, cancer, dementia, and type 2 diabetes—are one of the single biggest global problems threatening economic stability, national security, and the quality of life of billions of people. A comprehensive multi-layered global strategy must be implemented that includes many of the unpopular but proven policies that Mexico has vigorously attempted. We all will be closely watching the impact of their innovative polices.

Wishing you health and happiness,
Mark Hyman, MD