Action needed on causes of obesity to stop future pandemic deaths

In the year since 2020, and the last World Obesity Day (4 March), our lives have changed beyond anything we could have predicted. The health and social implications of COVID-19 have been myriad – to date responsible for the deaths of 2.5 million people and the cause of extensive disruption to health, education and economic systems.

Any suggestions that the virus would be a “great leveller” were rapidly dispelled: the burden of disease has not fallen equally, with the most vulnerable populations including older people, the socioeconomically disadvantaged, and people living with obesity.

It soon became evident that being overweight is a significant predictor of COVID-19 complications (hospitalization, intensive care and ventilation) and death. This reflects similar outcomes during, for example, the MERS epidemic: people living with obesity are at high risk of severe complications from viral respiratory diseases.

This is, of course, a tragedy for individual families – and also has vast economic implications. The International Monetary Fund (IMF) estimates that the accumulated cost of COVID-19 will be $22 trillion (2020–25). Combining this with a UK estimate that over a third of COVID-19 hospitalizations can be attributed to lack of physical activity and excess bodyweight, gives us a broad figure of $6-7 trillion of COVID-19 costs over this period that might be attributable to these predisposing risks.

This latest cost comes on top of the existing and increasing prevalence and impact of obesity, about which we have known for decades but failed to act comprehensively or effectively. There is a raft of international agreements and commitments, as well as national-level targets. In 2013, governments agreed to a World Health Organization (WHO) target to halt the rise in obesity by 2025 – but data suggest that almost all countries will fail to meet this. Instead, based on current trends, one in five adults will be living with obesity by 2025 – with all the attendant health and wellbeing repercussions, including susceptibility to COVID-19 and in all likelihood, to future pandemics.

Now is a unique moment to orientate towards a world that we really want, backed up with the political will for positive change. There is already a framework that sets out how to achieve this better world, agreed by all United Nations member states years before the onset of COVID-19, and which remains as relevant today as it has ever been: the Sustainable Development Goals (SDGs). The SDGs set clear targets for 2030, with good health, nutrition, equality and healthy environments at their heart, and requiring active and thoughtful partnerships within and between sectors. As many as 14 of the 17 goals – ranging from food to health to urbanization, are relevant to obesity.

To complement the SDGs, the obesity community developed the Global Obesity Forum Declaration 2021, which acknowledges and builds upon the many root causes (see image above) and solutions for obesity. The declaration establishes five areas for action in the COVID-19 era, ranging from prevention to equitable and accessible treatment and support for people of all ages, and recognizes that obesity is both a major risk factor for other health conditions and a disease in its own right. Ultimately, the World Obesity Federation, through its members and allies, are advocating for all governments to support a resolution on obesity at the World Health Assembly.

Of course, it is not just governments that have the responsibility to deliver a healthier world. As both the SDGs and the Global Obesity Forum Declaration make very clear, it is only by working together across the complex systems and societies within which we live that we will make real progress that reaches the most vulnerable. This was reflected in the theme of this year’s World Obesity Day, supported by obesity organisations and partners globally: Every Body needs Everybody.

Industry stakeholders can play a major part, and the World Economic Forum has long promoted and encouraged action by the private sector on health. In particular, the wellbeing of the workforce has been in sharp focus over the past year, as many of us have been forced to dramatically change our working patterns and employers have struggled to provide appropriate protection for onsite workers. Safety has been the first priority – but health promotion and resilience are also key, addressing the current and future health conditions that affect the productivity and wellbeing of employees.

This is not a new idea –smoke-free workplaces have been a significant success, greatly improving employee health, and in some cases serving as a model for governments to adopt – but it is now time for employers to extend their support to employees with (or at risk) of overweight and obesity. The World Obesity Federation has developed a support tool to encourage the adoption of healthier practices at work to address obesity, strengthen resilience and improve wellbeing.

COVID-19 has shown how vulnerable our world remains to health threats, but also that there is an appetite for change. To capitalize on this moment, the World Obesity Federation and the WHO, along with other key agencies, are forming a coalition to coordinate and drive global action on obesity. Inspired and driven by the insights and needs of people, with and affected by obesity, we are uniquely placed to take advantage of the political will for truly sustainable development, which will build a better world for everybody.