In 2015, scientists formed the Lancet Commission on Obesity to figure out how to end obesity, which threatens the health of 2 billion people worldwide. Now, the findings are in, but the problem isn’t what we thought it was. It’s actually much worse: Obesity isn’t a standalone problem but one in a trio of interconnected global pandemics, which the scientists call the “Global Syndemic.”
The trio refers to obesity, undernutrition, and climate change, which severely threaten human health in different ways but are all interrelated, explains the 56-page report published Sunday in The Lancet, a prestigious medical journal. Defining the “Global Syndemic,” it seems, isn’t just about semantics. It’s about reframing the three pandemics as a single super-problem so that we can start thinking about how to kill three birds with one stone. The accusing finger points squarely at Big Food and the industries that support it.
" They are both driven by the same unhealthy, inequitable food systems.
“Until now, undernutrition and obesity have been seen as polar opposites of either too few or too many calories,” said Boyd Swinburn, Ph.D., co-commissioner of the group and a professor of global health at the University of Auckland. The Commission comprises 26 experts from 14 countries, led by Swinburne as well as scientists from George Washington University and the World Obesity Federation.
“In reality, they are both driven by the same unhealthy, inequitable food systems, underpinned by the same political economy that is single-focused on economic growth, and ignores the negative health and equity outcomes,” he says.
It’s a complicated report, but the new perspective it offers is an important one to grasp. Here’s how obesity, undernutrition, and climate change fit together, and why Big Food — the multinational food and beverage industry, including companies like PepsiCo, Nestle, and Tyson Foods — is to blame.
Pandemic 1: Obesity
Worldwide obesity has tripled since 1975, says the World Health Organization, and it’s only getting worse. Over 10 percent of the global population is obese, and because it increases the risk for cardiovascular diseases, type 2 diabetes, and some cancers, obesity isn’t just deadly for individuals — it’s also expensive for societies to deal with. By the report’s estimate, obesity costs $2 trillion each year because of healthcare and lost productivity.
Pandemic 2: Undernutrition
Until the obesity epidemic began 40 years ago, undernutrition was the most widespread type of malnutrition around the world. According to the report, poor nutrition in Asia and Africa alone now costs about $3.5 trillion each year.
Not having enough food causes kids to undergo wasting, stunted growth, and micronutrient deficiencies, which are still issues today but increasingly coexist with obesity. The WHO calls it the “double burden of malnutrition”: an individual can be deficient in some nutrients while still obese, and likewise undernutrition and overweight can exist in the same family, community, or even nutrition.
Like Swinburn said, obesity may seem like the opposite of undernutrition, but they’re deeply intertwined biologically and socioeconomically. Kids who don’t get enough to eat when they’re young are at risk for obesity later in life, the Commission reports, and those kids tend to live in numerous lower- and middle-income nations where food security is an issue. Paradoxically, people in places that have mild to moderate food insecurity are actually at high risk of obesity.
Pandemic 3: Climate Change
And what’s threatening food security? Climate change is a major factor. Especially in less wealthy countries, climate change is causing “crop failures, reduced food production, extreme weather events that produce droughts and flooding, increased food-borne and other infectious diseases, and civil unrest,” the Commission writes.
And as countries develop, they shift toward urbanization and all the obesity-inducing, greenhouse gas-emitting activities that go along with it: driving cars, being sedentary, and starting to eat more “ultra-processed food and beverage products and beef and dairy products,” which emit tons of greenhouse gases into the air. This is where it becomes clear how Big Food fits in.
The Role of Big Food
Addressing malnutrition in general requires shifting worldwide eating habits toward a healthier, plant-based diet, says the Commission. It seems easy enough: Doing so would mitigate obesity for obvious reasons, and it would address undernutrition because those diets are healthier and more accessible. Most importantly, it would curb climate change since growing plants emits way fewer greenhouse gases than meat, dairy, and processed food.
The Commission hasn’t missed the fact that for over 30 years, member states of the World Health Assembly have endorsed policies to end obesity but nothing has happened. It chalks it up to lame governments, inert civilians, and the influence of Big Food.
“However, many countries’ efforts to include environmental sustainability principles within their dietary guidelines failed due to pressure from strong food industry lobbies, especially the beef, dairy, sugar, and ultra-processed food and beverage industry sectors,” the authors write.
By now, it’s no secret that transnational food companies get in the way of health policy. Just recently, Coca-Cola’s role in influencing China’s health guidelines was exposed, and another on the benefits of adding cheese and yogurt to the well-established (and historically dairy-free) Mediterranean diet was sponsored by the Australian dairy lobby. This influence feeds into what the Commission calls “policy inertia” — a lack of urgency among citizens and governments to create change, even though the Global Syndemic is slowly killing everyone and picking up speed.
So Now What?
Dismantling the insidious influence of Big Food on policy inertia won’t be easy or cheap, but as the researchers write, it could result in a “win-win-win” situation.
They’re calling for three key actions: the end of the $5 trillion in government subsidies handed out to food and fossil fuel corporations, a global agreement to limit the influence of Big Food, and a push among civilians to end the policy inertia that keeps Big Food in power.
"We’re running out of time.
They’re also calling for a $1 billion fund to support advocacy for policy initiatives to mitigate the Global Syndemic. That’s in addition to the $70 billion already being requested by the World Bank to address undernutrition and the $100 billion the Green Climate Fund is calling for to address climate change in low and middle-income countries.
Only time will tell whether wealthy nations will cough up the cash. But the sheer amount they’re asking for to address the Global Syndemic should give people pause: This is a really, really big deal.
“The only thing we can hope is that a sense of urgency will permeate,” said George Washington University public health expert William Dietz, Ph.D., a co-author of the study, reports Reuters. “We’re running out of time.”