Obesity has been defined as a pandemic that contributes to a global syndemic in conjunction with malnutrition and climate change. These three pandemics share structural determinants, such as multidimensional poverty, and require a holistic approach to the entire food system. The consumption of healthy eating is not only an issue of cultural capital, but mainly of availability and access (physical and economic), of which most of the population is deprived, both in quantity and sufficient quality. Structural public policies, which consider economic and social development, need to be promoted to combat this global syndemic.
The nutritional map of Junaeb was recently published, showing an increase in childhood obesity by 2020. Although with a slightly different methodology than previous ones (size and weight measurements were made by the guardians of children, and not by the teaching team), these data show a worrying increase in childhood obesity.
Obesity is a complex and multifactorial problem, where the main focus has been on the form of obese bodies and health implications. Individual responsibilities (personal choice, nutritional knowledge) have been attributed, omitting the importance of structural inequalities in obesity. We believe that it is essential to take into account the influence of the economic and political system on public policies aimed at preventing and treating obesity, which is why we think it is essential to consider sustainable food production, to ensure the protection of natural resources and to generate sufficient crop biodiversity, while maintaining local food heritage.
Evidence suggests that obesity is a risk factor for Covid-19. In Chile, during March, 9% of people hospitalized for Covid-19 developed obesity as comorability, after hypertension and diabetes. The high prevalence of obesity in Chile could help explain the complex situation Chile has experienced during the pandemic, independent of the measures that have been taken and the successful vaccination process. Studies show that obesity increases the risk of hospitalization, admission to intensive care, and the development of serious consequences that lead to death, including in young people. This shows a new consequence of obesity, beyond its traditional and well-known relationship with noncommunicable diseases such as hypertension, diabetes and cancer, also with communicable diseases such as Covid-19 and eventually future ones.
Our transdisciplinary working group for population obesity (GTOP) has as one of the pillars reflection because we are convinced that innovative proposals can emerge from it; we are interested in researching and problematizing the historical, social and cultural dimensions to understand the various psychosocial and biological phenomena that converge around obesity. We look at this problem from the role of the social determinants that condition over-malnutrition in people, to integrate into the analysis of cultural and legal dimensions, as well as the symbolic conceptions of populations about the body, identities and gender roles.
Our comprehensive proposal includes, but is not limited to, a universal minimum wage or specific bonds that allow access to the purchase of healthy foods; ensure availability of healthy foods through distribution chains not abandoned to the market; protect a certain amount of soils for food production; care for the environment in the face of climate change. In the short term, we propose tax measures such as taxes on unhealthy foods (“high in”) and subsidies for peasant agricultural production, artisanal fishing and shops that favor short circuits, such as fairs and markets. Public policies are urgently needed to point to the most structural causes of the problem and to actions that the evidence has shown to be most effective.
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