Obesity, now considered a pandemic, has been a priority on the international and national public policy agenda for several decades. Although specific progress has been made in certain contexts, no country has successfully controlled the epidemic ¹1. Roberto CA, Swinburn B, Hawkes C, Huang TT-K, Costa SA, Ashe M, et al. Patchy progress on obesity prevention: emerging examples, entrenched barriers, and new thinking. Lancet 2015; 385:2400-9.. The main barriers to its control include the private commercial lobby, governments’ inability or lack of political will to implement effective policies, absent (or insufficient) pressure by civil society for policy action, and limited scientific assessment of the existing control measures.

Effective obesity prevention involves inter-sector measures and strengthening food systems that simultaneously promote prosperity, equity, environmental sustainability, and health, regulation of advertising for ultra-processed foods and advertising targeted to children, improved food labeling, fiscal measures to discourage the purchase of ultra-processed foods and encourage that of natural, whole, or minimally processed products, promotion of healthy eating environments, promotion of maternal breastfeeding and healthy complementary infant feeding, and the development of actions in food and nutritional education. Latin America has witnessed innovative experiences such as taxing soft drinks in Mexico, new food labeling in Chile, and publication of meal-based food guides in Brazil and Uruguay that classify foods on the basis of their degree of processing.

Recording and analyzing obesity control initiatives are essential for consolidating effective measures in different settings. This highlights the timely publication of the article Obesity and Public Policies: The Brazilian Government’s Definitions and Strategies in this issue of Cadernos de Saúde Pública. According to the article and references, in the last two decades Brazil has made progress by designing strategies for obesity prevention and control both within the health sector and with other sectors and by investing in inter-sector governance mechanisms like the Inter-Ministerial Chamber for Food and Nutritional Security and the National Council on Food and Nutritional Security.

In recent years, Brazil has also formally expressed its intention to tackle the obesity problem, signing international agreements and setting targets in national plans, like those written into the National Plan for Food and Nutritional Security (PLANSAN) 2016-2019. These include curbing the growth of obesity in the adult population, reducing by at least 30% the regular consumption of soft drinks and artificial juices (from 20.8% to 14% of the population); and expanding by at least 17.8% (from 36.5% to 43%) the proportion of adults that regularly consume fruits and vegetables.

However, Brazil’s international commitments, the strategies laid out in different policies, and the targets set in inter-sector agreements by the Brazilian government have largely failed to materialize in solid, structural, and large-scale measures. The result is that obesity is still on the rise in the country. According to the National Health Survey in 2013, 57% of Brazilian adults were overweight, compared to 50% in 2008-2009, based on the results of the Brazilian Family Budgets Survey at the time.

Since many of the strategic actions for obesity prevention involve regulatory measures that curtail market practices by large corporations, the combination of rising obesity and lack of public policies for its control will tend to worsen in Brazil’s current political and economic scenario, marked by the aggressive resumption of the neoliberal agenda, protection of big capital, and backsliding on safeguards for established human and social rights. A clear example is the dismantlement of the government’s actions to promote sustainable systems for the production and consumption of nutritionally adequate foods ²2. Santarelli M, Burity V, Silva LNB, Prates L, Rizzolo A, Rocha NC, et al. Da democratização ao golpe: avanços e retrocessos na garantia do direito humano à alimentação e à nutrição adequadas no Brasil. Brasília: Rede de Informação e Ação pelo Direito a se Alimentar; 2017..

Given the above, little progress will be made without more incisive and joint action by civil society to demand that the existing commitments and targets set in recent years to control obesity in Brazil are translated as strategic large-scale actions. It is also necessary to invest in state and municipal-level experiences that can serve as examples and inspiration for other localities.

Academic institutions should play a crucial role in this context by supporting civil society’s political impact and backing truly effective public policies through the production and dissemination of scientific evidence on the issue. There are many gaps and challenges in such knowledge production, which include elucidating the determinants of obesity other than excessive calorie intake and sedentary lifestyle, such as pesticides and antibiotics in foods, extending research on the effects of consumption of ultra-processed food products by small children in order to complement the available scientific evidence on the general population that provides the basis for proposals for regulatory measures, and analyzing corporate policy practices by large transnational and conflicts of interest in the implementation of public policies. The prioritization of gaps and challenges should be defined through dialogue between academic institutions and public interest organizations that have obesity control on their agendas.

Finally, despite the gaps and challenges in knowledge production, the evidence already produced is sufficiently robust and striking and points to clear paths for structural measures in obesity control. It is not necessary to wait in order to move forward with such public policies.

Publication Dates