Global Obesity Forum 2021

The Global Obesity Forum meets annually to convene stakeholders representing different parts of the obesity community from across the globe.

In 2021, the Forum is being hosted by the founding members of the Global Obesity Coalition: World Health Organization, World Obesity Federation and UNICEF.

Introducing the Global Obesity Coalition

This Global Obesity Coalition was formed at the start of 2021, building on longstanding collaborations and the new momentum around obesity that has been precipitated by COVID19. The Coalition is being formally launched at this Forum.

The Coalition provides an opportunity for those working on different dimensions of obesity to align in leading, coordinating and driving action on obesity in 2021 and beyond. The Coalition does not have a formal membership structure; instead, it is operating as a flexible and activity based community - a coalition of the willing and active.

Within the context of existing frameworks and commitments, and working with affected populations, the Coalition will streamline priority global initiatives, help scale up national policymaking efforts to create healthy environments and support health systems in building back better and more equitably from the COVID-19 pandemic, including incorporating the needs of people with obesity in existing systems and as part of future pandemic preparedness. The Coalition recognises that there are no simple solutions: a comprehensive, system-wide approach is required, looking at changes needed at population and community level rather than focusing solely on individuals.

The Coalition will use its influence to ensure that obesity is on the agenda at high-level intergovernmental events, to support a Resolution on obesity at the World Health Assembly, and to drive regional and national initiatives. This year’s Global Obesity Forum is itself taking place in the week of the first ever UN Food Systems Summit.

The Coalition will be organised along three areas in which joint efforts are likely to be especially beneficial: shifting the obesity narrative; accelerating implementation of effective actions that promote healthy diets and physical activity; and integrating obesity prevention, management and treatment into primary health care. Each of these areas will be a focus of a breakout session at this year’s Forum, challenging participants to agree priorities that can form the basis for Coalition action in the near future. A fourth breakout session will additionally discuss innovation in obesity across these topics. Participants are encouraged to share their thoughts across all these areas throughout the Forum, using the chat function.

Shifting the obesity narrative

Popular narratives about the causes and nature of obesity are too often misleading, suggesting that obesity is a matter of individual responsibility or that it is found only in affluent countries and communities. In fact, obesity is a complex chronic disease strongly influenced by systemic societal and environmental injustice and inequity. It affects people of all ages, all geographies, and all socioeconomic backgrounds. But the flawed framing of obesity has led to stigmatisation and discrimination against people living with obesity (which is compounded by disrespectful and distorting language and images), siloed approaches to prevention and treatment, and political inaction across the board.

Changing the narrative is further complicated by the many norms and realities surrounding obesity. In many developed countries, the prevailing narrative is that obesity is a personal failure; in other societies, obesity may be associated with affluence and good health. Furthermore, a ‘double burden’ of malnutrition – undernutrition and micronutrient deficiencies combined with obesity and diet-related noncommunicable diseases - is prevalent in many parts of the world, complicating the policy response, often against a background of scarce resources. Research is needed to gather insights into local understanding and solutions, identify double-duty actions, and avoid transplanting a homogeneous, colonial and potentially inappropriate approach to obesity in different parts of the world.

This discussion will identify the most promising ways to change the narrative, asking whether there should be one or many narratives, and looking at ways to ensure that narrative(s) are inclusive, particularly of people living with obesity.

Accelerating implementation of effective actions that promote healthy diets and physical activity

The promotion of healthy diets and physical activity is essential for the prevention and management of obesity, and to ensure the future health of individuals, families, health systems and economies. Today, many people live, work or study in environments characterised by: low availability, accessibility, and affordability of healthy foods; aggressive marketing of unhealthy foods, including snacks and sugary beverages; and increasingly large portion sizes. These factors can contribute to unhealthy food consumption patterns. At the same time, many of our physical environments are not conducive to people being active as part of everyday life – urban design that encourages motorised traffic, a lack of pavements or cycle paths for non-motorised traffic, and insufficient green space for exercise and active recreation.

Numerous evidence-based actions have been identified, notably recommended in the report of the WHO Commission on Ending Childhood Obesity and in the WHO Best Buys for tackling NCDs. The discussion will concentrate primarily on dietary and food system interventions, as the Forum is timed to take place just ahead of two important forthcoming global events - the UN Food Systems Summit (23 September) and the Nutrition for Growth conference (December) – which there is the potential to influence.

Integrating obesity prevention, management and treatment into primary health care

Primary health care (PHC) is about delivering care for all, within communities, addressing physical, mental and social wellbeing and including health promotion, disease prevention, treatment, rehabilitation, and palliative care. A universal health coverage system whose PHC benefit package encompasses obesity can be an accessible route to the inclusion of obesity within health systems in low- and middle-income countries. PHC can address both obesity prevention – through timely identification and early intervention, such as cost-effective counselling around healthy diets and physical activity across the lifecourse, including routine follow-up and signposting to support resources – as well as basic treatment and management of obesity, which is particularly important in contexts, such as many low- and middle-income countries, where effective care such as bariatric surgery and pharmacotherapy are not likely to be feasible, at least in the near term, for a majority of the population.

Most importantly, integration of obesity into primary care assures earlier acknowledgment and a more rapid pathway to treatment given that the current approach is one in which individuals often delay seeking services until a co-morbidity such as diabetes or CVD is present.

Even before COVID19 disrupted primary health services and obesity care worldwide, there were serious shortfalls in the provision of obesity services. There is an urgent need for more training of primary healthcare workers in obesity prevention and treatment. A survey of 68 countries in 2018 found that there is a serious lack of adequate services, particularly in lower-income countries and in rural areas of most countries. Not all countries have professional guidelines for obesity treatment, which need to be appropriately adapted to national contexts.

This discussion will direct the Global Obesity Coalition in how to adapt and contextualise health-systems interventions and primary care to best deliver obesity prevention and treatment.

Innovative approaches to addressing obesity

Many of the actions and policies that can successfully address obesity are well known – but there is also a need for innovation across research, policy and implementation. This breakout session will highlight some novel approaches to address obesity from different angles – among them, new modelling of the cost of obesity, ‘triple-duty’ actions on obesity as recommended by The Global Syndemic report and innovation in cities (which are where the majority of the world’s population now live). Discussion on the barriers to and enablers of innovation across obesity research, policy and action will then provide direction on the opportunities and future priorities for the Global Obesity Coalition.

Private sector participants at the Forum will join this session, to explore the important contribution that they can make.

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