Make obesity prevention and management a central pillar of public health, experts urge

With the global NCD burden rising, we must act now to implement what works. This call to action aligns with the SNI’s “Race to the Finish” initiative to meet NCD targets by 2030 and comes as the world prepares for the Fourth High-level Meeting of the UN General Assembly on the prevention and control of NCDs in 2025, a pivotal moment to secure commitments on obesity as a public health priority.

Urgency for scaled-up action

At the 75th World Health Assembly, countries endorsed the “WHO Acceleration Plan to Stop Obesity”, and in 2023 WHO launched the “Health service delivery framework for prevention and management of obesity”, an integrated health service delivery framework for obesity to guide countries in expanding access to obesity services. This framework underscores integrating obesity prevention and treatment throughout the health system – from community and primary care to specialized services – and adopting a life-course approach to chronic care.

The demonstration platform for obesity in Ireland showcased how a national model of care can organize practical, scalable solutions – coordinating multidisciplinary teams, enhancing staffing and optimizing treatment – within the existing health system. These experiences demonstrate that effective obesity care can be delivered at all levels of care when backed by political commitment, strong governance and cross-sector collaboration.

The treatment of obesity is highly complex and costly at the societal level. The demonstration platform for obesity in Ireland highlighted the importance of a continued focus on driving significant changes to the obesogenic environment, that is environments that promote weight gain and hinder weight loss. Key factors include easy access to unhealthy foods, sedentary lifestyle promotion, harmful marketing practices and more.

Urgent actions needed include the following.

• Strengthen multidisciplinary obesity care models. Integrate obesity treatment and management into primary health care and referral systems. Establish multidisciplinary teams (including physicians, dietitians, nurses, psychologists and physiotherapists) to provide comprehensive, evidence-based treatment and support for people living with obesity. Ensure care pathways span primary, secondary and tertiary services, so patients receive continuous support from prevention through specialized care. Effective models should be scaled up and adapted in all countries. For example, in 2023 Portugal published a legal document that determined the implementation of an Integrated Care Model for the Prevention and Treatment of Obesity within the national health-care system, aligned with the WHO “Health service delivery framework for prevention and management of obesity”.
• Implement policies to tackle commercial determinants, conflicts-of-interest (also linked to the pharmaceutical industry) and food environments. Enact and enforce strong policies that reshape food environments in favour of health. This includes restricting the digital and traditional marketing of unhealthy foods; implementing easy-to-understand, front-of-pack nutrition labelling; mandating food reformulation to reduce salt, sugar and unhealthy fats; and using fiscal policies to discourage high-fat, high-salt and high-sugar products while promoting healthier reformulations. Special attention should be given to commercial determinants in digital spaces, including screen time and content exposure, as children and adolescents spend increasing time online. These well-being policies should be clearly defined, and social participation should be integrated into related actions. Additionally, nutritional education programmes should align with legislative measures on advertising to ensure consistency between regulations and the messages conveyed in educational institutions. Portugal, for example, succeeded in implementing mandatory restrictions on food marketing to children. Reinforcing messages across different sectors will significantly enhance their effectiveness.
• Expand early intervention and prevention programmes. Invest in preventive programmes across the life course with a special focus on children, adolescents and high-risk populations. Early-life interventions are critical, ranging from promoting healthy diets (including European Union school fruit schemes) and physical activity in schools and child-care settings (such as the “Slofit” initiative in Slovenia) to providing family-based lifestyle support. These measures help ensure that children have the best possible opportunity to achieve and maintain a healthy weight as they get older. Community programmes should target vulnerable and high-risk groups with culturally appropriate guidance on nutrition and activity. Preventive services, such as nutrition and physical activity counseling, psychological support and obesity screening, should be integrated into routine primary care and organized into multidisciplinary teams. By intervening early, we can halt obesity before it starts developing or at least before severe complications arise.
• Invest in workforce training and anti-stigma initiatives. Strengthen the health workforce’s capacity to address obesity without bias, especially sarcopenic obesity, which is the co-existence of low muscle function and mass with excess body weight. Integrate obesity education and training into medical, nursing and related health curricula and provide ongoing professional development in obesity management, including expertise in clinical nutrition, kinesiology, psychology and sleeping behaviour. For example, Ireland’s health system has introduced obesity training for medical and physiotherapy students, reaching over 3000 current and future health-care professionals since 2022. Similar investments are needed globally so that frontline providers can deliver respectful, effective care. Shifting the focus from “obesity” to “excess body fat” through body composition measurements can help combat stigmatization. In parallel, launch public health campaigns to reduce weight stigma and raise awareness that obesity is a chronic condition requiring support. Combating stigma will improve health-care-seeking and ensure all individuals feel welcome and supported in accessing obesity services.

A global priority – time to act

We urge governments, policy-makers and health organizations in every country to commit to these actions and make obesity prevention and management a central pillar of public health. To move beyond good intentions and ensure real implementation, coordination with other ministries and administrations is essential, as the Spanish model has done in its national obesity prevention plan. The human and economic costs of inaction are too high – but by scaling up comprehensive health system responses now, we can save lives, improve the quality of life of individuals, families, communities and nations, and move closer to our shared SDG targets.

As the upcoming UN High-Level Meeting on NCDs approaches, let us solidify our resolve to stop obesity through stronger measures to promote well-being across all sectors of society, including stronger health systems. The world is watching for leadership – and the time to accelerate action on obesity is now.