The collision course of obesity, undernutrition, and climate change - Shifting gears on the world’s biggest health challenge

8 February 2019

Securing the health of the planet, as well as ourselves, demands a global transformation, Cherry Zheng writes. 
Despite almost three decades of policy recommendations, obesity rates are soaring. Nearly two billion people are overweight or obese, costing $2 trillion a year – comparable to the global impact of armed violence and war.
The extent of the pandemic demonstrates this is far from a problem of individual willpower. Rather, it is a product of our modern food systems – the very same systems that are driving undernutrition and climate change.
This perfect storm of malnutrition – both obesity and undernutrition – and climate change is the “paramount health challenge” of the 21st century. Together, they represent ‘The Global Syndemic’, where ‘syndemic’ refers to two or more diseases that co-occur, interact, and share societal drivers.
A newly released report by the Lancet Commission on Obesity examines their links, the roles of government, the private sector, and civil society, and what can be done to tackle the pandemics in concert.
Climate change can be considered a pandemic alongside obesity and undernutrition due to its predicted “catastrophic” and global impact on human health. Storms, floods, drought, warming oceans, and rising sea levels threaten the world’s food security; worsening nutrient deficiencies, undernutrition and – less obviously – obesity.
Failing to act means the tremendous health gains of the past 50 years could be reversed by 2050. The broader costs such as loss of human potential, societal disruption, and environmental destruction will be borne by current and future generations.
Just as climate impacts food systems, food systems also impact climate. From intensive agriculture to transportation, the globalised mass production of food depends on fossil fuels, leading to greenhouse gas emissions.
If we include processes such as land conversion, the contribution of food to emissions is as high as 29 per cent. Within this, food waste is responsible for over 3.3 billion tonnes of carbon dioxide emissions annually, making it the third top emitter after the US and China.
Without drastic changes to how we produce and consume, it will be impossible to sustainably feed the world’s 10 billion people by 2050.
Beneath these interactions, malnutrition and climate change have shared roots in unsustainable consumption. The heart of the problem is weak political governance, where GDP growth instead of health is treated as the priority and the concentration of influence within large food corporations prevents meaningful change.
As stated by the former Director-General of the World Health Organization, “market power readily translates into political power.”
So it is for ‘Big Food’, which holds sway over food systems and governments around the world due to its financial heft and purported structural importance in supplying jobs and tax revenue.
A slew of tactics stymies reform, including voluntary self-regulation to avoid state regulation, public relations campaigns to portray industry as socially responsible, industry-funded research to undermine scientific evidence, and promoting the narrative that malnutrition is a personal failing. Big polluters have taken similarsteps to undermine climate action.
Perhaps most egregiously, public money in the form of subsidies and tax breaks goes towards these corporations to the tune of $5.3 trillion for fossil fuels and nearly half a trillion dollars for agriculture every year.
This leaves governments with the daunting task of mustering not only commitment but also the resources to act. The first means contending with conflicts of interest, power asymmetries, and duplication of efforts in the face of powerful lobbies. The second means having the organisational and strategic capacities to work towards progress. Many governments lack such resources.
The result for the public is predictable. Since visibility is low, the need for change is not well understood, let alone acted upon. People with obesity continue to face pervasive bias and stigmatisation, while transformative climate action has been delayed for a quarter of a century.
Thus, the Global Syndemic must be tackled at its roots. Foremost among the report’s recommendations is the idea of double or triple-duty actions. Just as obesity, undernutrition, and climate change reinforce each other, they can also be tackled together.
The World Bank estimates that achieving global targets for undernutrition will take $70 billion over the next 10 years. The Global Syndemic Commission calls for an additional $1 billion to jumpstart civil society, including devoting greater attention to traditional and indigenous knowledge.
There is a strong role for independent institutions to hold governments and industry accountable. The Commission proposes a binding treaty on food systems in a similar vein to those on climate change and tobacco, as well as a ‘Right to Wellbeing’ comprising a right to health, food, cultural rights, rights of the child, and a healthy environment.
Where, then, does the everyday person fit into the system? As consumers, there is an urgent need to overall eat less meat and slash food waste. As agents in society, we must bring an awareness of how malnutrition and climate change interact in all of our decisions as citizens, parents, customers, workers and more. For all its high-level policy recommendations, the Global Syndemic Commission notes that the “collective influence” of the people is critical.
But these actions are not available to everyone. Harmful habits are hardly choices when people are immersed in unhealthy environments, or when lack of time, money or access prevent them from having a healthy diet, let alone from mobilising for reform.
Ultimately, as a problem deeply entrenched in our global food systems, we must be wary of suggesting that the worst-affected individuals are the ones to blame.
Thus, governments must lead the way. The solution will not be a cure, but a transformation: one that confronts the underlying policies, incentives and norms that have enabled these vicious cycles of human and environmental decline.
Such a path is un-travelled and challenging. But even if it was easy, nothing will change unless policymakers – the people chosen to represent the best interests of our collective societies – take the reins.
This article was first published on PolicyForum.