Obesity is a topic that invites judgment, including self-judgment and, if you’re not careful, lots of body shaming too.
But the rising rates of overweight and obesity are a sign something is terribly wrong with our food systems and our food environment. The Department of Health has just concluded a public consultation for its revised national obesity strategy. This is a unique opportunity to expand consideration of obesity to the wider food environment and to debate how access to sustainably-produced food can contribute to improving both the health of the Irish population and our natural environment.
The prevalence of overweight and obesity at a global level are truly staggering: according to the World Health Organisation (WHO) worldwide prevalence of obesity more than doubled between 1990 and 2022.
More than two in five adults are now overweight or obese, and an estimated 35 million children under the age of five years are overweight. According to the most recent surveys, a total of 56 per cent of Irish adults are living with overweight or obesity, and one in five primary school children live with overweight or obesity.
RM Block
The data shows a strong link between socioeconomic status and obesity. While rates of severe food poverty in Ireland are low at about 2.4 per cent, in many disadvantaged communities, low household incomes combined with the proliferation of fast-food outlets and convenience stores means that healthy food options are simply not available for many people at affordable prices.
The causes of overweight and obesity are well understood. In most cases, overweight and obesity result from an imbalance of energy intake (diet) and energy expenditure (physical activity). Tackling both diet and activity levels can work at the level of the individual to improve overall health (if you can stick to the plan), and of course weight-loss medication is now available too.
However, framing obesity as a failure of individual willpower or unwillingness to change lifestyles ignores the powerful external forces that shape what we eat and how we move around. We are all now living in what nutritional experts call an “obesegenic environment”, where healthy, sustainable and affordable food is not easily available, but unhealthy foods and associated advertisements are all around us.
In addition, the physical environment makes regular, daily human mobility on foot or by bicycle difficult, especially where it is designed to primarily facilitate movement of cars and motorised traffic. And to cap it all, there is little regulatory control over the food industry that is making staggering profits from ultraprocessed foods that now dominate the shelves of supermarkets and convenience stores.
These ultraprocessed foods, which are products containing ingredients you wouldn’t typically find in a home kitchen, such as artificial sweeteners, preservatives and emulsifiers, are a leading cause of rising rates of overweight and obesity.
Tackling the phenomenon of ultraprocessed foods ingredient by ingredient is painfully slow against a backdrop where the food industry has unprecedented power and influence over policy
A landmark study by scientist Kevin Hall and colleagues published in 2019 found that ultra-processed diets cause excess calorie intake and weight gain. Yet to date, few measures have been effective in countering the influence of the food industry.
Since 2018, sugary drinks which are now subject to a tax in Ireland which has been quite effective in lowering the consumption of sugar, because it prompted the drinks industry to reformulate its products. However, tackling the phenomenon of ultraprocessed foods ingredient by ingredient is painfully slow against a backdrop where the food industry has unprecedented power and influence over policy. Meanwhile, many communities are living in food swamps surrounded by fast-food outlets or food deserts where they cannot easily obtain affordable healthy food.
This is taking place within a context of over-exploited natural resources. Globally, food systems are causing devastating environmental damage. They rely heavily on inputs of fertilisers, pesticides and freshwater, the consumption of which is putting critical planetary boundaries in jeopardy.
Long supply chains, processing and packaging also lead to environmental waste. Globally, about a third of all food produced is wasted, which squanders the land, water and energy used to produce it. The Irish Climate and Health Alliance estimates Irish households alone produce a quarter of the country’s food waste, costing about €700 per year per household.
Our diets are high in red and processed meats, sugar, salt and fat, and low in plant-based foods. This dietary pattern is both a risk factor for diet-related chronic diseases and, at the same time, the production of these diets, particularly from a livestock-heavy system, is a major source of GHG emissions, land use, and water pollution.
When the EAT-Lancet Commission looked at healthy, sustainable diets that would provide adequate nutrition for all within planetary boundaries, they concluded red meat consumption should decline to the equivalent of one medium-sized burger per week.
However, no Irish public health agency has yet adopted this guideline and even the EPA came under fire from the IFA for tweeting in 2023 about low-meat diets. Teagasc researchers have argued for a more gradual, nationally-focused approach that prioritises a “simple rebalance” of existing dietary patterns that includes meat and dairy.
As long as our State agencies are reluctant to put public health and the environment before economic considerations, I suspect very little will change and the pounds will continue to pile on.
Sadhbh O’Neill is an environmental and climate policy researcher
