The worldwide surge in obesity rivals war and smoking in terms of the global economic burden it imposes. Obesity is no longer a concern solely of higher-income, developed countries. Its prevalence has risen in all regions, including in low-income countries.

Today, nearly half of all countries are struggling with both under-nutrition and overweight/obesity. They often coexist in the same communities — even in the same household.

Economic and social transformations in many poor- and middle-income nations and the availability of over-processed foods have led to changes in lifestyle, including dietary habits, and reduced physical activity.

Not a single country saw declining obesity between 2000 and 2013. WHO estimates 1.9 billion overweight people, of whom a third are obese. This involves social and economic costs that society can ill afford to bear.

Huge price tag The 2013 edition of FAO’s State of Food and Agriculture noted that the social burden due to overweight and obesity has doubled over the past two decades. The cumulative cost of all non-communicable diseases, for which overweight and obesity are leading risk factors, were estimated to be about $1.4 trillion in 2010.

More recently, the McKinsey Global Institute estimated the global price tag of obesity — including the increasing the risk of heart disease, hypertension, strokes, diabetes, and some cancers — could run as high as $2 trillion a year, third only to smoking ($2.1 trillion) and armed conflicts ($2.1 trillion)!

Now, think of what could be done to tackle malnutrition if we threw that amount of money behind the effort. Increasing funding is necessary to scale up efforts, but it should be a part of a bigger effort to re-strategise our approach to tackling malnutrition in all its forms, deepening our focus beyond the immediate causes to include the broader socio-cultural, economic and political dimensions of nutrition.

This challenge was taken up at the Second International Conference on Nutrition (ICN2) in Rome in November 2014. At ICN2, governments committed themselves to addressing the broad spectrum of malnutrition — including under-nourishment, stunting, wasting, micronutrient deficiencies, obesity and related non-communicable diseases.

Making progress on these pledges entails shifting from treating the adverse effects of malnutrition to prevention by ensuring healthy balanced diets. We’ll need to develop new policies, strategies and programmes to do that.

Some possibilities First, let’s reform our food systems to ensure better nutrition for all. State of Food and Agriculture 2013 showed how food systems influence the quantity, quality, diversity and nutritional content of foods, and determine the availability, affordability and acceptability of foods needed for good nutrition. Reforming our food systems to improve nutrition will require growing nutrient-rich foods and ensuring healthy processing to minimise the loss of nutrients.

Second, we must make it easier for consumers to make choices that promote healthy diets. It will require increased investment in nutrition promotion and education programmes --- creating schools, work places and communities that make healthy diets easily accessible and encourage people to exercise more. It will require empowering consumers with information through formal and informal popular nutrition education.

Third, we must create a common vision and multi-sectoral approach involving governments, farming, health, retail and other relevant public and private sectors, as well as civil society. No sector or entity can effectively address the problem on its own.

Fourth, trade and investment agreements must be designed to influence food systems positively. By improving the availability of, and access to, food, effective trade can play a key role in achieving nutrition objectives. But such agreements should not “crowd out” the possibility of developing local agriculture.

Thriving local agriculture systems promote greater diversity in diets and generate jobs to help reduce rural poverty.ICN2 has set the stage for all actors to come on board to reverse the fast rising global obesity.

Malnutrition, from under-nutrition to obesity, is preventable at a relatively low cost. We must move quickly to reverse obesity trends and make hunger and all forms of malnutrition history.

The writer is the director-general of FAO

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