Groundbreaking weight-loss drugs like Ozempic and Wegovy have indeed sparked a great deal of excitement. These drugs, when combined with a healthier lifestyle that includes a balanced diet and regular exercise, have shown remarkable results. On average, they can lead to a 10% reduction in body weight that can be maintained for years. In the United Kingdom, more than two-thirds of adults and nearly three-quarters in the United States are classified as overweight or obese. This is a significant health crisis that not only affects individuals but also has a substantial impact on national economies, costing billions of dollars annually. As a result, physicians and policymakers have been looking at these drugs as a potential solution. President Biden's administration, for instance, recently proposed that Medicare and Medicaid cover the costs of weight-loss drugs to expand access for millions of Americans. However, addressing obesity requires more than just relying on technological fixes.
Addressing the Root Cause: The Broken Food System
The alarming increase in obesity over the past 30 years is not merely a result of higher living standards or a more sedentary lifestyle. The primary cause seems to be the transformation of our food environment. This transformation has significantly changed the types of food we consume and our eating habits. In recent years, scientists and health experts have been focusing on foods high in fat, sugar, and/or salt, as these drive unhealthy dietary habits. Companies have restructured the food system to produce ultraprocessed, highly palatable, and highly profitable foods. This has led people to snack more, eat larger portions, and prepare fewer meals themselves. For example, in the UK, the snack market has witnessed a significant boom, while the time spent preparing meals has decreased sharply.These changes have not only fueled the rapid increase in the consumption of salty, fatty, and sweet foods but have also led to a surge in meat consumption, especially in Europe and North America, where meat-heavy diets have become common. Apart from the increased risk of heart disease and other related health conditions, excessive meat consumption has had a devastating impact on the climate and biodiversity. Research shows that animal-based foods generate twice the greenhouse gas emissions of plant-based alternatives. Just as health experts urge us to reduce our intake of salt, fat, and sugar, climate scientists emphasize the importance of curbing meat and dairy consumption to keep global warming within safe limits.In an attempt to prevent a lasting change in people's eating habits, the meat industry is seeking technological fixes to reduce greenhouse gas emissions. For example, there has been a significant increase in funding for research on cutting farm emissions, such as feed additives designed to reduce methane levels in cows' burps. Such solutions are attractive to governments that are reluctant to introduce measures that influence consumer behavior. They are afraid of facing opposition from the Big Food lobby and being accused of overreach. Policies like sugar taxes or meat taxes are considered political hot potatoes and are avoided at all costs.But the overlapping crises caused by our broken food system, from the billions of dollars spent on diet-related health problems to the environmental degradation pushing our planet to its limits, cannot be ignored or fixed with simple technological tweaks. What is needed is a major shift in dietary habits towards foods that are beneficial for both people and the environment.To achieve this, the Eat-Lancet Commission, which consists of the world's leading nutrition and sustainability experts, advocates for a diet rich in fresh fruits and vegetables, whole grains, and plant-based proteins while reducing the consumption of animal proteins, dairy, and sugars. These recommendations provide a clear blueprint for ensuring both health and sustainability.It is unrealistic to expect consumers, who are conditioned by food environments designed for profit rather than human or environmental health, to drive this transition on their own. With unhealthy foods readily available and aggressively marketed, many consumers find it difficult to moderate their food intake, and in some cases, they even develop addictive behaviors.Governments and food manufacturers must take proactive measures to reshape these food environments. They can expand the agendas of campaigns aimed at reducing the consumption of salt, fat, and sugar to also include meat. This will encourage people to eat more plant-based whole foods and meat alternatives. Another potential solution would be to extend some nations' bans on promotions for unhealthy foods to cover meat products. Requiring food companies to report on the types of food they sell, including salty, fatty, and sweet foods and the ratio of plant-based to animal proteins, would also be helpful. These measures would prompt businesses to prioritize healthier and more sustainable options over less nutritious ones.None of this means that the new generation of weight-loss drugs cannot benefit individuals with obesity. For those trapped in a cycle of poor health, treatments like Ozempic and Wegovy can even save lives. Efforts to make these treatments widely available are a positive step. However, it is crucial to recognize that this approach only addresses one aspect of obesity and does not eliminate the underlying pathology. To defuse the time bombs of ill health and environmental catastrophe, we need to take fast and decisive action to remake our dysfunctional food system.Emily Armistead is the interim executive director of Madre Brava, a research and advocacy group.
