Ending childhood obesity: a time for action

Obesity is pervasive at international and national levels. Globally, 2.8 million adults die from obesity and this condition is considered the 5th leading cause of global mortality. According to the World Health Organization (Commission on ending childhood obesity: facts and figures on childhood obesity, 2017. Retrieved from http://www.who.int/end-childhood-obesity/facts/en/), one third of the population is obese. Worldwide obesity doubled over the past few decades and concomitantly, by 2014, approximately 1.9 billion people over the age of 18 were considered overweight. People who are overweight experience higher mortality compared to individuals who are underweight. In 2014, children under the age of five were impacted, with 5 million experiencing obesity or pronounced overweight. Given these statistics, this chapter examines the prevalence and causal factors for adult and childhood obesity in various countries.

There is unequivocal evidence that childhood obesity is influenced by marketing of foods and non-alcoholic beverages high in saturated fat, salt and/or free sugars (HFSS). Furthermore, there is convincing evidence that HFSS marketing in traditional media has detrimental effects on children's eating and eating-related behaviour, and HFSS marketing in digital media has similar effects with stronger effect in vulnerable groups. According to the WHO Commission on ending childhood obesity, efforts must be made to ensure that children everywhere are protected against the impact of marketing and given the opportunity to grow and develop in an enabling food environment - one that fosters and encourages healthy dietary choices and promotes the maintenance of healthy weight. Children are being continuously exposed to powerful food marketing, increasingly in the digital environment. Best-ReMaP partners were exploring how to better monitor food marketing and advertising activities, in particular of promotional activities targeted to and/or impacting children at one hand, and how could marketing activities could be better regulated. Main actions of Best-ReMaP consortium in this field were as following, among others: (1) to identify, develop and share best policy practices to reduce exposure of children to the (digital) marketing of unhealthy foods, (2) develop coordinated and comprehensive protocols and tools to monitor the extent and nature of (digital) marketing exposure of children, including the upgraded WHO nutrient profile model, and to (3) support Member States with the implementation of the new EU rules on audiovisual media services.

The concluding chapter to the book first recaps and then draws together the main emergent themes running through the book as a whole, which play out in the space between two core intentions animating the law in this field - to construct and protect a specific type of economic system and to establish and protect fundamental universal human rights. The themes discussed include legal fragmentation, legal capacity building and interdisciplinarity integration of the evidence-base into law and policy, and the broad potential of human rights law. Each theme poses a set of challenges, to which solutions are indicated. The last half of the chapter applies the thematic discussion and lessons learned to the possible development of a Framework Convention on Obesity Prevention, exploring how such a process may overcome the challenges identified and contribute to more harmonious international law and governance systems.