Santiago Farmers' Market Asparagus

Does Chile Have the Secret for Reversing Obesity Trends?

Writing in U.S. News, Deborah Cohen tells us that Chile has “taken the lead” toward ending the obesity epidemic. “The country’s success on this front can serve as a four-point lesson plan other countries could follow,” she says.

Aggressive Regulatory Strategies

What is this “success” of which she speaks? According to Cohen, Chilean policymakers did four things right. First, they took action without worrying too much about evidence. They acted on the evidence at hand.

Second, they named the culprit. It is the sugar, salt, and fat in processed foods, she says.

Third, they made decisions based what they judged to be best for their citizens. The food industry received a hearing, but no priority.

Finally, they developed simple, clear warning labels for bad foods with too much salt, sugar, calories, or fat. It’s a stop sign in black and white. And foods with that stop sign can’t go into schools and can’t be advertised to children.

Evidence of Impact?

For evidence that it’s working, she says 40% of Chilean citizens report using those symbols to help them decide what to buy. Sales patterns are shifting. Food manufacturers are reformulating their products to escape those symbols.

However, the real goal is to stop and reverse the growth in obesity prevalence. Measured by that criterion, we have no evidence for any success in Chile. The prevalence of obesity is still growing there.

Let’s think about other public health challenges. Real solutions are based on careful application of evidence. Protocols for containing the Ebola virus were grounded in evidence. Money and resources went into testing a vaccine and it proved to be effective. Evidence-based strategies made a real difference in health outcomes.

The response to HIV followed the evidence and HIV infection has become a manageable chronic disease instead of a uniformly fatal condition. Effective treatment prevents transmission. Though scientists hoped for an effective vaccine, we are still waiting for research to prove that we can have one.

But obesity prompts a different response from many people in public health. Otherwise thoughtful people have no problem proposing obesity solutions based only on logical deduction. These measures ought to work, so they’re good enough. No evidence for health outcomes needed. Are soda sales down? Good. It’s working.

We cannot help but think those people are not serious about obesity. Otherwise they would surely insist on better scientific evidence for solutions that actually work.

An Experiment, Not a Solution

Does Chile have the secret for reversing obesity trends? No. All they have are educated guesses.

Instead of declaring that Chile’s policies are successful, serious stakeholders should recognize them for what they are – experiments. The results need careful, objective analysis. That’s the only way to learn what will truly work.

Click here for more from Cohen’s perspective.

Santiago Farmers’ Market Asparagus, photograph © Matt Hintsa / flickr

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December 28, 2017

3 Responses to “Does Chile Have the Secret for Reversing Obesity Trends?”

  1. December 28, 2017 at 8:31 am, Fernando Vio del Rio said:

    It is true that Chile is implementing a food labelling policy, but without education, and the impact is not clear, in particular in children.
    The last National Health Survey 2016-2017 showed a 74.2% of the population with overweight or obesity, an increase from 61% NHS 2003 and 67% NHS 2009-2010. The main oncrease was in obesity from 22.9 to 31.2% in the last 6 years (overweight was maintained in 40% in the same period). Morbid obesity increased from 2,2% a 3,2% with 4,9% in the age group 30 -49.
    Thus, Chile is far away from a “success”. On the contrary, in the last 30 years it has been impossible to build a State Policy to cope with obesity, as was done to eradicate undernutrition in the 80`s

  2. December 28, 2017 at 10:21 am, Allen Browne said:

    Yup. It’s amazing how people can create change but don’t have the discipline to look for an effect – like better health.

  3. December 28, 2017 at 10:21 am, Ted said:

    Thank you for Fernando, for taking this seriously and providing your expert perspective.

    It deeply distresses me that people will accept wishful thinking and logical deductions as if they were facts. Health policies to address obesity are too important to cast aside the need for collecting good evidence to deliver serious solutions. We will never make real progress until we demand more rigor.