The “Success” of Food Policy in Chile to Fight Obesity

Eight years ago, Chile implemented a sweeping food policy initiative to fight obesity. Many public health advocates quickly endorsed these policies. Researcher Deborah Cohen praised this as a success and called it a four-point lesson plan for the U.S. and other countries to follow:

“Chile recognizes obesity rates are a crisis that demands urgent action. Instead of worrying about whether they had enough evidence to move forward, Chilean policymakers acted on the best evidence available. They were propelled to act given that two-thirds of the country’s population is overweight or obese and that a Chilean citizen was dying every hour from obesity. (It’s at least three people every 15 minutes in the U.S.).”

Chile did what a lot of health policy advocates are seeking for other countries to do. They targeted ultra-processed foods high in sugar, salt, and fat, taxed it, put simple warning labels on it, and imposed restrictions on its sales and marketing.

Changing Behavior? Yes

People with deep convictions that the template in Chile is right still label it as a success. In 2021, public health researchers from the University of North Carolina documented “important declines” in purchases of the targeted foods and beverages. They went on to show in a 2023 publication that the regulations “effectively reduced children’s exposure to unhealthy food marketing.”

For some people this is the definition of success. Gary Sacks, co-director of the Global Centre for Preventive Health and Nutrition at Deakin University in Melbourne told the BMJ:

“Chile is the success story. Their government has a comprehensive package of policies that they have implemented.”

Reducing Obesity? Improving Health? Not Really

Sticklers, though, seem to think that health policies should deliver actual improvements in health. Baylen Linnekin is a legal scholar focusing on food law and policy. He says:

“There is no evidence that any of these policies reduce obesity, and given that that’s the whole point, that’s a problem. They can cause people to buy less of something – but they may just be switching to different products.”

And in fact, a new analysis from the Pan American Health Organization and the World Health Organization concludes:

“Chile’s food regulations were not followed by a sustained decline in obesity in primary- and secondary-school students.”

To continue insisting that food policy in Chile should be a global template for fighting obesity while it shows no effect on obesity or health is a mistake.

Health promotion and obesity prevention are important goals. We should make the effort to find policies that work to advance those goals. Promoting ineffective policies harms the credibility of public health and gets in the way of genuine progress.

Click here for reporting from the BMJ and here for the analysis from PAHO and WHO.

Lamas in Chile Norte Grande, photograph by Luca Galuzzi, licensed under CC BY-SA 2.5

Subscribe by email to follow the accumulating evidence and observations that shape our view of health, obesity, and policy.

May 8, 2024