The narrative must shift away from individual choice on to structural factors
Over half of the global population will be living with overweight or obesity by 2035 if current trends continue, and more than 1.3 billion people worldwide will have diabetes by 20501; type 2 diabetes will account for most of the new cases, fuelled by changes in obesity and dietary risks.2 These trends are likely to have serious health, social, and economic effects, not least for low and middle income countries, which are forecast to bear the brunt of the increases. However, we already have evidence of the inequitable burden of obesity and type 2 diabetes, notably during the covid-19 pandemic when people with obesity and type 2 diabetes experienced poorer outcomes.3
In 2018, The BMJ launched Food for Thought, a collection exploring key questions around what we should eat to stay healthy and avoid disease.45 The collection showed how weak science, commercial influences, and conflicting media messages all co
Conceptualising ultra-processed foods high in carbohydrates and fats as addictive substances can contribute to efforts to improve health, argue Ashley Gearhardt and colleagues
The scientific understanding of addiction is evolving. Although addiction to certain foods is not included in diagnostic frameworks such as the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), research on this topic has grown rapidly in the past 20 years. Much of this research uses the Yale Food Addiction Scale (YFAS), which was developed to measure food addiction by assessing DSM-5 criteria for substance use disorder in the context of food intake (box 1).14
Box 1
### Yale Food Addiction Scale (YFAS)RETURN TO TEXT
A recent analysis of two systematic reviews including 281 studies from 36 different countries found the overall pooled prevalence of food addiction using YFAS was 14% in adults and 12% in children.89 This reported prevalence is similar to the levels of addiction seen for other legal s
Sarah Maessen and colleagues argue that identifying successful policies and practices in countries with falls in early childhood overweight can help enhance efforts and reduce within country inequities
Nearly every country worldwide has experienced a steady rise in the prevalence of obesity across all age groups in recent decades.1 However, there has been recent optimism about an apparent plateau in prevalence of unhealthy weight among children in some high income countries, particularly among young children.2 A World Health Organization analysis of national surveys from 144 countries described notable increases in the prevalence of overweight and obesity among preschool children (under 5 years) from 1990 to 2010, and predicted an acceleration in prevalence from 2010 to 2020.3 WHO highlighted the preschool years as a potentially critical time in the life course for development of obesity and related metabolic disorders, with most preschool children with overweight or obesity continuin
Carmen Piernas and Jordi Merino argue that suboptimal diet and poor metabolic health aggravated the covid-19 pandemic and require greater attention to increase population resilience and reduce health inequalities
The covid-19 pandemic emerged at a time when many countries were already grappling with unprecedented levels of obesity and cardiometabolic disease.1 Underlying poor metabolic health, unhealthy diets, and increased health inequalities compounded the pandemic’s economic, public health, and social burdens.
The initial policy responses reasonably aimed at containing the spread of the virus through restricting movement (lockdowns). However, in the context of suboptimal diets and poor metabolic health, these measures unintentionally imposed additional challenges on people’s lifestyles, with observed trends towards overeating, unhealthy snacking, and increased alcohol consumption across many countries.2 In addition, the pandemic restrictions amplified food insecurity, which fu
Manuel Romero-Gómez and colleagues discuss how diet and modifiable factors can help prevent of non-alcoholic fatty liver disease and the importance of engaging all society through awareness, education, and policy change
### Key messages
Non-alcoholic fatty liver disease (NAFLD) is characterised by fat accumulation in hepatocytes in people who drink little or no alcohol and is strongly related to metabolic disorders like obesity, type 2 diabetes, dyslipidaemia, and arterial hypertension.1 The global prevalence of NAFLD has increased over time, now reaching more than 30% of the general adult population, with an estimated annual growth of 0.7%.2 NAFLD is a complex, heterogeneous, and dynamic disease, and progression to fibrosis (scarring of the liver) occurs in around 10-15% of patients with NAFLD.3 NAFLD is one of the main risk factors for developing liver cancer, which represents the third highest cause of death by cancer in the latest Globocan report.4
People with obesity are 3.5 t