Strengthening Systems to Create Healthy Food Environments and Reduce Global Obesity

This series paper argued for a strengthening of accountability systems across all actors to substantially improve performance on obesity reduction. To achieve the World Health Organization’s target to halt the rise in obesity and diabetes, dramatic actions are needed to improve the healthiness of food environments. In view of the industry opposition and government reluctance to regulate for healthier food environments, quasi-regulatory approaches might achieve progress. A four step accountability framework (take the account, share the account, hold to account, and respond to the account) is proposed.

The framework identifies multiple levers for change, including quasi-regulatory and other approaches that involve government-specified and government-monitored progress of private sector performance, government procurement mechanisms, improved transparency, monitoring of actions, and management of conflicts of interest. Strengthened accountability systems would support government leadership and stewardship, constrain the influence of private sector actors with major conflicts of interest on public policy development, and reinforce the engagement of civil society in creating demand for healthy food environments and in monitoring progress towards obesity action objectives.

This paper is a part of The Lancet Series: Obesity 2015, which explores how food environments can facilitate unhealthy eating, exploiting people’s biological, psychological, social, and economic vulnerabilities.