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Fighting obesity goes beyond the fight to change lifestyle, scientists say

Medicines for the treatment of obesity, such as Ozempic, were considered the main scientific advances of 2023 by the magazine Science. However, overweight rates have been growing throughout the world, particularly in Latin America. Estimates from 2020 indicated that 14% of the world population lived with obesity. The forecast is that, in 2035, this rate will be 24%, including children, adolescents and adults.

“It is important to find nutritional and pharmacological strategies to mitigate the problem, but is this enough? We know that the impact of socioeconomic and environmental factors outweighs any others that influence the occurrence of obesity, including genetic components or attempts to blame the individual for being obese. The fact is that obesity goes far beyond the individual fight against a sedentary lifestyle and changes in lifestyle”, he states. Marcelo Mori member of the Center for Research on Obesity and Comorbidities (OCRC ) – a Research, Innovation and Dissemination Center (CEPID ) from FAPESP based at the State University of Campinas (Unicamp).

Mori is one of the authors of an article published this Monday (04/03) in the magazine Nature Metabolismwhich highlights the need for initiatives aimed at understanding obesity to involve multidisciplinary and global approaches.

In the work, researchers from Unicamp, University of São Paulo (USP) and Universidad Nacional Autónoma de México (Unam) list eight main determinants – physical environment, dietary exposure, economic and political interests, social inequity, limited access to scientific knowledge, culture , contextual behavior and genetics – to explain the growth of obesity in Latin America and to guide the construction of more effective public policies and strategies.

“We list aspects whose effects on weight gain overlap, highlighting the idea of ​​looking at the problem more carefully and more broadly, interfering with the issue based on more contextualized solutions. Are they lifestyle changes? They are, but they need to be especially based on changes in the community and the environment, not exclusively attributing such an obligation to the individual,” she says.

“There are regional differences related to socioeconomic and cultural issues that can impact the obesity epidemic and this means that there is no single solution to the problem”, adds the researcher.

In the work, the researchers highlight that, in past decades, higher rates of obesity were recorded in children and adults in developed countries compared to developing countries. However, when comparing more recent trends in obesity prevalence, data have consistently shown steeper increases in developing countries.

According to national survey data, a large proportion of the Latin American population is overweight or obese: 75% of adults in Mexico, 74% in Chile, 68% in Argentina, 57% in Colombia and 55% in Brazil. Among children and adolescents, rates of overweight and obesity are also high: 53% (Chile), 41% (Argentina), 39% (Mexico), 30% (Brazil) and 22% (Colombia).

For researchers, the sharp increase cannot be explained simply by genetic factors or individual choices, but rather by a combination of structural and contextual factors, which in the article the researchers call systemic determinants.

The article proposes another perspective on the problem of obesity in Latin America. Mori recalls that several studies, mainly in animal models, have already demonstrated that both lack and excess food intake by parents, especially during pregnancy, can result in changes in the offspring that predispose them to metabolic diseases in adulthood.

“Middle- and low-income countries, as is the case in most Latin American countries, in less than 50 years went from a reality with high rates of malnutrition to accelerated growth in obesity. Therefore, it is possible that this rapid transition from food deficiency and malnutrition to the abundance of ultra-processed and high-calorie foods is a relevant aspect in the induction of an epigenetic inheritance, contributing to the recent high rates of obesity, especially in children. This is something that needs to be further investigated in human obesity”, he says.

With this, according to the researchers, preventive and therapeutic paths against obesity that are based on collective actions gain light.

“One solution we indicate in the article is to encourage policies that facilitate traditional eating and regulate ultra-processed foods – which have greater caloric density and are less nutritious. This must be associated with incentives for physical activity, the promotion of healthy habits and adequate nutrition in schools. Furthermore, it is necessary to motivate pregnant women to adopt a quality diet, breast-feeding and offer healthy foods from early childhood. We propose that the focus needs to be on women and children, who may be more susceptible to change and among whom obesity is growing the most in Latin America”, he says.

Another aspect highlighted by the researchers is the impact of limited access to scientific knowledge as one of the determinants of obesity.

“In addition to greater access to scientific knowledge and issues related to open science, we highlight that the investment and amount of research on obesity carried out in Latin America are very small in proportion to the number of people with obesity. We have relevant studies conducted here, but we need more and for them to be more widespread,” he says.

In Mori's assessment, scientific production in Latin America in the area of ​​obesity needs to be more representative, especially in genetic and social studies. “Most of these studies are carried out in countries in the Global North. As long as this is the reality of the data we have on obesity, we will continue to have a knowledge gap on how to mitigate obesity in our region,” he says.

“In this way, we buy from developed countries both the problem and the potential solution. Because, in addition to copying lifestyle habits and acquiring the formulas proposed by these countries, we also pay for food that puts us in this situation and for medicines that, for now, only reach a small portion of the population. Ultimately, we are paying twice and still losing the fight against the obesity epidemic,” he says.

The study Determinants of obesity in Latin America can be read at: www.nature.com/articles/s42255-024-00977-1#:~:text=There%20are%20eight%20determinants%20of,or%20individual%20(outer%20circle).

Source: CNN Brasil

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