The growing concern of child obesity has elicited numerous reactions among policy makers, nutritionists, and the general populace across the globe. Current indications reveal a fast-food epidemic invading countries globally. According to the World Health Organization (WHO), some 22 million children are classified as overweight worldwide, aggravating the tide of nutrition and food-related chronic diseases [1]. With today’s United Nations emphasis on curbing world hunger and malnutrition, action should also be taken regarding the obesity epidemic. Lead by the United States and Canada, countries have rallied to combat this nutrition epidemic using governmental regulations. As part of an epidemiological transition, the obesity epidemic appears to spread explosively across populations and across all age groups, so that by 2050, many parts of the world will begin to resemble the current situation in the U.S. For all these populations, the strong influence of the social environment— food availability and marketing— on body composition and health will increasingly be noticeable [2]. There is a yawning gap in comprehensive research and policy analysis of existing national responses directed toward the determinants of obesity. The bulk of available research, whether epidemiological, academic research, or advocacy, has centered on food and physical activity environments but has studied nations and world regions almost exclusively in isolation. This lack of a broad base of systematic comparative evidence has been a serious impediment to wider diffusion or understanding of interesting and potentially useful policy innovations.
1. Introduction to the Global Obesity Epidemic
A global epidemic, the obesity pandemic involves chronic excess weight gain resulting from an energy imbalance [3]. More specifically, energy intake consistently exceeding energy expenditure contributes to obesity and its resultant complications. Female sex, advanced age, low socioeconomic status (SES), high fertility, and social isolation are some of the physiological and environmental parameters constituting the biological and social determinants of obesity. By promoting excess food intake and low energy expenditure in different ways, these determinants are thought to interact and predispose populations to energy imbalances and weight gain. It is important to note that may be consistent across societies but are nevertheless dynamic and may vary with cultural contexts, policies, technological advancements, and events over time. To date, the obesity pandemic has resulted from a multiplicity of interactions between older accounts [4].
2. Understanding the Causes and Consequences of Obesity
Obesity is characterized by abnormal or excessive fat accumulation that may impair health. While BMI does not directly measure body fat, it is calculated from weight and height. A classification system based on BMI scores has been established by the National Institutes of Health; individuals with BMI reaching 25 kg/m² are considered overweight and those exceeding 30 kg/m² are classified as obese. The most prevalent measure of obesity is, therefore, the BMI. Other models of obesity often relied on waist circumference and waist-to-hip ratio to estimate fat distribution. Although BMI is the simplest measure of obesity, it is also the most criticized. Nevertheless, BMI remains the most commonly used measure of obesity at the population level in many epidemiological settings and health organizations. A BMI greater than 23 is considered a risk for an overweight public health problem in most Asian populations and countries.
3. Epidemiology and Statistics of Obesity Worldwide
From the description of obesity as a pandemic in 1997, to being declared an epidemic in 1999, to simply proclaiming the need for action on the part of governments in 2004, or all of them, this should have been enough warning signs to move action items from feasibility studies to implementation. In May 2016, a World Health Assembly resolution urged Member States “to take action to promote healthy diets and physical activity in children through relevant policies.” The terms of this resolution between the WHO and member states are merely words on paper, and there appears to be little hope for implementation. After all, “It is currently not known which policy options are effective in reducing the burden of childhood obesity.”
An estimated 46 million children under the age of five were overweight in 2020, with the majority living in low- or middle-income countries. Furthermore, 39 million children under the age of five were considered stunted, and 149 million were considered underweight. Globally, in September 2020, it was estimated that approximately 1.47 billion adults were living with obesity (BMI ≥30 kg/m2); this is close to 30% of the global adult population. By projections made in 2015, by the year 2030 there will be approximately 2.16 billion adults living with obesity (BMI ≥30 kg/m2). Currently, obesity is the most prevalent, non-communicable disease in North America. The Western Pacific has the greatest projected relative increase in the number of adults with obesity from 2010 to 2030 and will soon be the region with the largest number of adults living with obesity. Obesity is classified based on BMI, a measure of weight adjusted for height, and childhood obesity is classified based on the international growth standards established by the WHO, which are based solely on weight-for-length/height. However, BMI is known to vary across ethnicities; there is a need for ethnicity specific classifications for adult and childhood obesity. Due to the epidemic level and global scope of the disease, there is a need for local, national, and international vigilance and attention [5].
4. The Role of Genetics and Environment in Obesity
Obesity is a complex social problem in which one may uncover deeper genetic mechanisms that invite co-evolution with the environment and public health intervention strategies. Individual body mass index (BMI) derives from the interaction of nutrient energy intake, energy expenditure, and body weight trajectories, which are modeled by quanta population ecology. In this complex system, feedback mechanisms and certain factors converge to increase a population’s body mass. The primary mode of convergence is social interaction. Cross-generational social interaction induces phenotypic coupling (phenocopy) within modern human populations, which positively reinforces grand-maternal epigenetic inheritance, neuroplasticity, and cultural assimilation of polygenic SNPs, but negatively reinforces healthful lifestyle patterns [6].
In all organisms, phenotypic coupling adapts to the bounded and equal convergence gradient of the environment such as food and reproductive resources. In mass-simplified models of animals and plants, the maintenance of convergence requires the balance of population between fast-growing and slow-growing species. Population equilibrium bifurcates at a critical resource input/output ratio, leading the equilibrium population to shift to either chaotic oscillation or global convergence [7]. For human populations, plummeting death rates and inequality of social classes yield unequal convergence of urbanized populations to greater body mass. This imbalance induces the natural selection of beneficial alleles and population divergence of anthropometric profiles, of which historical records remain in present-day global populations.
5. Socioeconomic Factors and Obesity Disparities
Recent global healthcare data indicate building barriers to food, housing, jobs, opportunities, and health care among the broadening arrow of the wealth gap. In parallel, a social gradient in health has been observed in high-income nations, where health inequalities have been shown to be ongoing across the life course and begin at birth. The social gradient in health differs with illness type, showing greater socioeconomic disparity for obesity and infant mortality than for all-cause mortality and life expectancy. Obesity has traditionally been associated with affluence in lower-income countries, though recent evidence suggests that this relationship appears to be changing, with lower-income countries undergoing economic transition in much the same manner as have many high-income countries [8].
The global epidemic of obesity, noncommunicable disease, and its risk factors is most pronounced among lower-income countries, including those in transition, where few if any options exist for affordable dietary alternatives and where norms and cultures that support obesity prevention have not been established. At low levels of economic development, material wealth is the primary determinant of food availability; hence, wealthy people are much less likely to engage in jobs requiring high levels of physical activity. Moreover, wealth locally protects against negative energy balance caused by undernutrition and physical labor. As economies develop, barriers to food availability are predicted to be reduced for the poor, though food price structure may still favour wealthier groups. Conversely, at the next stage of economic development, the increasing availability of inexpensive energy-dense minimally processed “fast foods,” combined with greater barriers to affordable physical activity, are predicted to enhance further group disparities in diet and obesity risk [9].
6. Impact of Obesity on Health and Healthcare Systems
Obesity is an abnormal or excessive fat accumulation that presents a risk to an individual’s health. A body mass index (BMI) of 30 or greater is generally considered as obese. Children aged from 5 to 19 years old, is overweight when their BMI is greater than +1 (above the 85th centile)and obese when their BMI is greater than +2 (above the 95th centile) according to the International Obesity Taskforce (IOTF) [10]. It is currently estimated that over 500 million people are obese worldwide and is associated with several serious chronic diseases such as cardiovascular disease (CVD), type 2 diabetes, hypertension, cancers, and stroke. Obesity-related chronic diseases have a detrimental impact on the quality of life and disability-adjusted life years (DALYs).
The economic case for preventing and treating obesity is clear. Worldwide, the costs of obesity are considerable and estimated to be 3.3% of total GDP in Organisation for Economic Co-operation and Development (OECD) countries. Within Europe, the costs associated with obesity account for 2–8% of the health budget, and in the UK, the direct annual costs from treating health complications associated with obesity is over £6 billion. There is a clear socio-economic gradient. In high-income countries, the risk of obesity is higher in population groups who have lower socio-economic status. The recent COVID-19 pandemic has highlighted that obesity is a risk factor for severe symptoms from COVID-19. Nevertheless, government restrictions imposed on society acted in a way that further increased population levels of obesity.
7. Psychological and Social Implications of Obesity
Exploring the psychological and social implications of obesity, weight gain, and being overweight, when coupled with lifestyle changes, can generate emotional difficulties. Aside from these, people with obesity or weight issues face ridicule, bullying, and discrimination, all of which carry emotional ramifications. It is a vicious cycle that perpetuates itself. Living in a stigmatizing society has a huge effect on the affected person’s life and mind; hence treating obesity as an epidemic—without looking at its holistic impact—may not provide a lasting solution or effective means of contact for those concerned [11].
Obesity stigma begins before weight, puberty, or school and is pervasive and progressive. It feels worse than racial discrimination or even learning disabilities. It takes on many forms, which can include ridicule, bullying, teasing, rejection, lower peer acceptance, isolation, social and occupational discrimination, prejudice and discrimination from health care providers, and discrimination in education and employment. Stereotypes perpetuating this behavior, such as laziness, stupidity, untrustworthiness, and lack of self-discipline, adversely impact societal perceptions, policy responses, and trajectories of obesity and health among individuals [12].
8. Nutritional Science and Obesity Prevention
Dietary factors play a significant role in the etiology and prevention of obesity and must also be considered in strategies to reduce obesity risk. The essential role of nutrition in obesity prevention is widely recognized, and nutrition is an integral part of most national obesity-prevention strategies. There is also scientific consensus on the recommendations that have emerged regarding nutrition and obesity prevention [13]. Nevertheless, nutrition and obesity prevention remain poorly understood topics among the general public, which is troubling given the critical role the public plays in the dissemination of healthy lifestyles within their families, communities, workplaces, and schools. An understanding of the scientific evidence and recommendations is critical to the public’s role in obesity-prevention strategies. Obesity is characterized by excessive fat accumulation and is highly stigmatized. Individuals with obesity are often considered to be at fault for their weight status due to personal failings, such as a lack of willpower, self-discipline, and ambition. However, there is increasing acceptance of obesity as a complex health condition influenced by genetic, behavioral, and environmental factors [2]. Environments that promote energy imbalance and excessive weight gain abound. Unplanned, poorly designed, or default public policy decisions, such as the proliferation of energy-dense nutrient-poor foods (unhealthy food) and sugar-sweetened beverages in the food supply, and the promotion of these food products with attractive pricing and advertising, further drive energy imbalance.
9. Physical Activity and Exercise Guidelines for Obesity Management
Physical activity plays an important role in obesity and overweight management. Regular physical activity is essential for weight control. It increases energy expenditure and prevents the decline in metabolic rate that accompanies weight loss and, thus, enhances the effectiveness of low-energy diets. Exercise is the fundamental choice for obesity and overweight management since it is helpful to both weight loss and weight maintenance. Exercise may help prevent the negative consequences of weight-related behavior on well-being. Physical activity should also be encouraged in children [14]. This applies to routine activities such as walking and cycling as well as recreational and sports-based programs. Based on both epidemiological evidence and recent findings from controlled intervention studies, recommendations for the physical activity and exercise regimens most likely to achieve weight loss and weight maintenance in individuals at high risk of developing obesity are outlined [15].
10. Behavioral Interventions for Weight Loss and Maintenance
This article focuses on behavioral interventions aimed at facilitating weight loss and sustaining healthy lifestyle changes, as described by [16]. Individuals are assisted in self-restructuring their lifestyle and environment to manifest accessible changes known to contribute to obesity, often through specific problem-solving tactics for traversing health-related habits. The behavioral strategies/techniques assisting with weight loss and the maintenance of healthy lifestyle changes are examined in this contribution [17].
Most behavior modification strategies focus on increasing awareness around triggers for the problem behavior; they focus on identifying feelings and beliefs around the weight issues or the consequences of the problem behavior. Other strategies function to increase structure around common weight-related behaviors; such reinforcement strategies provide support to common environments influencing behavior that enables change. Finally, efforts seek out actions involving the establishment of realistic goals for changes, such as visible and attainable weight and health changes, or a time frame for physical activity improvements.
11. Medical Treatments and Surgical Options for Obesity
With the growing epidemic of obesity, it is becoming increasingly important to investigate available medical and surgical interventions for this condition. There are currently medical, surgical, and behavioral treatment options available for individuals suffering from severe obesity. While it is well established that diet and exercise, alone or in combination with medication, are effective in managing mild to moderate obesity, they have many limitations in treating severe obesity. The most effective option in the treatment of morbid obesity is surgical intervention. In massive weight loss patients, body contouring surgery is often performed to remove excessive skin and other subcutaneous tissues. Complicated surgery and increased incidence of complications involving the surgical site justify meticulous selection of patients needing this type of intervention [18].
Obesity is a chronic, multifactorial disease that has reached epidemic proportions globally, affecting all demographics, and represents one of the largest threats to public health. Clinical evidence indicates that obese individuals (body mass index > 30 kg/m2) are at significantly greater risk of developing obesity-related comorbidities such as type 2 diabetes, hypertension, dyslipidemia, obstructive sleep apnea, and certain types of cancers, than non-obese individuals. The consequences of these morbidities include a diminished quality of life, increased health care costs, cardiovascular disease, and increased mortality. Accordingly, obesity, and its associated comorbidities, present a significant burden to health care systems worldwide [19].
12. Public Health Policies and Programs for Obesity Prevention
An increasing number of countries and regions are developing and implementing public health policies, action plans, and programs dedicated to preventing obesity at the population level. A number of these incorporate WHO’s Global Strategy on Diet, Physical Activity, and Health, which emphasizes such actions as modifying the food and physical activity environments, with the aim of enhancing experience of a healthy, active lifestyle and reducing exposure to risk factors in communities and through schools [20]. Besides WHO’s framework, various other conceptual and policy frameworks concerning obesity prevention have emerged, e.g., the United States’ Institute of Medicine report on Preventing Childhood Obesity, the European Union’s Community Strategy on Nutrition, Overweight and Obesity, Australia’s At a Glance Fact Sheet on Childhood Obesity, WHO Europe’s Strategy on Nutrition, Overweight and Obesity, the United Kingdom’s National Health Service plan for tackling obesity, and the Canadian Heart Health Initiative’s Childhood Obesity Prevention Project. Several population-based community interventions have been and are being conducted to prevent obesity in children and/or adults. Some programs are designed to prevent obesity specifically, whereas others have wider aims, e.g., undertaking a comprehensive process to promote healthy nutrition and/or physical activity. A number of the different approaches are in pilot or evaluation phases. Forestalling clinical symptoms of obesity while children are still in the growth phase is seen as a way to prevent adult obesity and related chronic diseases [2]. Before and after school, schools, and parents promote physical activity, life-skills training, and healthy eating, and discourage sedentary leisure-time, thus influencing children’s local environments. Obesity prevention is coordinated by local stakeholders and evaluated on different levels whilst attention is also paid to sustainability of the actions taken.
13. School-based Interventions and Childhood Obesity
Increasing human weight gain and fatness from time of birth till death is inescapable as an individual ultimately becomes thinner and dies, which is a permanent and eventual evolution. The permanent fatness of an individual obstructs the longevity of life. There is a complex relationship between biochemistry, physiology, genetics, hypnotics, sleep, life cycle, and social behaviors. Obesity is a global issue and epidemic, which affects individuals across the life cycle. Life cycle starts from simple and lower forms, prokaryotes and eukaryotes, to complex and higher forms [21]. Obesity is common since the first period of life. The onset period of obesity differs among different species of living individuals. In general, hydration, hypertriglyceridemia, and hypercholesterolemia are the key players during the fatty evolution from birth to 5 years old. After that, basal metabolic rate (BMR) and the state of hunger compete with the weight gain.
To prevent the fatness evolution of living individuals, it is a must to target the prevention during the earliest periods. It is crucial to use anti-obesity methods against hormonal and neural rooted under a right moda. Once it gets stuck in the cross-talk, it becomes a dia-besity auto-maintaining state, which is invisible and inescapable throughout life, and will ultimately go either quicker or quieter to death. Childhood overweight and obesity are significant public health challenges prevalent worldwide. In 2010, an estimated 43 million children under the age of 5 years were overweight or obese globally, with the majority living in developing nations. Furthermore, the overall prevalence of young children’s obesity has steadily climbed from 1980 to the present. With the continued growth of childhood obesity, the number of obese children is expected to rise to over 60 million globally by 2020. Children with obesity are more likely to develop and adult obesity later in life. To combat childhood obesity, there is an urgent need for comprehensive initiatives and programs focused on addressing risk factors, particularly dietary and physical inactivity, which can be effective in preventive strategies [22].
14. Workplace Wellness Programs and Obesity Management
[23]. The workplace offers a particularly suitable setting, as adults spend more than half of their day there and many spend most of their waking hours there [24]. By influencing behavioral factors at this setting, the workplace may contribute to combating the obesity epidemic at a societal level.
15. Community Engagement and Advocacy for Obesity Awareness
Focusing on the community level, as a third tier, there would be consideration of engagement about the obesity epidemic at the community level. Community engagement is vital to combatting local, state, national, and global epidemics. There is a discussion of the best strategies for raising awareness of the obesity epidemic. Community-driven efforts, activism campaigns, and advocacy campaigns merit consideration. Attention to the obesity epidemic needs to be at an individual and community level. Advocacy, activism, awareness-raising, and concerted community action galvanizes individuals, grass-roots organizations, NGOs, physicians, commercial organizations, public health organizations, policymakers, and other allies. Community level actions are crucial for raising awareness of the obstacles to exercising, the reliance on fast-food convenience foods, the burden of two-career families, the dirtiness of public parks, cranky old people shaking their sticks at children walking or riding bicycles to schools, and a world dominated by sedentary opportunities filled with passive messages about food choices [25].
16. Technology and Innovations in Obesity Management
Advancements and innovations in technology are being leveraged for obesity management and intervention. Modern technology offers better Health Information Technology (HIT), Internet, interactive tools, and technology-enhanced strategies that support obesity prevention and management efforts. Technological innovations, devices, and tools in health promotion settings augment obesity interventions. Integrating such technology in settings has been emphasized by many experts and organizations worldwide [26].
Today’s world is reaching toward an unprecedented technological era. Health technology and telecommunication are harnessed together to serve health needs and expectations. Developing and publicizing digital Health (eHealth) solutions is a worldwide priority that seeks to enhance cost-effective health delivery systems. Emphasis is now placed on healthy lifestyle-based approaches to improve obesity prevention and management programs, positively impacting individuals, communities, and environments. Strong support exists for utilizing technology to extend health information and education.
17. Cultural Considerations in Obesity Prevention
Cultural considerations must be taken into account when researching obesity prevention. The connection between cultural beliefs and practices surrounding diet, physical activity, and body shape and size, as well as how these affect how people respond to and manage obesity, is examined. In addition to cultural themes, specific cultural considerations are offered that will contribute to an understanding of how cultural perceptions affect a community’s understanding and management of obesity. Insights into how different cultural narratives shape attitudes toward dietary habits and physical activity, resulting in different community-based designs, are offered [27]. Understanding these cultural nuances and their influence on body shape and size is crucial in designing effective obesity prevention strategies that are culturally sensitive and tailored to specific communities.
The ICAA Good Practice Guidelines indicate that strategies must be grounded in an understanding of the distinctive cultural attitudes that affect how obese individuals view and react to their condition. Culturally relevant anti-obesity campaigns are being developed in collaboration with specific organizations to build on these different cultural narratives. An example of how this process is being accomplished within different cultural contexts is presented, outlining particular cultural considerations to examine when researching obesity [28].
18. Ethical and Legal Issues in Obesity Treatment
Obesity is a disease affecting an ever-growing number of people around the globe. It has been attributed to a combination of factors including diet, sedentary lifestyle, lack of education, geography, socioeconomic status, genetics, comorbidities, and emotional state. A critical examination of moral, ethical, legal, and policy implications surrounding those factors is pertinent to ensure proper management and treatment in a fair and appropriated manner [29]. The World Health Organization has defined specific body mass index categories that classify individuals based on weight, height, and degree of excess body fat [2]. This classification serves as the basis for national obesity prevalence statistics. Also proposed is a wide arsenal of treatment options including lifestyle changes, medication, augmented reality exergames or surgery, among others. Comprehensive analysis of several of the most salient obesity-related factors has been performed and maximally standardized treatment options have been suggested (Table 1 of Politi, 2018). Further examination into the ethical and legal issues surrounding the treatment of obesity and subsequent appetite dysregulation is now warranted.
More than a third of U.S. adults (35.7%) and almost 1 in 5 youth (ages 2–19 years) have obesity. Contributing factors for obesity include demographic, geographic, cultural, individual, food and activity environment, institutional, economic, food supply, food advertisement, and public policy considerations. The ever-growing prevalence of obesity presents the question of how to address it: how to treat, how to manage, and how to prevent this disease from rapidly spreading? The explosion of obesity-related health consequences has contributed to an equally growing interest in the underlying issues surrounding this disease. Broadly, four major moral inquiries can be constructed regarding food intake and obesity. These inquiries can be classified as internal (individual) and external (organizational/societal) forces. Each inquiry artificially compartmentalizes the myriad of possible factors contributing to obesity treatment and weight loss into broadly controlled factors and those generally considered “within” society’s control.
19. Global Collaborations and Initiatives in Combating Obesity
Focusing on global efforts, this section examines collaborative initiatives and partnerships aimed at combatting obesity on an international scale. It seeks to explore the role of global collaborations, multilateral organizations, and cross-border efforts in addressing the complexity of the obesity epidemic. By highlighting these global endeavors, the section underscores the importance of collective global action in tackling obesity as a shared challenge. Tackling the global epidemic of obesity requires international cooperation and cross-border efforts. Policy solutions to obesity must include action by countries with both developed and developing economies; and should ideally include coordination with private industry, particularly the food and beverage sector [2]. Beyond the World Health Organization, other multilateral organizations such as the Economic Community of West African States, Pacific Islands Forum Secretariat, and the Alianza Panamericana de Lactancia Materna have emerged developing and coordinating region-specific responses to the obesity epidemic. In addition to these regional responses, movement among countries on national legislative efforts is being coordinated cross-nationally. For example, the growing network of countries sharing information and coordinating ongoing legislative efforts was facilitated through the formation of the “FoodLeg” network and the FLegal network.
Globalization, along with the emerging and diverging roles of multinational corporations and transnational organizations is neither straightforward, nor necessarily positive [30]. Obesity in high-income countries has been interpreted as a complex social and public health issue of individuals contributing to a growing epidemic that increasingly threatens healthy and productive life expectancies in those populations. In contrast to the focus on high income countries, obesity has burgeoned in low-income and transitional economies. National governments, multilateral organizations, and private industry must collaboratively translate the global goals set by the WHO framework and plan into national priorities and legislation. Co-sponsors of the framework include a broad coalition of states, UN agencies, and intergovernmental organizations who can be mobilized to create priorities for global action that set the stage for local initiatives.
20. Future Trends and Directions in Obesity Research and Policy
Future research agendas for public health nutrition are informed by recent trends in obesity research and policy development. In addition to examining the emergence and role of new policies, program interventions, and stakeholder coalitions, these trends affect the research agenda; provide an impetus for action; and involve new actors, policy arenas, and tools for both intervention strategy design and evaluation [2]. The perception that the obesity epidemic is growing out of control has triggered a demand for more innovative approaches. New paradigms, data, tools, and methods are evolving to conceptualize and test food environment changes: large-scale public health campaigns to change eating, eating practices, and urban food environments; collaborations for policy initiatives and strategies to address food security and land use; food firm reformulation efforts; novel dietary instruments; and new cross-jurisdiction policy comparators.
The approach to responding to the food environment and other determinants of nutrition and obesity must be comprehensive, long-term, and coordinated across food firms, various levels of government, and sustainability sectors. Greater attention needs to be paid to prevent duplication of initiatives and resolve policy tensions across sectors. The emergence of strong social media networks and communities of practice can be helpful in responding more comprehensively, expeditiously, and effectively to the problematic food environment and related determinants of inequities. As strategic coalitions to shift societal goal priorities are built, public health advocacy efforts will reshape the research agenda to more effectively deal with the determinants of inequities in nutrition, diet, and obesity [20].
21. Conclusion and Key Takeaways
The global obesity epidemic has become a significant public health crisis, affecting millions of individuals and communities worldwide. Rising rates of obesity dramatically impact marginalized and vulnerable populations. The daily lives of these high-risk groups are profoundly shaken, leading to unhealthy diets and nutrition habits which activate the epidemic’s vicious cycle. The epidemic also amplifies health inequities and disparities of social, economic, and health trends, calling for social change approaches originating from the community level. The multi-faceted consideration of immigrant experience and environments contributes to a better understanding of the mechanisms through which obesogenic environments emerge and interact with individual activities [2]. However, it remains uncertain how the experience of restrictive immigrant environments prompts preparedness for challenges in achieving a healthy lifestyle. Most obesity solutions focus on a biomedical perspective of individual lifestyle change. Hence, there is a call to shift focus to a wider societal and environmental vision of prevention. A better grasp of the systems, structures, and drivers causing rapid environments is critical to support effective prevention and intervention strategies. Swift responses need to proactively reduce health threats posed by the pandemic and other natural disasters that intensify the spread of obesity and related non-communicable diseases (NCDs). Since 2015, credible responses to the global obesity epidemic at the state level gained traction through national laws and guidance, and at the city level through local ordinances and plans. However, legislation at both levels mainly aims to offset rising risks dynamically posed by fast-evolving obesogenic environments rather than proactively preventing those changes [31]. In addition, there is a scarcity of legislation that effectively removes existing obesogenic drivers. More systematic inquiries into the content and effectiveness of individual laws at the national level are warranted, as many responses are still nascent and poorly enforced. Proposed solutions and strategies should be analyzed for broader elements to support state-level action on childhood obesity.
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