Prevention and control of obesity in China

Obesity has become a global public health crisis, 1Wang Y Lobstein T Worldwide trends in childhood overweight and obesity.Int J Pediatr Obesity. 2006; 1: 11-25Crossref PubMed Scopus (1920) Google Scholar, 2Wang Y Mi J Shan X Wang QJ Ge K Is China facing an obesity epidemic and the consequences? The trends in obesity and chronic disease in China.Int J Obesity. 2007; 31: 177Crossref PubMed Scopus (520) Google Scholar, 3Ng M Fleming T Robinson M et al.Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013.Lancet. 2014; 384: 766-781Summary Full Text Full Text PDF PubMed Scopus (6729) Google Scholar, 4Wang Y Wang L Qu W New national data show alarming increase in obesity and noncommunicable chronic diseases in China.Eur J Clin Nutr. 2017; 71: 149Crossref PubMed Scopus (48) Google Scholar and China has the largest number of affected people worldwide, with about 46% of adults and 15% of children being obese or overweight.4Wang Y Wang L Qu W New national data show alarming increase in obesity and noncommunicable chronic diseases in China.Eur J Clin Nutr. 2017; 71: 149Crossref PubMed Scopus (48) Google Scholar Increasingly Chinese society is making efforts to address the rising obesity and chronic disease epidemic.3Ng M Fleming T Robinson M et al.Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013.Lancet. 2014; 384: 766-781Summary Full Text Full Text PDF PubMed Scopus (6729) Google Scholar In this context, in 2015, two of us (YW and YY) initiated a project that aimed to synthesise existing evidence in the field and help enhance obesity and chronic disease prevention and control efforts in China. Approximately 30 international and domestic experts with expertise in diverse fields ranging from public health to medicine worked closely during 2015–19 and developed a seven-chapter, 246-page report, published in April.5Wang Y Sun M Yang Y China blue paper on obesity prevention and control. Peking University Medical Publisher, Beijing2019Google Scholar The report systematically reviewed numerous existing obesity prevention policies in China, in other countries such as the USA, Canada, the UK, Australia, Mexico, Denmark, Chile, and Japan, and those advocated by international organisations including WHO and UNICEF. Considering the special social, cultural, economic, and contextual factors in China, the report proposes the following policy recommendations for China: (1)Make government responsible and enhance cross-sector collaboration. This includes integrating obesity prevention and control into government mandates and the day-to-day work of relevant government agencies and authorities, improving and completing the nutrition policy system, and fostering the training of nutritional experts and professionals.(2)Make better use of health professionals' institutions to promote large-scale, population-level educational programmes and campaigns; to provide individual-level counselling and guidance on obesity prevention, control, and treatment; to implement 360°, multilevel, multicomponent, and multisector prevention and intervention programmes and related research; and to develop and improving surveillance systems at national and local levels.(3)Engage families and individuals in obesity prevention and control by making individuals accountable for their health.(4)Improve obesogenic environments by establishing and improving regulations and policies on fast food expansion, marketing, food labelling, and nutrition education; establishing and improving regulations and policies on food storage and restaurant and food wholesale surveillance and management; encouraging healthy food supply and choices in the workplace; improving the school environment; improving land use planning; encouraging public transportation; improving built environments that encourage physical activity; ensuring protected time for adequate physical activity at school; and changing social norms and culture regarding healthy weight and energy balance behaviours through social marketing, traditional mass media, social media, etc.(5)Improve obesity treatment by standardising clinical guidelines, practice, and services; enhancing professional training in obesity diagnosis, prevention, and treatment; and promoting self-management of overweight and obese patients.(6)Reform health insurance policies to facilitate obesity prevention and treatment. The report also points out directions for future research: (1) promote long-term, large-scale, multilevel, multicomponent obesity research; (2) emphasise evidence-based policies and interventions; (3) promote research on healthy eating policies and interventions; (4) promote research on implementation, expansion, and sustainability of school-based research; (5) explore novel research approaches and intervention methods; (6) enhance research on environmental risk factors for obesity; and (7) enh ance research on outcome and impact evaluation. The report provides a comprehensive reference and important guidelines for future work on obesity prevention and treatment in China. It aims to strengthen research and to promote prevention of obesity and chronic diseases, multidisciplinary cooperation, development and implementation of new government policies, and broad society mobilisation. The report development process also promoted cooperation and exchanges among domestic and international experts and stakeholders, which will help expand future collaborations. These experiences could provide a useful insight for other countries in their efforts to fight obesity and chronic diseases. We declare no competing interests.