Getting Fat: “What” is Eaten is as Important as “How much” is Eaten

Obesity is becoming an enormous global problem and urgent measures are needed to contain it. Traditional thinking that it is just a problem of energy balance has led to educational approaches to get people to eat less and exercise more becoming the standard interventions. However, new evidence suggests that it is not just how much you eat, but what is being eaten that is driving the problem. Evidence for the various causalities, especially sugar intake, and the sort of approaches needed to stop the problem getting worse are presented. Policy actions to promote healthy diets cannot just focus on information based approaches that will help the public make better informed choices (e.g. media campaigns, dietary guidelines). In addition, more structural approaches are needed such as fiscal measures, and restrictions on advertising. Policy assessments should be carefully designed based on a theory of change, using indicators of progress along the various pathways towards the long-term goal of reducing obesity rates. The most important research needed is to strengthen the monitoring and evaluation of such programme approaches using a plausibility approach. No country has demonstrated success in controlling obesity yet.