Triple Threat or Single Threat? How Obesity, Undernutrition and Climate Change Are Related

The Global Syndemic view of the interaction and common drivers of obesity, undernutrition, and climate change.

What do obesity, undernutrition and climate change have in common?

They are all linked to one another according to a recent report released by the Lancet Commission. The report calls the connection between the three a “Global Syndemic”– a synergy of three epidemics that “affects most people in every country and region worldwide.”

The report was led by the University of Auckland, George Washington University and the World Obesity Federation in conjunction with 43 experts from 14 countries in various areas of expertise, including Drexel University’s Shiriki Kumanyika, PhD, MPH, of the Dornsife School of Public Health.

According to the report, climate change is expected to significantly worsen malnutrition (which includes obesity and undernutrition, and other diet-related disease risks), which is already the greatest cause of poor health and premature death globally.

The report has called for radical change to address the Global Syndemic – specifically, changes in how the world eats, lives, consumes and moves. All three issues are linked through common drivers, but also shared solutions.

Recommendations from the report tackle all three issues, including restrictions on commercial influences in policy development processes, with clear and robust conflict of interest management.

One specific recommendation would be to adjust the costs of products that are unhealthy and bad for the environment to reflect the damage they impose. A sugary drink tax is an example of this. Mexico introduced a sugary drink tax across the entire country and within two years saw consumption reduced by nearly 8 percent. The Commission recommends $1 billion in the type of philanthropic effort that supported advocates in Mexico as an amount that could plausibly support the use of similar approaches in 100 other countries.

Globally, government subsidies to the tune of US$5 trillion go towards products that harm the environment or health with the cost paid for by tax payers.

But the researchers note that these strategies will only be effective “if there is broad support – from governments, corporations and the general public.” And even with broad support, “global agreements can be fragile,” they write, citing the U.S.’s withdrawal from the Paris Climate Change Agreement.

Kumanyika recently shared her insight on the report’s findings with the Drexel News Blog.

What is your role with The Lancet Commission report?

In my role as Co-chair of Policy and Prevention in the World Obesity Federation and as a U.S. based obesity researcher, I helped with planning the early stages of the formation of the Commission, which began its work in late 2015, and then participated actively in the process of developing the report. My particular interests were in clarifying the relevant health equity issues, considering cultural issues related to obesity, promoting grassroots approaches to foster the needed social change, and motivating positive change from the business sector.

What is the impact of the report?

The Lancet has facilitated numerous commissions on global health issues and I expect that the report will draw major attention because of the Lancet’s visibility globally and their dissemination efforts, along with those of the World Obesity Federation and other involved institutions. 

The impact we hope to make is getting people to see that these pandemics are interrelated and that pursuing them together makes much more sense than looking at them in silos.  We hope to take the conversation about these issues to a very high level that considers the urgent need for the types of bold, transformative thinking and action—and funding—that we recommend.

There are two instances in the report that bring Philadelphia to mind – the enactment of a sugary drink tax and continuing to follow the Paris Climate Change Agreement despite the withdrawal of the U.S. Do you see Philadelphia as being an influential city for the actions the report is recommending?

The report recommends actions that are needed and relevant at global, national, and local levels.  Although I don’t have a list of everything Philly is doing, at the local level the City is definitely attuned to and taking action on obesity, sustainability and food insecurity. Perhaps this report will stimulate looking for more overlap and synergy among these efforts, if not already being done. And supporting the national effort to follow the Paris Agreement also shows our willingness to speak up on this issue at the national level.

Shiriki Kumanyika, PhD, MPH is a research professor in the Dornsife School of Public Health.

Media interested in an interview with Kumanyika, should contact Annie Korp at 215-571-4244 or