Addressing the global obesity crisis: what levers to promote healthier diets?
Editorial
According to the World Health Organization (WHO), obesity is a chronic, relapsing disease driven by complex interplay of genetics, neurobiology, eating and lifestyle behaviours, food environments and broader socioeconomic forces. In the last decades, profound transformations linked to globalization and industrialized food systems have reshaped diets, lifestyles and access to food, fostering increasingly obesogenic environments. The result is a global public health crisis: more than one billion people are now living with obesity, and prevalence continues to rise in nearly every country (NCD Risk Factor Collaboration, 2024).
In 2022, 43% of adults worldwide were overweight, compared with 25% in 1990, and around 16% were living with obesity. Once considered an issue confined to high-income countries, overweight and obesity are now rapidly increasing in low- and middle-income regions, including among the most vulnerable populations (NCD Risk Factor Collaboration, 2024). Children are not spared: an estimated 35 million children under five years old were overweight in 2024, with nearly half living in Asia (UNICEF, 2025).
These trends are particularly concerning given the well-documented health consequences. Elevated body mass index is a major risk factor for noncommunicable diseases, contributing to an estimated 3.7 million deaths in 2021 alone. Beyond physical health, childhood and adolescent obesity carries psychosocial burdens, affecting quality of life, educational outcomes and long-term wellbeing (GBD 2021 Risk Factor Collaborators, 2024). Economically, the burden is equally alarming, with global costs projected to reach US$ 3 trillion annually by 2030 (Okunogbe et al., 2022).
In this context, understanding how to effectively prevent overweight and obesity and encourage healthy diet is more urgent than ever. This issue of the Global Fruit and Veg Newsletter explores three complementary approaches that shed light on the complexity of dietary behaviours and potential levers for action.
The first article (Vaughan et al., 2026) based on data from the WHO COSI surveillance system across eight European countries, examines the relationship between children’s food preparation skills and their dietary habits. The findings suggest that greater involvement in food preparation at home is associated with higher fruit and vegetable consumption. However, most skills were also linked to a slightly higher risk of obesity, highlighting the nuanced nature of these relationships. Notably, the simple act of peeling foods was associated with a reduced obesity risk of around 15%. These results underline both the potential and the limits of focusing on individual skills and point to the need for further research to clarify causal pathways.
The second article (Nzesi et al., 2026) evaluates whether economic incentives can shift dietary behaviours. In this randomized controlled trial conducted in New York among adults with overweight or obesity, price reductions on fruits, vegetables and non-caloric beverages led to measurable changes. A 15% discount significantly increased fruit consumption over time, while a 30% discount temporarily boosted vegetable intake and resulted in modest early weight loss. These findings highlight the role of affordability as a key determinant of food choices, while also suggesting that sustained behavioural change may require more than short-term financial incentives.
The third article (Gonzalez et al., 2026) explores an innovative community-based intervention in Mexico, where children were trained as “health promoters” to influence their peers. Compared with traditional education strategies, this approach led to improvements in body composition, dietary quality and biological markers among participating children. By leveraging social dynamics and peer influence, the intervention illustrates the potential of community-driven models to foster healthier environments and behaviours.
Taken together, these studies reinforce a central message: tackling obesity requires multifaceted strategies that go beyond individual responsibility. As obesity continues to rise globally, particularly in settings undergoing rapid nutritional transitions, designing effective, equitable and sustainable interventions remains a critical priority.
Clinical psychologist, Behavioural therapist, and Professor em. at Ghent University, Faculty of Psychology. In addition to teaching assignments in the field of developmental psychopathology, she conducts research in particular on the development of childhood obesity, its treatment and the related problems associated with the problem of overweight in children. She has written several books and articles on childhood obesity.
She is member of several European associations (e.g. European Child Obesity Group, European Association for Behavior Therapy, the COST-CA16102 European Network) and the Eating Disorder Research Society. She is awarded as honorary member of the Italian Association for Behavior Therapists (2004 -) and the Dutch Association for Behavior Therapists (2013 – ).