Addressing overweight and obesity in LMICs in the realm of rural development and food systems

Overweight and obesity rates across low- and middle-income countries have approached levels found in high-income countries. While overweight and obesity are more prevalent in urban areas, they are also on the rise in rural areas. Little research has been conducted on the effects of food systems on overweight and obesity. This paper presents the findings of a comprehensive literature review of the evidence on the main drivers of overweight and obesity, described using a food systems framework and illustrated with concrete examples from five countries. Available evidence on intervention strategies with the potential to prevent and/or reduce overweight and obesity was also reviewed and compared with identified drivers and practice-based examples from the selected countries. This paper shows how systemic the issue of overweight and obesity is, with drivers being present in nearly each segment of the food system. It helps to explain the complexities of addressing overweight and obesity across different levels, and why there are few proven interventions that are effective at the individual level. The study results show that food system-related interventions are applying traditional approaches such as food package labelling, price manipulation and changing the food environment, and that there is a gap in evidence on what works and what does not. The findings in this paper could be used to inform future agriculture and food systems investments for better nutrition and health outcomes.