The 2002 joint consultation of the Food and Agriculture Organization of the United Nations and the World Health Organization used a systematic approach to published evidence to rank possible interventions. This ranking may, however, be misleading because comparable research efforts have not been applied to these or to other, potentially valuable measures. Furthermore, individual interventions may not be effective in isolation.
The food industry is the largest, most powerful industry of all; food is essential for life and health, and the industry must remain profitable. The industry is largely driven by commercial forces aimed at maximising consumption and hence profit. Given people's increasing reliance on processed and precooked food, the industry needs to assume much more responsibility for preventing obesity. Governments, as custodians of public health, have keys roles in creating the conditions for this to happen. Voluntary agreements have not been enough. Foods that are less energy dense are needed; this would reduce the total energy content of what is sold and eaten in meals and snacks, without reintroducing calories in other foods.
What is provided determines what is eaten, and so what is provided has to change. This will require attention to pricing and marketing policies, product design, portion sizes, energy content and density, and customer information. Moreover, the advertising of energy dense foods needs to be substantially curtailed—“out of sight, out of mind” holds especially true for children.
The Treaty of Rome included the principle that public health consequences should be considered for all decisions made in public life: ministers can no longer ignore this issue. We need effective regulations or active support and incentives for measures that reflect “corporate social responsibility.”