Obesity – WMA – The World Medical Association

Adopted by the 76th WMA General Assembly, Porto, Portugal, October 2025

PREAMBLE

The World Medical Association recognizes obesity as a widespread, long-term chronic disease and a global concern. The WMA notes that obesity is increasing among all age groups. Still, the rise in children including adolescents is of particular concern as earlier onset leads to worsened chronic disease burden over the life course. Obesity can affect both mental and physical health and can lead to discrimination, stigma, and bullying.

Obesity is a major health problem affecting all countries and all social and economic groups. It puts much pressure on healthcare resources. It is not an aesthetic problem, it is a medical problem that increases the risk of many other illnesses and health problems and, due to its scale and consequences, it is a public health problem of the highest priority.

Obesity’s causes are complicated and relate to changes in society and the economy, including the environment that encourages obesity. The causes of obesity may be multifaceted, encompassing various factors such as environmental influences on physical activity, biological and medical conditions, psychological factors, maternal and developmental aspects, dietary habits, and economic and social elements.

The WMA acknowledges that social determinants of health significantly contribute to obesity. These determinants partially account for the disparities observed in racial and ethnic minority groups.

Physicians can be instrumental in both preventing and treating obesity. However, their potential may be hindered by insufficient education regarding obesity or subconscious and conscious biases toward patients with obesity. This may subsequently affect the quality of care offered to patients with obesity.

The WMA emphasizes the need to stimulate and support multisectoral country-level action on obesity across the globe.

The prescription of drugs for the treatment of obesity should be based on a medical diagnosis with strictly scientific criteria.

The WMA recalls its policies on Free Sugar Consumption and Sugar-sweetened Beverages, the Global Burden of Chronic Non-Communicable Disease, and Primary Health Care. These policies provide important context and guidance for addressing the obesity epidemic.

RECOMMENDATIONS

The WMA recommends all Medical Associations to call for policies that reduce the incidence of obesity, including:

Learning about healthy diets in school curricula;
Facilitating access to physical activity and sports for all parts of the population;
Actively using consumer protection regulations to restrict marketing and raise prices of unhealthy products.

The WMA urges all Medical Associations to advocate for the recognition of obesity as a chronic disease requiring medical care and appropriate support, and the integration of obesity prevention, management, and treatment into national health services. All stakeholders must work together to address this global health concern.
The WMA calls for integrating obesity prevention, management, and treatment into Universal Health Coverage as an ‘essential health service.’ This includes access to evidence-based therapies and treatments for obesity, ensuring these services are universally available, accessible, affordable, and sustainable.
The WMA encourages physicians to use their leadership roles to push for obesity reduction to be a priority for national health authorities and to advocate for policies suitable for different cultures and ages, involving physicians and other key stakeholders.
The WMA acknowledges that there are various treatment options for patients with obesity. These range from lifestyle and behavioral changes to pharmacotherapy, medical devices, and metabolic and bariatric surgery.
Primary prevention is a crucial objective for physicians in addressing obesity, but only limited effective methods to achieve it are currently available. While progression of and complications associated with obesity can be prevented and treated, there is a need to develop and support additional effective strategies to reduce its incidence. We must promote health information and education based on sound scientific criteria that inform, help and support the population in the prevention and management of this disease.
Physicians need thorough education on obesity to fully understand the disease. This will enable them to treat it effectively, minimize prejudice and stigma, advocate for relevant policies, and lead treatment teams efficiently.
Physicians attending to pediatric patients should understand the specific details associated with childhood and adolescent obesity, especially the necessity for prevention and early intervention. They should be able to identify rare types of obesity, as failure to do so can result in detrimental health consequences.
The WMA recommends a multisectoral approach, based on the principles of primary health care, to prevent, treat, and manage obesity. This approach involves various sectors, including health, education, and social services, with physicians playing a crucial role in this multisectoral approach.
The WMA encourages its Constituent Members and physicians to advocate for healthy diet, to promote regular physical exercise and to combat diet and nutrition misinformation spread particularly on social networks.
The WMA calls for firm action against self-proclaimed therapists and unproven therapies.

Adopted by the 70^th WMA General Assembly, Tbilisi, Georgia, October 2019

PREAMBLE

Non-communicable diseases (NCDs) are the leading causes of death worldwide. Every year 40 million people die from NCDs [1]. The most common causes of these diseases are poorly balanced diet and physical inactivity. A high level of free sugar consumption has been associated with NCDs because of its association with obesity and poor dietary quality.

According to the World Health Organization (WHO), free sugar is sugar that is added to foods and beverages by the manufacturer, cook or consumer that results in excess energy intake which in turn may lead to parallel changes in body weight.

WHO defines free sugar as ‘all sugars that are added during food manufacturing and preparation as well as sugars that are naturally present in honey, syrups, fruit juices, and fruit concentrates.’

Sugar has become widely available and its global consumption has grown from about 130 to 178 million tonnes over the last decade.

Excess free sugar intake, particularly in the form of sugar-sweetened beverages, threatens the nutrient quality of the diet by contributing to the overall energy density but without adding specific nutrients. This can lead to unhealthy weight gain and increases the risk of dental disease, obesity and NCDs. Sugar-sweetened beverages are defined as all types of beverages containing free sugars (include monosaccharides and disaccharide) including soft drinks, fruit/vegetables juices and drinks, liquid and powder concentrates, flavored water, energy and sports drinks, ready-to-drink tea, ready-to-drink coffee and flavored milk drinks.

The World Health Organization recommends reducing sugar intake to a level that comprises 5% of total energy intake (that is around 6 teaspoons per day) and not to exceed 10% of total energy intake [2].

The price elasticity of sugar-sweetened beverages according to a meta-analysis published in USA, is -1.21. This means that for each 10% increase in the price of sugar-sweetened beverages, there is a -12.1% decrease in consumption. Successful examples of price elasticity were seen in Mexico as the consumption of sugar-sweetened beverages decreased after imposing the sugar tax.

Data and experience from across the world demonstrate that a tax on sugar works best as part of a comprehensive set of interventions to address obesity and related chronic diseases. Such interventions include food advertising regulations, food labelling, educational campaigns, and subsidy on healthy foods.

RECOMMENDATIONS

The World Medical Association (WMA) and its constituent members should:

call upon the national governments to reduce the affordability of free sugar and sugar-sweetened beverages through sugar taxation. The tax revenue collected should be used for health promotion and public health preventive programs aimed at reducing obesity and NCDs in their countries;
encourage food manufacturers to clearly label sugar, if present, in their products and urge governments to mandate such labeling;
urge governments to strictly regulate the advertising of sugar containing food and beverages targeted especially at children;
urge national governments to restrict availability of sugar-sweetened beverages and products that are highly concentrated with free sugar from educational and healthcare institutions and replace with healthier alternatives.

Constituent members of the WMA and their physician members should work with national stakeholders to:

advocate for healthy sustainable food with limited free sugar intake that is less than 5% of total energy intake;
encourage nutrition education and skills programs toward preparing healthy meals from foods without added sugar;
initiate and/or support campaigns focused on healthy diets to reduce sugars intake;
advocate for an inter-sectoral, multidisciplinary and comprehensive approach to reducing free sugar intake.

References

[1] http://www.who.int/fr/news-room/fact-sheets/detail/noncommunicable-diseases

[2] WHO Guideline: Sugars Intake for Adults and Children 2015

Adopted by the 57^th WMA General Assembly, Pilanesberg, South Africa, October 2006
and revised by the 67^th WMA General Assembly, Taipei, Taiwan, October 2016
and rescinded and archived by the 76th WMA General Assembly, Porto, Portugal, October 2025

PREAMBLE

Obesity is one of the single most important health issues facing the world in the twenty-first century, affecting all countries and socio-economic groups and representing a serious drain on health care resources.

Obesity in children is of increasing concern and is emerging as a growing epidemic in itself.

Obesity has complex origins linked to economic and social changes in society including the obeso-genic environment within which much of the population lives.

Therefore the WMA urges physicians to use their roles as leaders to advocate for recognition by national health authorities that reduction in obesity should be a priority, with culturally and age appropriate policies involving physicians and other key stakeholders.

THE WMA RECOMMENDS THAT PHYSICIANS:

Lead the development of societal changes that emphasize environments which support healthy food choices and regular exercise or physical activity for all people, with a specific focus on children;
Individually and through medical associations, express concern that excessive television viewing and video game playing are impediments to physical activity among children and adolescents in many countries;
Encourage individuals to make healthy choices and guide parents in helping their children to do so;
Recognise the role of personal decision making and the adverse influences exerted by current environments;
Recognise that collection and evaluation of data can contribute to evidence based management, and should be part of routine medical screening and evaluation throughout life;
Encourage the development of life skills that contribute to a healthy lifestyle in all persons and to better public knowledge of healthy diets, exercise and the dangers of smoking and excess alcohol consumption;
Advocate for appropriately trained professionals to be placed in educational facilities, highlighting the importance of education on healthy lifestyles from an early age;
Contribute to the development of better assessment tools and databases to enable better targeted and evaluated interventions;
Ensure that obesity, its causes and management remain part of continuing professional development programmes for health care workers, including physicians;
Use pharmacotherapy and bariatric surgery consistent with evidence-based guidelines and an assessment of the risks and benefits associated with such therapies.

Adopted by the 67^th WMA General Assembly, Taipei, Taiwan, October 2016
and rescinded and archived by the 76^th WMA General Assembly, Porto, Portugal, October 2025

PREAMBLE

Childhood obesity is a serious medical condition and a major public health concern affecting many children. Childhood obesity is emerging as a growing epidemic and is a challenge in both developed and developing countries. Due to its increasing prevalence and its immediate and long-term impact on health, including predisposition to diabetes and cardiovascular abnormalities, childhood obesity should be viewed as a serious concern for public health. The increase in childhood obesity may be attributed to many factors:

Recent studies show that marketing targeted at children has a wide influence on the shopping trends and food preferences of households all over the world. Special offers, short-term price reductions and other price promotions and advertising on social as well as traditional media all play a role in increasing product demand.

Many advertisements are in conflict with nutritional recommendations of medical and scientific bodies. TV advertisements for food and drink products with little or no nutritional value are often scheduled for broadcast hours with a large concentration of child viewers and are intended to promote the desire to consume these products regardless of hunger. Advertisements increase children’s emotional response to food and exploit their trust. These methods and techniques are also used in non-traditional media, such as social networks, video games and websites aimed at children.

Unhealthy dietary patterns, together with a sedentary lifestyle and lack of exercise, contribute to childhood obesity. The sedentary lifestyle is the most predominant one in the developed world today. Many children typically spend more time than ever in front of screens, rarely engaging in physical activities.

International corporations and conglomerates that manufacture foods and beverages are not always subject to regional regulations that govern food labeling. Concern for profits may come at the expense of corporate responsibility for environmental and public health issues.

Products containing large amounts of added sugar, fat, and salt can be addictive, especially when combined with flavor enhancers. In some countries, not all ingredients are required to be listed on food labels and manufacturers often refuse to release data on methods employed to maximize consumption of their products. Governments should require that all ingredients in food and beverages be clearly labeled, including those proprietary ingredients intended to increase consumption of the product.

Socioeconomic disparities also correlate with increasing rates of childhood obesity. The link between living in poverty and early childhood obesity continues to negatively affect health in adult life.[1] Exposure to environmental contaminants, sporadic medical checkups, insufficient access to nutritious foods and limited physical activity lead to obesity and other chronic illnesses that are all more prevalent among children living in poverty.

RECOMMENDATIONS

A comprehensive program is needed to prevent and address obesity in all segments of the population, with a specific focus on children. The approach must include initiatives on price and availability of nutritious foods, access to education, advertising and marketing, information, labeling and other areas specific to regions and countries. An approach similar to that on tobacco in the WHO Framework Convention on Tobacco Control is advocated.
International studies stress the importance of adopting an integrated approach to education and health promotion. Investment in education is key to minimizing poverty, improving health and providing economic benefits.
Quality education offered in formal settings to children aged 2 to 3 years, combined with enrichment activities for parents, and sufficient supply of nutritious food and beverages may help to reduce the rate of adolescent obesity and reduce its health implications throughout the life course. Developing early healthy eating practices and experiencing flavors of healthy food when very young appear to be positive factors in prevention of childhood obesity.
Governments should invest in education related to menu design, food shopping including budget setting, storage and preparation so that people are better equipped to plan their food intake.
Governments should seek to regulate the availability of food and beverages of poor nutritional value, by a range of methods including price. Attention should be paid to the availability close to schools of establishments selling products of poor nutritional quality. Governments should seek to persuade manufacturers to reformulate products to reduce their obesogenic effects. Where possible government and local authorities should seek to manage the density of such establishments in the area.
Governments should consider imposing a tax on non-nutritious foods and sugary drinks and use the additional revenue to fund research and epidemiological studies aimed at preventing childhood obesity and reducing the resulting disease risk.
Ministries of health and education should regulate food and beverages that are sold and served at educational and healthcare facilities.
Given the scientifically proven link between the extent of media consumption and adverse effects on body weight in children, the WMA recommends that the advertising of non-nutritious products be restricted during television programming and other forms of media that appeal to children. Regulators should be aware that children access television programs designed for adults and ensure that legislation and regulation also limits marketing associated with such programs.
Governments should work with independent health experts to produce sound guidance on food and nutrition, with no involvement of the food and drink industry.
Governments and local authorities should subsidize and encourage activities that promote good health among their residents, including providing safe spaces for walking, bike riding and other forms of physical activity.
Parents have a crucial role in fostering physical activity in their children. Schools should incorporate daily physical activity into their daily routine. Participation in sport activities should be possible for everyone regardless of their economic situation.
National Medical Associations should support or develop guidelines and recommendations to ensure that they reflect current knowledge of prevention and treatment of childhood obesity.
National Medical Associations should work to raise public awareness on the issue of childhood obesity and highlight the need to tackle the rising prevalence of obesity and its health and economic burden.
Clinics and Health Maintenance Organizations should employ appropriately trained professionals to offer classes and consultation in selecting appropriate amounts of nutritious foods and beverages and attaining optimal levels of physical activity for children. They should also ensure that their premises are exemplars in the provision of healthy food options.
Educational facilities should employ appropriately trained professionals who educate for healthy lifestyles from an early age and allow all children, whatever their social environment, to practice regular physical activities.
Physicians should guide parents and children in how to live healthy lives and emphasize the importance of doing so, and must identify as soon as possible obesity in their patients, particularly children. They should direct patients suffering from obesity to the appropriate services at the earliest possible stage, and conduct regular follow-ups.
Physicians and health professionals should be educated in nutrition assessment, obesity prevention and treatment. This could be accomplished by strengthening CME activities focused on nutritional medicine.

[1] WHO Commission on Social Determinants of Health (Closing the Gap in a Generation) 2008.