Intended for healthcare professionals

Letters Women and children’s health in covid-19 recovery

Tackling childhood obesity in the wake of covid-19: lessons from Chile

BMJ 2021; 373 doi: (Published 25 May 2021) Cite this as: BMJ 2021;373:n1338
  1. Rosemarie R Patterson, foundation year 2 doctor,
  2. Sangeetha Sornalingam, senior GP teaching fellow,
  3. Max Cooper, senior lecturer in general practice
  1. Department of Primary Care and Public Health, Brighton and Sussex Medical School, Watson House, Falmer, Brighton, UK
  1. rosemarie.patterson1{at}

Modi and Hanson highlight the importance of placing the health of children at the centre of post-pandemic measures to reduce social inequality, improve population health, and promote economic recovery.1 They rightly call for policies aimed at socioeconomic determinants of health, in order to break existing structures of disadvantage.

The Chilean response to the childhood obesity epidemic offers an example of public health interventions tackling structural factors.2 Economic growth in Chile over the past two decades has led to the increased production, availability, and advertising of energy rich foods.3 Rates of childhood obesity have doubled in the same period, with 60.1% of children overweight at age 10-11 in 2018 (compared with 35.2% in the UK).45

Following commissioned research and stakeholder consultation, the Chilean government has implemented comprehensive national laws, including a strict food labelling system and sugar tax.267 Foods with a “black” warning label cannot be advertised to children or on daytime television or sold in schools or with promotional toys.8 Widely implemented mass media campaigns have helped educate viewers about healthy life choices.7 Pressure has been placed on industry to alter production to improve the nutritional quality of widely available products.9 These interventionalist approaches resulted in reduced sales of unhealthy foods and increased public engagement in choosing healthier alternatives.10

Despite these steps, the impact of covid-19 has been linked to a further rise in childhood obesity in Chile.5 Its government must, therefore, go even further. There are currently no requirements for labelled food to be higher cost and fast food is excluded from restrictions.7 Physical activity interventions risk being overlooked by being delegated to municipalities.7 Laws are also focused around sales, rather than tackling underlying socioeconomic systems which result in poverty and poor educational attainment.7 Despite these limitations, there is much the UK government can learn from Chile about tackling childhood obesity.


This article is made freely available for use in accordance with BMJ's website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.


View Abstract