Over the last few decades, rates of obesity have been rapidly rising, first across the developed world and, more recently, in developing countries. The health impacts can be myriad and serious, and the implications for individuals and for governments – including increasing health-care costs and falling economic output – are clear. Policymakers will be faced with the financial consequences of obesity – and they are well placed to take action to control the epidemic and its health repercussions, through better prevention (involving many government departments) and management. However, are their perceptions of obesity and obesity policy accurate? Do they appreciate the extent of the epidemic, the drivers of obesity, and the tools and actions that need to be taken to make a difference?

To address these questions, the European Association for the Study of Obesity, with C3 Collaborating for Health, surveyed 333 policymakers, from legislative and executive branches of government, in 11 countries – Brazil, Bulgaria, Canada, Denmark, England, France, Germany, Italy, Mexico, Spain and the United States. * Those who took part were selected for their position in government, not for their particular responsibility for obesity.

The survey found that almost all the policymakers saw the individual as having responsibility for reducing obesity in the future – with family and the food industry also having a powerful influence. Other groups, such as health-care professionals, government, society and employers were seen as less responsible. Similarly, while physical activity, and marketing of and access to unhealthy food, were seen by a large majority of the policymakers as being important drivers of obesity, there was less consensus on the strength of the role played by issues such as limited finance and genetics.

Policymakers varied in their response to questions on national obesity policy and tools and their effectiveness – and, as the country summaries make clear in the first part of this report, the countries vary greatly in the extent to which policies to tackle obesity are in place. Policymakers’ perceptions of national policy and knowledge of policies and the impact of different approaches (such as lifestyle interventions, drug treatment and surgery) differed, both in terms of whether they are a good course of action and whether they are currently in place and effective.

The survey also uncovered some gaps in knowledge among many of the policymakers. For example, policymakers were often not fully informed on the prevalence of obesity and (in particular) overweight, and their responses about progress and policy do not always reflect reality.