Promoting Physical Activity Matters for Health, but Not Enough to Turn the Tide of Obesity

Obesity has been widely recognized as a global epidemic since the late 1990s and the economic costs of obesity and its related comorbidities (i.e., direct medical costs and indirect productivity costs) have been a societal concern across high-, middle-, and low-income countries. In response to the rise in physical inactivity and sedentary lifestyle, particularly since the turn of the 21st century, various strategies have been considered to integrate physical activity into people’s lifestyles. Despite the health benefits of physical activity demonstrated by a large body of epidemiological studies, adhering to recommended guidelines has only resulted in modest changes to body weight and composition. In other words, a longer duration of physical activity would be needed to achieve a noticeable reduction in overweight and obesity. Rather than doubling or tripling the duration of physical activity, following a healthy diet has been deemed crucial for long-term weight management and obesity management. Other than ultra-processed foods and sugar-sweetened beverages, however, a growing body of epidemiological, experimental, and preclinical studies suggests that synthetic ingredients and additives added during cooking, industrial processing, and beverage manufacturing contribute to overweight, obesity, and an array of health issues (e.g., hormone disruption, gut inflammation, and an increased risk of chronic diseases). For these reasons, collective efforts to reform existing food and beverage systems through local, regional, and national governance would be needed to turn the tide of obesity.