- Among the 20 countries projected to be highly affected by rising obesity rates, the new Obesity Response Index identifies Serbia, France and Brazil as having the most effective responses, while Rwanda, India and Nigeria lag the furthest behind.
- On average, the 20 countries scored just 55.6 out of 100 — halfway to where they need to be. Experts are calling for greater investment, stronger political commitment and long-term strategies to confront a crisis projected to cost 3% of global GDP by 2035.[1]
- The research builds on the US Obesity Response Index, which compares state responses. Minnesota, Kentucky and Colorado ranked strongest, while Georgia, Arizona and Kansas had the weakest responses.
London, UK – 14 October 2025 – One in eight adults worldwide lives with obesity[2]—a complex disease that experts warn could affect a quarter of the global population within the next decade.[3]A new Obesity Response Index from Economist Impact, supported by Lilly, ranks 20 countries highly impacted by obesity and identifies those developing the most effective responses.[4] Despite adult obesity rates
doubling since 1990[5], the research finds major gaps in policy implementation.
“As obesity rates climb, the countries hit hardest remain dangerously underprepared and without the robust prevention and treatment strategies needed to turn the tide,” said David B. Sarwer, Ph.D., Director of the Center for Obesity Research and Education at Temple University in America.“Obesity is not just an individual health issue but a mounting societal and economic crisis. The disease is projected to cost the world $4trn a year by 2035. The Obesity Response Index exposes the gaps and highlights solutions, giving leaders a clear path to stronger, coordinated action.”
Evaluating country responses: the Obesity Response Index
The index rates countries on 30 indicators across four pillars: policy and governance; obesity management; food quality and access; and physical activity. With an average score of just 55.6—based on official policies rather than actual implementation—countries are only halfway towards an effective response to the crisis and real-world performance may be even worse.
Although no country demonstrated a truly effective response, strategies from Serbia, France, and Brazil emerge as relatively more effective than others, whereas Rwanda, India, and Nigeria face the most significant challenges.
All countries show a mix of strengths and weaknesses in their national obesity responses, but the highest-ranked stand out for pairing strategies with dedicated investment. Their common strengths include dedicated funding, involving people living with obesity in decision-making and creating clear care pathways—turning policy commitments into tangible action.
By contrast, countries with the least effective responses, such as Rwanda, India and Nigeria, often grapple with deep-seated challenges, including limited access to care and weak integration with broader health systems.
The Obesity Response Index
“Obesity is one of the fastest-growing public health challenges of our time, yet most countries are falling short in responding effectively,” said Elly Vaughan, principal, health policy, Economist Impact. “This index makes clear that tackling obesity requires coordinated and long-term strategies. The countries with stronger responses are demonstrating that progress is possible—but greater investment and political will are essential to move from a focus on prevention alone, to one of both prevention and treatment for people already living with this disease.”
Turning policy into progress
The research reveals a critical gap—and an opportunity. Countries must use the findings to identify where action is needed, identify best practices and prioritise a holistic response to rising obesity rates. Best practice policy principles—as endorsed by reputable international organisations—include:
Strengthen clinical care pathways
- Update national guidelines with cost-effectiveness reviews
- Establish clear pathways for diagnosis and long-term management
Ensure equitable access to obesity care
- Provide equitable access to nutrition counselling, behavioural therapy, medication and bariatric surgery
- Recognise obesity as a disease to reduce barriers to access
Improve food environments
- Implement programmes addressing food insecurity, including in high-income countries
- Incorporate front-of-package nutrition labelling and regulate unhealthy food marketing to children, as recommended by the WHO
- Introduce WHO-recommended taxation on unhealthy foods and drinks
Promote physical activity
- Capitalise on schools as a facilitator of physical activity, aiming for 60 minutes of daily activity aligned with WHO guidelines
- Develop national plans promoting and supporting active travel and accessible public spaces
Protect against weight stigma
- Expand legal protections to prevent weight-based discrimination
- Train healthcare providers on evidence-based, person-centred obesity care
Having policies on paper is not enough—the real challenge is implementation. Countries must recognise obesity as the complex, chronic disease it is and respond with adequately funded, whole-of-society approaches that span prevention through treatment.
To access the index and to learn more, please visit: https://impact.economist.com/health/obesity-response-index/global
To explore the full findings of the US Obesity Response Index, please visit:
[1] https://data.worldobesity.org/publications/WOF-Obesity-Atlas-v7.pdf
[2] https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
[3] https://www.worldobesity.org/news/economic-impact-of-overweight-and-obesity-to-surpass-4-trillion-by-2035
[4] The 20 countries were selected for their high obesity rates, both current and projected.
[5] https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight