Obesity and Intersectionality: Brazil's Experience in Advancing Equity through Transformative Public Policies

Abstract

Obesity and food and nutrition insecurity are increasingly understood as syndemic outcomes of enduring social inequalities. In Brazil, these conditions disproportionately affect Black women in socially vulnerable contexts, due to the intersection of gender, race/ethnicity, and low socioeconomic status. In response, Brazil has launched the new Intersectoral Strategy for Obesity Prevention, which frames obesity as a multidetermined condition shaped by social, economic, cultural, and environmental factors. Grounded in intersectionality and rights-based governance, the Strategy is structured around 3 axes: promoting healthy food environments; strengthening social protection systems and integrated care; and fostering social mobilization and stigma reduction. Its Operational Plan includes goals, indicators, and mechanisms for accountability, with active participation of people living with obesity. Actions are planned across short-, medium-, and long-term horizons and will be revised annually to reflect territorial realities. The Strategy prioritizes children and families registered in the Cadastro Único (CadÚnico, Brazil's unified registry for social programs), particularly recipients of Bolsa Família (a conditional cash transfer program for low-income families). The Strategy also addresses the impact of ultra-processed foods, environmental degradation, and commercial determinants of health. The urgency of this agenda is underscored by projections for 2035 and growing inequalities in food access and affordability. Brazil's leadership in the Global Alliance for Ending Hunger and Poverty, an international initiative launched in 2024, reinforces its commitment to systemic transformation and cooperation. By integrating intersectionality, participatory governance, and structural interventions, the Strategy contributes to global efforts to prevent obesity and promote equity, dignity, social justice, and food and nutrition security.

Keywords: epidemiology; food and nutrition security; food environment; intersectionality; obesity; public policies.