The 20th
anniversary
edition
March 14 & 15, 2025
at UNESCO • Paris

What observations led you to create the CNAO, and how does your collective work to address the gaps identified in the management of obesity?

Anne-Sophie Joly : Observations that led to the creation of the CNAO (22 years ago):

- The founder's personal experience, facing the difficulties related to obesity.
- A realization from her work in medical journalism, revealing the gap between the discourse directed at doctors (scientific, technical) and that addressed to patients, which is often shame-inducing (lack of willpower, gluttony, laziness, intellectual incapacity, etc.).
- The lack of a clear framework for managing obesity. From its inception, CNAO focused on developing best practice recommendations, establishing a reference system for medical care.

The collective’s actions, which deploy a multi-pronged strategy:

- Media advocacy, aimed at raising awareness among the general public and political decision-makers (to use it as a lever for both population and political engagement).
- Local actions, relying on the associative network and collaborating with learned societies.
- Co-construction of public policies, where possible.
- Information and awareness campaigns through the media to disseminate clear and inclusive messages.

You mentioned that weight management is not limited to nutrition. Could you elaborate on how you incorporate emotional management and pleasure into the patient journey? How do you address obesity as a whole?

A holistic approach to obesity that results from multiple factors that can impact eating behavior, depending on their role:

- Genetic and environmental factors (especially up to the age of 20): mode of birth (vaginal birth or cesarean, which implies exposure or not to certain microbes), feeding (particularly breastfeeding), energy expenditure, exposure to pollutants and endocrine disruptors.
- Physical, psychological, and social factors: various traumas (aggressions, grief, hypersensitivity, abandonment, separations, etc.), which influence the relationship with food.

Food can become a refuge against emotional suffering, mixing pleasure, relief, and sometimes guilt. Understanding whether a person is eating out of physiological hunger or to fill an emotional void requires introspection, often a long process that involves support.

Eating is essential for life, and depending on the individual and the situation, food can act like antidepressants without necessarily leading to eating disorders. Food can serve as a refuge against emotional pain, combining pleasure, relief, and sometimes guilt.

Understanding whether someone is eating due to physiological hunger or to fill an emotional gap requires introspective work, often long and supported. It takes time and can last decades. It’s crucial to redefine for each individual the sources of distress and identify who is responsible; it’s not necessarily the patient for what they carry. Simultaneously, it’s important to recognize that many people with obesity are also epicureans, enjoying life's pleasures, but are genetically predisposed to weight gain.

Obesity is often underestimated, yet it requires a 360-degree intervention. Few people truly understand this issue, and the same goes for national and political levels, even though obesity is the fourth leading cause of mortality worldwide. Within the CNAO, the issue is addressed as best we can, with what we have and the means available to us.

It’s been a commitment of over 25 years to a national and international public health issue with repeated alarm calls from the WHO. Like the "One Health" approach to planet health, it doesn’t seem to concern many.

Market economy can function, but we must not separate health safety and food sovereignty—one does not oppose the other. Political decisions at both national and international levels must change the approach. The question to ask is: Are we willing to knowingly harm our childr

Obesity is often surrounded by stigma and prejudice. In your opinion, what tools are effective in providing better support to patients and deconstructing the negative image of obesity in the collective mindset?

Two key areas to focus on: informing and training people:

- Informing the public, explaining the causes of obesity, and helping certain individuals recognize they are in denial about being obese.
- Training all health professionals (medical and paramedical), as well as those involved in education (starting with early childhood).

It is essential to:

- Stop harassment via social media.
- Implement legal frameworks to combat body shaming.
- Show more diversity across all professions, starting with the media.
- Without forgetting the priority: the health of individuals.

How to care for those affected and prevent others from being affected, highlighting the importance of prevention and transforming the agri-food industry.

As a signatory of the ARCOM food charter since 2010, you chose not to support the proposals for 2025, deeming them too unambitious. You are now working on a new charter to address current challenges. How do you envision this new charter transforming media practices and communication around food and obesity? What specific obligations do you hope it will impose on the media to promote a healthier and more realistic representation of food?

There has been team work among all the signatories of the charter since this summer, even during school holidays, with objectives to be met in the short, medium, and long term, starting with more consistent communication throughout the years.

To conclude, what are your long-term aspirations for the CNAO and the recognition of obesity as a disease within the French healthcare system? What concrete changes do you hope to see in the coming years?

What we’ve been asking for years, which would allow us to truly advance on the issue of obesity and, more importantly, "One Health," is:

- An obesity plan similar to the cancer plan, renewable every 10 years, based at the Elysée, with fundamental research working on agriculture, food production and transformation, marketing, consumption, and its health effects, including the societal aspect.
- To be more respectful and attentive to our planet and our health. This must be disconnected from the political mandates of individuals. It must be a national and international priority, not for the CNAO, but for the populations. This goes beyond the collective’s ambition, which does what it can. It’s about human reason.

There is societal and political responsibility. We cannot say that nothing has happened and that we weren’t aware of it. What the collective does is modestly highlight small things, but progress can only happen through teamwork.