In 2012, Chile passed a law intended to reduce obesity in the country. It included several novel features, such as a front-of-package label, limitations to marketing and advertising, and policies targeting schools. The law required the creation of a regulation to address its implementation. Between 2012 and 2015, a process was carried out to generate this regulation that finally came into force in June 2016. This process confronted several difficulties: the involvement of multiple actors, political changes in national government, and endless negotiations to define the operational details of the regulation. The end result was one of the most discussed health policies of recent years in Chile. This article tells the story of the process defining this regulation, carried out between 2012 and 2015. It describes its evolution from a legal perspective but also reveals the trade-offs faced by the team in charge of providing the operational definitions for the implementation of the law. The article presents the main challenges as well the strategies used by the team at the Ministry of Health to overcome the many difficulties that arose during the process of implementing Chile's food labeling and marketing law. The experience of the Chilean reform may provide practical information and lessons for other countries and policy makers embarking on the task of preventing and reducing obesity. Although the Chilean experience has its own particularities, it also suggests common difficulties for similar reform processes in terms of technical challenges-such as the definition of concepts and the scope of regulation-and political challenges-like the opposition of the food industry and conflicts of interest among governmental institutions.

Obesity is a chronic disease with an increasing prevalence in all groups of age, and is associated to increased general mortality and cardiovascular risk. The multidisciplinary non surgical approach must be the treatment of choice for obese subjects. However, the results of such approach among subjects with severe or morbid obesity, are unsatisfactory. In this group of patients, bariatric surgery and specifically gastric bypass achieves good long term results, maintaining a low body mass index, reducing complications and improving quality of life. Considering the widespread practice of bariatric surgery in Chile, the Nutrition Unit of the Ministry of Health formed a task force to propose update guidelines for the surgical treatment of obesity. These guidelines were proposed after a thorough literature review and discussion with groups that practice bariatric surgery using defined protocols. This document provides a summarized version of the guidelines. The first section discusses the background for bariatric surgery and the second part give specific recommendations for patient management and the formation of reference centers for surgical management of obesity.

Chile has implemented several strategies to decrease the burden of obesity and chronic diseases. The Food Labeling and Advertising Law (Law 20.606) requires a front-of-package “high in” warning label when energy and nutrients of concern (ENC) (total sugar, saturated fats, sodium) exceed established limits. This study aims to evaluate the impact of Law 20.606 on the ENC declaration of packaged foods in Chile, before and after the law implementation. We analyzed food nutritional labeling declarations from 70% of the most consumed packaged foods in Chile. Data collection was conducted in 2013 and 2019 in Santiago. Pictures from all sides of the package were taken from 476 products, classified into 16 food groups. All food groups had changes in the ENC declaration during the study period. Total sugar content showed the highest reduction (−15.0%; p = 0.001). Dairy, confitures and similar and sugary beverages had the greatest reduction in energy and total sugar content (p < 0.01). Energy, total sugar and sodium front of package “high in” simulation was significantly reduced in dairy, sugary beverages, flour-based foods, confitures and similar, fish and seafoods, fats and oils, spices, condiments and sauces and sugars (p < 0.05). We observed that companies reformulated products to adapt to the new regulation.

In Chile, the NCFP has had an impact on the reduction of anemia and improved the iron status of children aged 11 to 18 months. Increasing the consumption of this iron-fortified milk could enhance the impact of the NCFP.

J, et al. Using evidenceinformed policies to tackle overweight and obesity in Chile. Rev Panam Salud Publica. 2017;41:e156. doi: 10.26633/RPSP.2017.156 An increasing number of studies from countries around the globe have described a cumulative proportion of the population suffering from overweight or obesity. The World Health Organization (WHO) has warned that in 2008, this epidemic reached catastrophic levels, affecting at least 35% of adults 20+ years of age and causing over 2.8 million premature deaths per year worldwide (1).The overweight and obesity epidemic is threatening the developed as much as the developing world (2). In countries that pertain to the Organization for Economic Cooperation and Development (OECD), estimates show that 1 in 5 children are either overweight or obese and 18% of adults are obese (3). In Latin American countries, 20% -25% of the population under 19 years of age (more than 25 million children and 15 million adolescents) are either overweight or obese (4) and almost 1 in 4 adults are obese (5).Chile was on the same path as prevalence of obesity increased from 23.2% in 2003 to 31.2% in 2017 and overweight increased from 37.8 % to more than 39% during the same time period (6). Moreover, 10.3% of children less than 6 years of age (7) were obese in 2014, as was 1 of every 4 children entering primary school in 2013 (8).An additional concern regarding the overweight and obesity epidemic in Chile is its unequal distribution. Obesity prevalence among people with a lower level of education almost doubles its prevalence, compared to those with the highest level of education. Moreover, the unequal distribution is also observed by genre, with a greater proportion of women affected in low and medium educational level, as shown in Figure 1 (6