Combined Food Policies, Including Labeling and Advertising Bans, Plausibly Reduce Childhood Obesity

A new study published in The Lancet has found that Chile's comprehensive Food Labeling and Advertising Law (FLAL)—which combined front-of-package warning labels, advertising restrictions, and school food regulations—is plausibly linked to a measurable decrease in excess weight among young schoolchildren. The findings represent the first evidence that a coordinated package of food policies, rather than a single intervention such as a sugar tax, can produce population-level reductions in childhood overweight and obesity.^1,2

For pharmacists, who are often the most accessible point of contact for families navigating nutrition, weight, and chronic disease prevention, the study offers concrete evidence to support conversations about how the broader food environment shapes a child's health trajectory.

“Health care professionals should alert their patients about the need to buy and consume less harmful products,” Guillermo Paraje, PhD, professor of economics at the Universidad Adolfo Ibáñez Business School in Chile and lead author of the study, said in an interview with Pharmacy Times. “And front-of-pack labels, if properly designed, can provide an easy way to interpret nutritional composition.”

What the FLAL Includes

Implemented in 2016, the FLAL was among the first policies in the world to combine 3 strategies recommended by the World Health Organization: mandatory front-of-package warning labels (black octagons) on foods and beverages high in sugar, sodium, saturated fat, or calories; restrictions on marketing such products to children younger than 14 years; and bans on selling these products in schools. The law was rolled out in 3 phases with progressively stricter nutrient thresholds, with phase 1 taking effect in 2016 and phases 2 and 3 following in 2018 and 2019. Because phases 2 and 3 occurred after the study period, the results reflect only the earliest, least restrictive stage of the law.^1-3

Study Design and Key Findings

Investigators used a cohort difference-in-differences approach, drawing on national administrative data from more than 300,000 children aged 4 to 6 years across Chile's public and publicly subsidized schools between 2012 and 2017. They compared cohorts of children unexposed to the FLAL (those entering prekindergarten in 2012 and 2013) with cohorts exposed to phase 1 during prekindergarten, kindergarten, and first grade (those entering in 2014 and 2015). The final analytic sample included 321,597 students, and the primary outcome was a binary measure of excess weight, defined as overweight or obesity.¹

Children with 18 months of exposure to phase 1—covering both kindergarten and first grade—showed the largest reductions in excess weight. Girls had a 2.85% lower probability of excess weight (95% CI, –4.07% to –1.63%), and boys had a 2.40% lower probability (95% CI, –3.58% to –1.22%). Even after just 6 months of exposure, during first grade alone, girls had a 1.91% lower probability of excess weight and boys a 2.24% lower probability, both statistically significant. In absolute terms, this corresponds to roughly a 1.2 to 1.4 percentage point drop from pre-FLAL prevalence rates of approximately 47.7% for girls and 52% for boys.^1,2

Plausible Causality, Not Proof of Direct Effect

The study's authors describe their findings as a "plausible causal effect" rather than definitive proof, a distinction rooted in the assumptions underlying the difference-in-differences design. The approach relies on the premise that, absent the FLAL, exposed and unexposed cohorts would have followed similar weight trends over time, an assumption that cannot be directly tested but was supported by pre-policy trend data. The researchers also noted that children's weight and height were measured by trained school staff, who may not achieve the same precision as clinical settings.^1,2

Despite these limitations, Paraje said the results offer some of the strongest evidence to date that a bundled policy approach—rather than isolated measures—can shift childhood obesity trends at a national scale.²

Context for Future Impact

Because the analysis captured only phase 1 of the FLAL, before nutrient thresholds were tightened in 2018 and 2019, the true magnitude of the law's effect may be understated. Nieves Valdes, PhD, associate professor of economics at Universidad Adolfo Ibáñez Business School, noted that subsequent phases likely had a larger impact, citing evidence of steeper declines in sales of labeled products during phase 2 compared with phase 1. Separate research has also linked the FLAL to measurable reductions in the sugar, sodium, and saturated fat content of packaged foods and to declines in sugar-sweetened beverage purchases following its implementation.^2,3

Implications for Pharmacists and Pharmacy Practice

For pharmacists, the study reinforces a point increasingly emphasized in pharmacy-based weight management literature: individual counseling on diet and physical activity is most effective when reinforced by a supportive food environment. Pharmacists are frequently identified as among the most accessible health care professionals for discussing nutrition, weight, and chronic disease risk with families, particularly in community settings where formal referral pathways may be limited.^4,5

As policymakers in other countries weigh similar front-of-package labeling and marketing restriction proposals, pharmacists may find themselves fielding questions from patients about what such labels mean and how they relate to broader efforts to prevent obesity-related conditions, including type 2 diabetes, hypertension, and cardiovascular disease, all of which carry elevated long-term risk when excess weight begins in early childhood. Even modest reductions in childhood excess weight, the study authors note, may translate into meaningful downstream reductions in chronic disease burden, an outcome pharmacists are positioned to support through ongoing patient education and engagement.^4,5

REFERENCES

1. Paraje G, Valdes N, Macaya AV, Corvalan C, Popkin B. The impact of Chile's multipronged food labeling and advertising law on early childhood excess weight: a cohort difference-in-differences study. Lancet. Published online first: June 11, 2026. doi:10.1016/S0140-6736(26)00651-3

2. The Lancet: Combined food policies, including labelling and advertising bans, have real-world impact on reducing child obesity, first evidence plausibly shows. News Release. EurekAlert! Released June 11, 2026. Accessed June 15, 2026. https://www.eurekalert.org/news-releases/1131458

3. Reyes M, Taillie LS, Popkin B, et al. Changes in the amount of nutrient of packaged foods and beverages after the initial implementation of the Chilean Law of Food Labelling and Advertising: a nonexperimental prospective study. PLOS Medicine. Published Online July 28, 2020. doi:10.1371/journal.pmed.1003220

4. AlOmeir O, Almuqbil M, Alhabshi HA, et al. Exploring the role of community pharmacists in addressing obesity: a Saudi Arabian perspective. Front Public Health. 2025;13. doi:10.3389/fpubh.2025.1503260

5. Garza A. Childhood obesity: Following in dangerous footsteps. Pharmacy Times. Published October 15, 2025. Accessed June 15, 2026. https://www.pharmacytimes.com/view/childhood-obesity-following-in-dangerous-footsteps