Healthcare policies in Türkiye have for decades been focused on increasing general health insurance coverage and building healthcare infrastructure. In the last 20 years, such policies have managed to fulfil the health requirements of a young generation. Due to such developments, Türkiye's healthcare sector today is more developed than many European countries, and the country has shown remarkable progress in health metrics. However, today a silent and insidious crisis threatens these achievements. It is neither an infectious disease nor a sudden economic shock; it is the uncontrolled rise of clinical obesity.
According to a recent white paper published by IQVIA, a company specialized in health research, titled “The Obesity Landscape in Türkiye,” the country has crossed a dangerous threshold. The prevalence of obesity in the adult population is approximately 32.1%, making Türkiye by far the most obese country in Europe. In 2005, this rate was around 16.6-19%. In other words, obesity has almost doubled in two decades. This is a world record! Today, approximately 20 million citizens live with clinical obesity. If no action is taken, it will not be surprising if we reach the rates of the U.S. (40%), the world leader in this area, within 10 years.
To understand how Türkiye presents this unusual metabolic picture in Europe, one must look not only at individual rationality but also at the economic structure of recent years. Prolonged inflation and economic fluctuations have fundamentally changed household consumption habits. With the highest food inflation among OECD countries, Türkiye has seen the prices of fresh fruits and vegetables, quality protein, and nutritious foods skyrocket, while socioeconomic necessity has driven families towards highly processed, high-calorie but low-nutritional-value foods. Today, obesity in Türkiye has become a disease of economic vulnerability, not of wealth.
Two additional structural changes have accelerated this nutritional deterioration: the proliferation of chain supermarkets and the rise of online food ordering platforms. Neighborhood grocery stores and local markets have been replaced by a few discount chain conglomerates, with approximately 56,000 branches nationwide. These businesses prefer products with long shelf lives, high carbohydrate content, and high trans-fat content. While these foods provide cheap satiety, they damage metabolic health. Taking advantage of the public’s lack of awareness in healthy food consumption, these chains can reap very high profits and dominate the market excessively.
On the other hand, online delivery platforms, which have become widespread, are causing traditional home cooking culture to be replaced by convenience. The algorithms of these platforms encourage ultra-processed products, prioritizing speed and taste over nutritional value, with aggressive discounts. This situation fuels sedentary lifestyles and excessive daily calorie intake in cities, creating a perfect storm for metabolic collapse. While the 10-35% commission these platforms take per order generates a huge profit for them, their aggressive marketing deepens individual food crises and exacerbates individual problems such as eating disorders, binge eating, and overeating.
Obesity is a public health crisis that reduces an individual's quality of life, restricts their mobility, and threatens their psychological health. As obesity among youth is increasing starting in the early childhood, associated problems such as diabetes, hypertension, joint problems, and respiratory illnesses are beginning to appear at younger ages. Individuals struggling with obesity are frequently subjected to discrimination and stigmatization. Obesity directly affects not only an individual's own body but also their family, their participation in the workforce, and their social productivity.
Unfortunately, in Türkiye, obesity is often defined as an individual failure, which further deepens the problem. However, reducing obesity solely to a lack of willpower ignores structural inequalities, food policies, and economic difficulties.
The financial burden on the Turkish healthcare system is growing day by day. According to the IQVIA report, the annual burden of obesity-related health problems has reached approx. $8 billion. The tremendous burden of the approaching aging crisis is not included in this. Obesity is not just a disease; it is a major driving force behind cardiovascular diseases, kidney failure, osteoarthritis, some types of cancer, and especially Type 2 diabetes. The burden that Type 2 diabetes places on the Social Security Institution (SGK) budget is a harbinger of a general financial collapse. Diabetes treatment is a capital-intensive process. Under General Health Insurance, many services are financed, from medication costs to dialysis, bypass surgeries to amputations, usually free of charge. However, SGK, unlike most European countries, does not allocate sufficient budget to preventive health services, and instead finances treatment after the disease has already developed. In other words, we are financing the disease, not the health.
The paradox is this: while sufficient resources are not allocated to preventive services, chronic diseases related to obesity are financed with almost no co-payment. What needs to be done is to immediately shift to preventive health services and incentivize individuals for a healthy, independent aging process for as long as possible in their lives, and to produce proactive policies for this.
Attributing obesity solely to individuals’ lifestyle choices is precisely the problem. Türkiye must address the obesity epidemic as a serious threat requiring urgent public health and socioeconomic intervention. The stigmatizing and individual-blaming approach must be abandoned; a systemic intervention-based approach must be adopted.
The state requires to intervene proactively and step up for structural adjustment and financial courage. A decisive health taxation should be implemented on ultra-processed foods, high-fructose corn syrup, and sugary drinks. Moreover, it should subsidize the supply chain of fresh agricultural products to make healthy food accessible for the general public. Strict regulation of digital food platforms and chain supermarkets is also an essential step, as transformative action is impossible without increasing physical access to healthy food.
Similarly, making nutritional warning labels mandatory on the front of packaging and preventing algorithmic incentives for metabolically harmful products are also crucial. However, whatever is done, it must be done without stigmatizing individuals, and by establishing the socio-economic infrastructure that will help individuals break the “obesity cycle.”
In short, the obesity crisis in Türkiye is now a public health problem. And if measures are not taken, this crisis is a harbinger of a financial crisis that could soon bring healthcare services to the brink of collapse. The time for light-hearted public service announcements and superficial awareness campaigns is over. Obesity is no longer an ordinary health problem; it is also a matter of economic survival for the country. Unless comprehensive reforms are implemented immediately and a nationwide “healthy eating” emergency is declared, the rising obesity pandemic could spell the end of Türkiye's generous welfare system.
