It is really tempting to keep them separate.
First, dealing with undernutrition is difficult enough without having to deal with overnutrition (basically overweight and obesity and the related chronic diseases of diabetes, coronary heart disease, high blood pressure and some forms of cancer).
And of course, dealing with undernutrition is one great way to help prevent overnutrition later in life. In addition, dealing with overnutrition means having to grapple with the food industry and a whole range of factors outside of nutrition's comfort zone: urban development, education, trade, taxes and agriculture for example.
Also, there aren't exactly a range of interventions and policies that have been shown to be effective to inspire us to ramp up action on the overnutrition front.
Finally, it is not easy to get research funding to address the two in an integrated fashion.
But I think the separation (which I have also contributed to) is no longer sustainable.
First, overnutrition does not operate a different space: it is not just a later in life phenomenon--it is happening to under 5's; it is not just in urban areas and it is not just in middle and upper income countries--it is everywhere.
Second, the undernutrition community can't avoid engaging with the private sector--not having to deal with the private sector is no longer a reason for not getting involved overnutrition.
Third, we now know that the fight against undernutrition has to go way beyond health, and into the wider development space. This is something even more obvious in dealing with overnutriton.
All the reasons for separating the two are dissolving.
So, seemingly, something that is difficult (undernutriiton reduction) just got much harder (dealing with under and over nutrition). But is that really so? Can an integrated approach help us address both issues better? I think that may be the case.
Making development more nutrition sensitive and making nutrition more politically aware surely brings the worlds of over and undernutrition together, indeed, shows they were never that far apart in the first place. They should no longer be separated at birth.
In this context, a new World Bank review of Global Evidence on the Double Burden of Malnutrition from the World Bank (by Roger Shrimpton and Claudia Rokx) is comprehensive and well done, but depressing (coming soon on the World Bank website). It is depressing because it shows how divided the two camps are and how that is to neither's advantage. Beyond the physiological linkages there has not been much thinking in the past 10 years on how to bring them together in the policy, programme, training, communication and advocacy spaces.
I think policymakers are about to get a wake up call from advocacy groups, consumers, the health community, and even some industry leaders, to do something.
The Double Burden is here to stay. Perhaps it is time to drop the Double (on the double).