A critical analysis of obesity prevention policies and strategies

Salas, Ximena Ramos; Forhan, Mary; Caulfield, Timothy; Sharma, Arya M.; Raine, Kim

doi:10.17269/CJPH.108.6044

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A critical analysis of obesity prevention policies and strategies

Author(s): Ximena Ramos Salas , Mary Forhan , Timothy Caulfield , Arya M. Sharma , Kim Raine

Publication date (Electronic): September 1 2017

Journal: Canadian Journal of Public Health

Publisher: Springer Science and Business Media LLC

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Abstract

Public health policies have been criticized for promoting a simplistic narrative that may contribute to weight bias. Weight bias can impact population health by increasing morbidity and mortality. The objectives of this study were to: 1) critically analyze Canadian obesity prevention policies and strategies to identify underlying dominant narratives; 2) deconstruct dominant narratives and consider the unintended consequences for people with obesity; and 3) make recommendations to change dominant obesity narratives that may be contributing to weight bias.

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Most cited references 40

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Bodies of research pertaining to specific stigmatized statuses have typically developed in separate domains and have focused on single outcomes at 1 level of analysis, thereby obscuring the full significance of stigma as a fundamental driver of population health. Here we provide illustrative evidence on the health consequences of stigma and present a conceptual framework describing the psychological and structural pathways through which stigma influences health. Because of its pervasiveness, its disruption of multiple life domains (e.g., resources, social relationships, and coping behaviors), and its corrosive impact on the health of populations, stigma should be considered alongside the other major organizing concepts for research on social determinants of population health.

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The recognition of obesity as a disease was in theory established in 1948 by WHO's (World Health Organization) taking on the International Classification of Diseases but the early highlighting of the potential public health problem in the United States and the United Kingdom 35 years ago was considered irrelevant elsewhere. The medical profession disregarded obesity as important despite the new evidence and WHO data set out in the 1980s. Only in 1995 did WHO find greater problems of overweight than underweight in many developing countries but it required the first special obesity consultation in 1997 and particularly the Millennium burden of disease analyses to suddenly highlight its crucial role in the current unmanageable and escalating medical costs globally. Governments now recognize the overwhelming industrial developments that guarantee an escalating epidemic but neither they nor WHO know how to engage in changing the societal framework to promote routine spontaneous physical activity and a transformation of the food system so that low energy-density food of high nutrient quality becomes the norm.