Obesity – an ‘ecological public health' perspective
Thursday 5 June 2008
'Is obesity the result of an outbreak of gluttony and sloth, or can it be linked in with climate change?' visiting Research Fellow at City University, Geof Rayner, asked delegates in the Tackling obesity plenary. What is actually needed is an ecological public health perspective, he said.
'If it is all down to individual behaviour, then what advice is being offered to those people?' The answer is the increasingly bizarre offerings of the diet industry. 'The more the obesity epidemic takes hold, the less relevant the diet industry appears to be,' he said, as it actually depends on failure and 'serial dieting' to sell its products. The answer clearly does not lie with drugs or mass bariatric surgery either.
The diet industry and medicine have been of limited benefit because they fail to address the environmental and social factors that influence individual behaviour, he told delegates. Even the fabled healthy 'Mediterranean diet' no longer exists, he said, with the majority of children in poor areas of Italy now overweight or obese and the same phenomenon occurring in Greece, Spain, Malta and elsewhere. 'It's not just an American and British problem,' he said.
Population weight has been rising in most societies in defiance of stigma and powerful societal norms of 'thinness', and different conceptions of obesity have led to 'policy cacophony.' 'Different models seem partial and add to the confusion about what a unified model would be,' he said.
But the model gaining relevance is the ecological one, he stressed. 'Energy – societal and individual – is at the nub of weight gain,' and this has huge policy implications. 'We need to look at the world as a system, not just as individuals.' The ecological public health model of obesity looks at ‘obesogenesis' as a historical process, and one that incorporates government failure and market failure, he said.
'We're looking at the world as a system and seeing ways in which the drivers of weight gain interact.' These include things like the food supply chain and the 'colonisation of everyday life by the food industry. 'The world around us has changed,' he said. Economic change is linked to the increased consumption of fats and processed food, the 'supermarketisation' of food retail and longer and longer supply chains. 'All of these factors connect with the warming of the earth,' he said.
'The fattest societies are also the biggest users of fossil fuels,' he continued. 'Instead of using human power we're using fossil power. We need to re-set the parameters of behaviour.' This goes beyond individual behaviour to encompass governments and organisations, he said. 'The world has changed, and the challenge is huge. We have to think long term, offer clearer lines of action, define actions and strategies which could be implemented now and captivate the public imagination about a healthier future and how we get there.'
Watch Geof Rayner's speech as part of the plenary session: Tackling Obesity