Volume 196 - Issue 9
A big-picture approach to big people
Author: Garry J Egger
Med J Aust 2012; 196 (9): 567. || doi: 10.5694/mja12.10361
Published online: 21 May 2012
Published online: 21 May 2012
To the Editor: Your focus on obesity in the 20 February 2012
issue of the Journal expresses the frustration of many of us working in this area. After 25 years, it is clear that we have achieved little in reducing the problem at the population level and that the existing model for dealing with obesity, based on personal ...
To the Editor: Your focus on obesity in the 20 February 2012 issue of the Journal expresses the frustration of many of us working in this area. After 25 years, it is clear that we have achieved little in reducing the problem at the population level and that the existing model for dealing with obesity, based on personal behaviour change, has failed.
While preventive actions such as teeth cleaning are relatively teachable, complex biological drives such as hunger and sex are largely resistant to behavioural change interventions in environments of abundance. If public health warrants a change in such drives, they are probably best dealt with by modifying causal environments.
Government concern over obesity, however, is moderated by vested interests, which could be challenged by creative lateral thinking. Taxpayer-funded election campaigns, for example, would reduce the ability of the ubiquitous lobby industry to dictate policy (eg, unhealthy food marketing) that may be in the best interest of shareholders, but not the community.
It is clear that obesity has a (macro) economic driver. While increases in wealth in poor countries enable the population to achieve a healthy body weight, continued increases result in obesity.1 This is worse in Western developed countries (like Australia) with greater income inequality and “harder” (ie, more market-liberal) forms of capitalism.2 The only countries where obesity has decreased in recent years (with the exception of those at war) are those that have suffered an economic downturn (Cuba, Nauru, Japan).3 It will be fascinating to see what happens in Greece as the European economic crisis unfolds.
And while no one would advocate the Greek experience as a solution to obesity, we must acknowledge the big-picture causes of the problem rather than continue to blame the victims to deflect interest in our untouchable economic system.
Competing interests
No relevant disclosures.
References
- Offer A, Pechey R, Ulijaszek S. Obesity under affluence varies by welfare regimes: the effect of fast food, insecurity, and inequality. Econ Hum Biol 2010; 8: 297-308. 0_CHDGGFHG
- Egger G, Swinburn B, Amirul Islam FM. Economic growth and obesity: an interesting relationship with world-wide implications. Econ Hum Biol 2012; 10: 147-153. 0_i1142857
- Tapia Granados JA. Response: on economic growth, business fluctuations and health progress. Int J Epidemiol 2005; 34: 1226-1233. 0_pgfId-2532719