Obesity, especially childhood obesity, has received increasing public attention in the last couple of years. Governments around the world are being urged to provide solutions to the problem.
Within Australia, much of both the public discussion as well as the governmental response to obesity has focussed on the responsibility of the individual to eat well, be active and avoid being obese. This “personal responsibility” mantra is alive and well within public policy approaches to obesity and related chronic diseases. And yet obesity remains a problem, with no evidence that its prevalence, and its resultant health and economic consequences, are waning. Something ain’t right.
A recently released report from the UK Government’s Foresight Programme provides a fresh approach to thinking about obesity, and a varied set of solutions to dealing with it.
The report highlights that the obesity epidemic can only be prevented by taking a whole-of-society approach. Individual action (the default position within much of Australia) cannot be the major focus of policy – that approach is doomed to failure. The Foresight report likens obesity prevention to dealing with climate change – partnerships are required between business, civil society, government departments and science.
The report found that no single response was likely to have a major impact on obesity. Rather, a mix of interventions is required.
The top 5 policy responses that the report assessed as having the greatest potential impact on levels of obesity in the next four decades were:
- modifying the built environment so that walking and cycling are made easier and more accessible
- controlling the availability of, and exposure to, foods that cause obesity (eg junk foods, soft drinks)
- targeting health interventions for those who are at high risk of obesity
- increasing the responsibility of organisations for the health of their employees
- early life interventions at birth or in infancy
The report provides some principles that are directly relevant to Australia. Firstly, we, too, need a systems-wide approach to obesity that looks at the broad physical activity, dietary, social, cultural and economic environments. The many drivers of the obesity epidemic lie outside the portfolios of the hapless State and Federal health ministers who are currently told to fix the problem of obesity, but have no authority to influence its complex causes. Secondly, the prevention of health problems needs to be given a much higher priority at both a governmental and societal level.
Additionally, coordinated multi-sector and multi-level action is required – the State and Federal Governments, various industries, a range of NGOs, health professionals, local government, consumer groups, as well as others, all need to be involved and cooperating. Fourthly, we need long-term sustained interventions – no quick fixes here. And finally, whatever is done needs to be evaluated so we can learn from it.
These principles all make profoundly good sense. But will we see the political will – and the community support of this – to take this approach? If not, then obesity and chronic disease will have a worsening impact on the health and well-being of our society.