The 4th March 2020 marks the launch of the first unified World Obesity Day, uniting organisations, national obesity days and weeks from across the globe to strengthen the voice for addressing obesity, with the aim to inspire global change in policy, attitudes and action. This year the theme explores the true ‘roots’ of obesity: moving away from the simplistic “eat less, move more” advice we hear all too often, to understanding that obesity is a chronic condition with multiple causes.
Obesity is complex
Obesity occurs when energy intake from food and drink is greater than the body’s energy requirements over a prolonged period. Many people believe therefore that to lose weight you must simply consume less food and drink and increase the amount of exercise you do; however, research continues to show that this approach is far too simplistic, particularly while competing with environments that promote obesity, termed ‘obesogenic environments’.
An ‘obesogenic’ environment is one that promotes weight gain by acting on individual physiology and psychology, influencing individual lifestyles.
Although personal choice plays a role in weight gain, in obesogenic environments, inactivity and overconsumption of energy dense foods is easy, affordable and widely accepted, making an unhealthy lifestyle the default option.
But that’s not all…
The Foresight report,1 written for the UK Government, identified 7 clusters of factors and behaviours that contribute to obesity:
These clusters are interconnected, e.g. some individuals may exhibit compensatory behaviour such as allowing themselves an energy-dense snack as a ‘reward’ after exercising. This connectivity is important when designing/delivering interventions; it may help to explain unexpected impacts or losses of impact due to mitigating effects of different factors/behaviours.
Food poverty can increase the risk of obesity
Another often misunderstood contributor to obesity is food insecurity. Food insecurity is defined as the “inability to dependably afford sufficient or adequate food.”2 In January this year A Menu For Change revealed that almost 600,000 emergency food parcels had been handed out by Scottish foodbanks in the last 18 months.3 This means that on average over 1000 food parcels were given out every single day!
While it might seem contradictory at first, food insecurity and obesity often occur alongside each other: both are consequences of social inequities.
A good example to demonstrate how the two can co-exist is by looking at the affordability of the UKs dietary guidelines, the Eatwell Guide. The Food Foundation’s 2018 report on the affordability of the UK’s Eatwell Guide found that the poorest 10% of Scottish households would have to spend 68% of their disposable income on food to meet the costs of the Eatwell Guide, in comparison to only 7% for the richest 10%.4 The report concludes that the food budgets in more than half of UK households are likely to be insufficient to meet the government’s recommendations for a healthy diet. This equates to around 14.4 million households in the UK that are potentially unable to afford the diet recommended in the Eatwell Guide.
The Food Foundations ‘The Broken Plate’ report also highlighted that, per calorie, healthy foods are three times more expensive than unhealthy foods, removing the choice for many individuals and families on low incomes.5
Weight stigma and ‘fat-shaming’ can increase the risk of obesity
Research has also found that weight stigma and shaming itself can increase the risk of obesity: something many people might also believe to be the opposite. Weight stigma can cause people to skip doctors’ appointments for fear of being subjected to weight bias, poorer quality of care and worse outcomes, and avoid taking part in exercise. Physiological changes have also been noted, such as increased levels of cortisol, a hormone that promotes weight gain.6
A multi-factorial approach to addressing a multi-factorial condition
As the roots of obesity run so deep, it is clear to see why a multi-factorial, whole-systems approach is required to try to reduce the weight of the population. With so many things working against us, making slow, small, stand-alone changes in policy will simply not scratch the surface. A report from the McKinsey Institute7 identified 74 policy interventions in 18 areas, across a range of different sectors which they say, if implemented and sustained, will help to address the rising levels of obesity. At Obesity Action Scotland, we support many of these policy interventions in our calls to:
Read more about our key recommended actions in our selection of briefings and factsheets.
1. Butland B, Jebb S, Kopelman P, et al (2007) Foresight. Tackling Obesities: Future Choices - Project Report. 2nd Edition.
2. Tinkler J, Ritchie J (2016) Barriers to Healthy Food. Postnote 1–7
3. IFAN - Menu For Change (2019) Emergency Food Parcel Provision in Scotland April 2018 to September 2019
4. Scott C, Sutherlan J, Taylor A (2018) Affordability of the UK’s EatWell Guide
5. The Food Foundation (2019) The Broken Plate. Ten vital signs revealing the health of our food system, its impact on our lives and the remedies we must pursue.
6. WHO Europe (2017) Weight bias and obesity stigma:considerations for the WHO European Region
7. Dobbs R, Sawers C, Thompson F et al (2014) Overcoming obesity. An initial economic analysis. Discussion paper. McKinsey Global Institute