How can we prevent obesity?

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What works in preventing and treating obesity is the multi-billion dollar question these days. There are strong connections between obesity and physical activity and nutrition – undeniably – but strategies that simply focus on exercise and healthy eating aren’t working. Extreme measures such as bariatric surgery are becoming very popular, but some have questioned whether surgery is a sustainable solution for most people.

Some researchers are starting to look at obesity holistically, and they see a bigger picture emerging. They are seeing that poverty and the environment are intimately and intricately linked to obesity-related disease, especially for women. When you can’t access healthy food (a situation known as ‘food insecurity’) and can’t afford (or have time for) exercise, the message of ‘just eat right and get fit’ falls flat. And the poorer you are, the more likely you are to have lead in your homes, live near polluting factories, buy cheaper and more toxic-filled products, etc. So, the poorer you are, the more likely you are to be exposed to obesogens.

Focussing only on exercise and eating right isn’t working

Why Diet and Exercise is Not a Treatment for Obesity
By Ayra M. Sharma, 2011
Discusses the failure of dieting and increased exercise to treat obesity effectively.

Inactivity Does Not Explain Canada’s Obesity Epidemic
By Ayra M. Sharma, 2011
Discuses recent findings that “overweight and obese kids and adults are only marginally (if at all) less active than their ‘normal’ weight counterparts.”

Canadian Lifestyle Choices: A Public Health Failure
By Daniel RosenfieldPaul HébertMatthew StanbrookNoni MacDonaldKen FlegelJane CouttsCanadian Medical Association Journal, Volume 183, Number 13, September 20, 2011
Argues that obesity prevention programs focussing only on persuading individuals to make healthy lifestyle choices are not working, and that health professionals should be advocating for more effective public health policies – such  as banning trans fats and reducing salt in processed food – that make it easier for Canadians to make those choices.

Prevention of Diabetes Throughout an Obesogenic World
By Mickey Chopra and Thandi PuoaneDiabetes Voice, Volume 48, Special Issue, May 2003, pp. 24-26
Discusses how most efforts to combat obesity that have focussed only on providing education and skills to help individuals to lose weight have failed, and argues for a different approach: a combination of price manipulation, public education and clear nutrition labelling.

Exposing the Diet Myth: Diets Make You Eat Less
By Randi E. McCabe, National Eating Disorder Information Centre
Looks at the myths surrounding dieting and weight loss.

Food insecurity and obesity are related

The food insecurity-obesity paradox as a vicious cycle for women:  a qualitative study
By Andrea S. Papan and Barbara Clow, Atlantic Centre of Excellence for Women’s Health, 2012
Relates the stories of women who have experienced weight gain in the context of food insecurity and offers insights into the nuances of the food insecurity-obesity paradox. Looks at how, for these women, this paradox affected their daily lives, what challenges they faced as well as what coping strategies they used.

Recipes for Food Insecurity: Women’s Stories From Saskatchewan
By Yvonne Hanson, Prairie Women’s Health Centre of Excellence, 2011
Explores how food insecurity, policies and programs affect women's health and well-being. Finds that low income is the most significant risk factor for food insecurity for women and that Aboriginal off reserve households are most likely to experience food insecurity.

Food Insecurity and Obesity: Understanding the Connections
Food Research and Action Centre, 2011
Discusses recent research that shows a higher risk of overweight/obesity among food insecure women than among food insecure men.

The Relationship Between Food Insecurity and Obesity in Rural Childbearing Women
By Christine Olson and Myla Strawderman, The Journal of Rural Health, Volume 24, Issue 1, Winter 2008, pp. 60–66
Interesting study in which the authors suggest weight discrimination may be a factor in women getting well-paying jobs.

The Nutrition Transition and Obesity
Food and Agriculture Organization, United Nations
Explains ‘nutrition transition’ – major changes in diet and physical activity – a phenomenon underlying the rising rates of obesity in the developing world.

The role of Big Food

Food Sovereignty: Power, Gender, and the Right to Food
By Rajeev C. Patel, PLOS Medicine, Volume 9, Number 6, 2012
Argues that gender is key to food insecurity and malnourishment, because women and girls are disproportionately disempowered through current processes and politics of food's production, consumption, and distribution.

The Perils of Ignoring History: Big Tobacco Played Dirty and Millions Died. How Similar is Big Food?
By Kelly Brownell and Kenneth Warner, The Milbank Quarterly, Volume 87, Number 1, 2009, pp. 259-294
Compares how both the tobacco and food industries influence public opinion, legislation and regulation, litigation, and the conduct of science. Argues for better standards that are not regulated by the food industry itself.

A Desired Epidemic: Obesity and the Food Industry
By Deborah Cohen, The Rand, 2007
Argues for much stronger government regulation of the food industry as an important strategy to prevent obesity.

The Fat of the Land: Do Agricultural Subsidies Foster Poor Health?
By Scott Fields, Environmental Health Perspectives, Volume 112, Number 14, 2004
Discusses the possible effects of farm subsidies on unhealthy food produced in the U.S. and argues for more subsidies for fruit and vegetable growers to encourage healthier eating.

The Yale Rudd Center for Food Policy and Obesity
Lists resources for further reading on the role of the food industry in the development of obesity.

Unite Here: Real Food, real Jobs
An organization of food service workers in the US who want to cook and serve ‘real food’ – with local, fresh, sustainable ingredients – not processed and frozen products.

Extreme measures such as surgery becoming more popular

Lap-Band Critics Decry Excess Rhetoric on Weight
By Alizah Salario, WeNews, 2011
Criticizes the use of the Lap-Band, a surgically-implanted device that cinches the stomach and drastically restricts food intake. Approximately 80 percent of those who elect for the Lap-Band are women.

Weight-Loss Surgery Cuts Cancer Risk in Women
Colorectal Cancer Association of Canada, 2009
Reports on research suggesting that obese women who undergo bariatric surgery experience a 42 percent drop in their cancer risk.

Why White girls are Getting More Weight Loss Surgery
By Meredith Melnick, Time Healthland, 2007
Reports on findings that the rate of weight loss surgery in the U.S. went up by 700% between 2005 and 2007 and is increasing disproportionately among white teenage girls.

NEXT:

Is obesity really an epidemic? Should we wage war on it?
Health at Every Size:  Can we make peace with obesity?