Do food manufacturers bear a responsibility for the global obesity crisis? Of course they do. So do restaurants that offer nutritionally poor fare and exorbitant portion sizes. But the decision to consume foods and drinks that cause waistlines to expand ever further still rests with the individual. So, from which end should we try to tackle the problem?
Experts remain divided over the issue, despite of decades-long research on the true causes of excessive weight gain. What is unclear to most is where countermeasures should be implemented first, at the supplier -- or the consumer level.
In a special series on the subject, the medical journal The Lancet has published different points of view, leaving considerable space for further discussion.
A majority of study findings, however, seem to lean towards top-down solutions such as regulatory measures that force food suppliers to better comply with dietary guidelines and recommendations by health experts, rather than a bottom-up approach with a primary focus on consumer behaviour.
Although obesity is a complex issue, many debates about its causes and solutions are centered around overly simple dichotomies that present seemingly competing perspectives. Examples of such dichotomies explored in this series include personal versus collective responsibilities, supply versus demand-type explanations for consumption of unhealthy foods, government regulation versus industry self-regulation, and so forth, according to the series' final report. While people ought to be held responsible for their health and well-being, environmental factors can support or undermine their ability to act in their self-interest, the authors conclude.
"Today's food environments exploit people's biological, psychological, social and economic vulnerabilities, making it easier for them to eat unhealthy foods. This reinforces preferences and demands for foods of poor nutritional quality, furthering the unhealthy food environments. Regulatory actions from governments and increased efforts from industry and civil society will be necessary to break these vicious cycles," they argue.
Not everyone agrees with one-sided attempts at solution finding of either kind. Dr. Mike Gibney, the director of the Institute of Food and Health at the University College Dublin, Ireland, and author of Ever Seen a Fat Fox? Human Obesity Explored, calls for a combination of bottom-up (consumers) and top-down (governments, industries) approaches.
Multi-faceted action that attacks the problem at its roots, namely individual eating behaviour, but doesn't let "Big Food" off the hook, is the most promising way to go, he says in an interview with Food Navigator. We do have the required resources to make a change, he says, it's just the will that is lacking to follow through on what we know - on either side.
While obesity has been acknowledged as a global epidemic, it is unlikely that universally applicable solutions can be found. Methods that may work locally or regionally may fail on a larger scale. Differences between cultures, customs, education, economic status and governance may prove too great to overcome.
Some have suggested to take up the fight against obesity in similar fashion as the so-called "tobacco wars" in the 1990s, when policies were put in place that helped reduce tobacco use. But although anti-smoking campaigns and programs played an important role, it was also due to intense education efforts about the health risks that led many smokers to quit.
We should be careful, however, to expect too much from such strategies, even if they have worked in the past, because the issues differ. Looking at the tobacco or alcohol model with their top-down measures is flawed because neither has much in common with food, Dr. Gibney cautions. You can wean yourself from smoking or drinking but not from eating, he says. That means that ultimately consumers remain in the driver seat when it comes to making lasting changes, albeit they can use all the help they can get.
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