Symposium – Challenging interventions with an obese society

ISBNPA St Andrews Brochure_Page_1This satellite meeting, on Monday 8th June 2015 at the University of St Andrews offers a range of interactive sessions, work-share structured discussions and a designer led approach to creative opportunities for increasing awareness and action around physical activity and diet for weight management. Presentations include recent work on new visual tools for assessing unhealthy body weight in children, effective communications and brief interventions.

Those with an interest in optimising communications about obesity research (involving diet and physical activity) are welcome to the meeting for an interactive day with time for sharing experiences, reflections and ideas.

There will be the opportunity for a walk and talk poster presentation session, with a prize for the most innovative presentation.

For more details see http://isbnpasat2015.org/ or contact (jc100 @st-andrews.ac.uk) or (a.s.anderson @dundee.ac.uk)

Complex obesity debate

A report by Vikki Entwistle, Associate Director, SDHI.

On Friday 18th May we were delighted to welcome a diverse audience that included public health leads and practitioners from NHS Tayside and NHS Fife as well as academic colleagues from a range of disciplines from the Universities of St Andrews and Dundee to a seminar given by Dr Stacy Carter from the Centre for Values, Ethics and the Law in Medicine at the University of Sydney.
Stacy took us through a carefully constructed and well illustrated argument against presenting public health activity as activity against obesity. She started by stressing that body weight is related to health, but in a complex variety of ways, so weight loss contributes significantly to health gain in some people (e.g. those who have diabetes or pre-diabetes) but not all people, and efforts to lose weight can be harmful in various respects. Thus while support for weight loss can be a very appropriate and important goal in the clinical care of some individuals, it is potentially problematic as a public health goal.

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Stacy argued that at a population level, talking about obesity as a target problem to be addressed is just one way of ‘framing’ (or looking at) a cluster of important contemporary health and social problems. As some collective (public) actions that aim to improve population health or the broader wellbeing of communities already illustrate, we can identify factors that tend to contribute to poor health and wellbeing in a range of sectors (transport, food policy, industry regulation, housing, social development etc.). Stacy’s key point was that not only was it important to support collective action to tackle all of these, it would be more ethical to present the target of such action not just or primarily as obesity but rather as the social causes of poor health. She explained that that the obesity frame reinforces the negative labelling and stigmatisation of people who are obese, and directs attention to the ‘canary in the coal mine’ rather than the ‘gas leak’ of conditions producing poor health that should be the primary concern. An alternative framing of the problem that focused more explicitly (in words as well as in action) on the social contributors to poor health, would raise fewer ethical problems.

Stacy’s presentation stimulated a wide-ranging and vigorous debate that highlighted the contestability of some key public health concerns and approaches. For me, this confirmed a need to consider the ethical as well as the empirical aspects of public health, and to promote robust conversations between policy leaders, practitioners and researchers about both.

The slides from this presentation will follow shortly.

SDHI Seminar ‘Rethinking the ‘war on obesity’ – an ethical argument

SDHI are delighted to announce another seminar.  It will take place on:

Friday 18th May 2012

between 2pm and 4pm

and will be led by

Dr Stacy Carter

Centre for Values, Ethics and the Law in Medicine

University of Sydney 

Stacy M. Carter is a Senior Lecturer at the University of Sydney; from 2012 to 2015 she is an Australian National Health and Medical Research Council Career Development Fellow. Her empirical and theoretical work focuses on the ethics of public health, her methodological work focuses on qualitative research. In her
current funded projects she is investigating ethical aspects of three public health practices: health promotion, intervening in overweight and obesity, and screening populations for cancer. She is also participating in projects on diverse topics including: preventive care in dentistry, marijuana smoking in the Northern Rivers of NSW, and how tobacco smokers quit without assistance. She leads the public health ethics research stream at the Centre for Values, Ethics and the Law in Medicine at the University of Sydney.

Rethinking the ‘war on obesity’: an ethical argument

This seminar will be held in

Room 2F13, Dalhousie Building

University of Dundee

In recent decades, society has changed in ways that promote development of non-communicable diseases. Urban environments, transport systems, and food production and supply systems interact to increase the prevalence of chronic diseases in populations. I will refer to this as a disease- promoting social shift. However, I will argue, we have developed a bad habit in population health. We have become accustomed to referring to this disease-promoting social shift as a problem of overweight and obesity, and thinking of ourselves as focusing our interventions on overweight and obesity. I will argue that this is not necessary: we can address the disease-promoting social shift without focusing on bodyweight. Focusing on bodyweight is also unethical for four reasons. First, it distracts from the fundamental causes of the problem, unjustly suggesting that responsibility rests primarily with individuals. Second, it causes some harm and fails to recognise other important harms. Third, it feeds arguments about ‘the nanny state’ and thus focuses debates on alleged erosions of relatively unimportant consumer freedoms, while diverting attention from more morally significant erosions of freedom of opportunity. Fourth, it neglects, and even exacerbates, problems of inequity. I will conclude that we should stop thinking of ourselves as being engaged in a ‘war on obesity.’ It would be more ethically justifiable to think of ourselves as intervening in the societal structures and conditions that are leading to increases in non- communicable disease, and to act accordingly.

ALL WELCOME

If you would like to attend this seminar please contact Rosanne Bell r.c.bell@dundee.ac.uk