Earlier this year, the Institute of Medicine launched a groundbreaking report on “Solving the Weight of the Nation.” In it (and in the accompanying HBO documentary), public-health officials argued that structural elements in our society rather than individuals are mostly responsible for the nation’s obesity epidemic.
To slow down or reverse the epidemic, the IOM report stressed, we need to make major changes in our schools, workplaces and communities. Simply scolding (and stigmatizing) individuals to eat less and exercise more will not solve the problem.
Of course, as I’ve noted here before, the structural message is not one that Big Food wants to hear, as it would curtail their sales and their profits. So the pushback against actions like taxing soft drinks has been loud, strong, and mostly successful.
But the structural message is not one that the American public wants to hear, either.
In a commentary published Wednesday in the New England Journal of Medicine, three health-policy researchers, including Sarah Gollust of the University of Minnesota, ask the question, “Are Americans ready to solve the weight of the nation?”
Sadly, their answer is no. For as they point out, public surveys consistently find that most people blame individuals rather than society for obesity.
“Only 18 percent of Americans identify external factors (exposure to junk food, lack of safe places for children to play, and limited availability of healthy foods in some neighborhoods) as the biggest causes of childhood obesity,” Gollust and her colleagues write, “whereas 64 percent identify personal factors (overeating, lack of exercise, and watching too much television) as the biggest causes.”
Beliefs about how the childhood obesity problem can be solved also tend to focus on individual rather than joint responsibility — especially among people who identify themselves as politically conservative. When asked who bears the most responsibility for childhood obesity, conservatives are more likely than moderates or liberals to point the finger at parents and children than at the food and beverage industry or government policies.
Reprinted with permission of the New England Journal of Medicine
These misconceptions about what has fueled our obesity problems hinder efforts to combat it, write Gollust and her colleagues. What’s needed, they add, is a more comprehensive effort to inform the public about the real causes of the obesity epidemic:
Rigorous evaluation research has been conducted in the past decade to identify effective interventions and policies for combating obesity. A similar research-driven effort is needed to identify effective communication strategies that encourage the public to accept the evidence base regarding the environmental determinants of obesity and the necessity of a collective response.
Getting the public to accept evidence-based research is easier said than done, however. After all, we live in a country where, according to a recent Gallop poll, 46 percent of its adults reject the overwhelming and incontrovertible evidence of evolution — a percentage that’s actually increased by 2 percent over the past 30 years.
Unfortunately, the NEJM commentary is behind a firewall. The U of M has provided, however, a brief video of Gollust discussing the paper. Her co-authors are Colleen Barry of Johns Hopkins University and Jeff Niederdeppe of Cornell University.