Framing obesity in UK policy from the Blair years, 1997-2015: the persistence of individualistic approaches despite overwhelming evidence of societal and economic factors, and the need for collective responsibility.

Since 1997, and despite several political changes, obesity policy in the UK has overwhelmingly framed obesity as a problem of individual responsibility. Reports, policies and interventions have emphasized that it is the responsibility of individual consumers to make personal changes to reduce obesity. The Foresight Report 'Tackling Obesities: Future Choices' (2007) attempted to reframe obesity as a complex problem that required multiple sites of intervention well beyond the range of personal responsibility. This framing formed the basis for policy and coincided with increasing acknowledgement of the complex nature of obesity in obesity research. Yet policy and interventions developed following Foresight, such as the Change4Life social marketing campaign, targeted individual consumer behaviour. With the Conservative-Liberal Democrat government of 2011, intervention shifted to corporate and individual responsibility, making corporations voluntarily responsible for motivating individual consumers to change. This article examines shifts in the framing of obesity from a problem of individual responsibility, towards collective responsibility, and back to the individual in UK government reports, policies and interventions between 1997 and 2015. We show that UK obesity policies reflect the landscape of policymakers, advisors, political pressures and values, as much as, if not more than, the landscape of evidence. The view that the individual should be the central site for obesity prevention and intervention has remained central to the political framing of population-level obesity, despite strong evidence contrary to this. Power dynamics in obesity governance processes have remained unchallenged by the UK government, and individualistic framing of obesity policy continues to offer the path of least resistance.

Socio-economic status, forms of capital and obesity.

INTRODUCTION: While the relationships among socio-economic status (SES) and obesity are powerful and synergistic, the SES construct is insufficient to describe some of the cultural influences on status production in society, and therefore on obesity production. Socio-economic status has two closely related dimensions. The economic one is represented by financial wealth while the social one can incorporate education, occupational prestige, authority and community standing. These are, however, incomplete explanations for the relationships between societal inequalities and obesity. DISCUSSION: Cultural factors associated with SES and obesity are examined here by using Bourdieu and Boltanski's theory of practice, which links economic, social and cultural forms of capital (or value) in an overarching category of symbolic capital. These represent categories through which power relationships within society are negotiated. This construct permits a more complete examination of societal stratification and its human biological consequences and amplifiers, since it incorporates the notion of cultural value in different groups of, for example, preferences in body size and shape. The focus is primarily on the USA, although it draws on literature from elsewhere in the industrialized world where appropriate. Differences in obesity rates across major ethnic groups are discussed, because this is an area in which forms of capital differ, and may offer new insights into obesity and factors that predispose to it, as forms of symbolic capital.

Frameworks of population obesity and the use of cultural consensus modeling in the study of environments contributing to obesity.

Obesity in Eastern Europe has been linked to privilege and status prior to the collapse of communism, and to exposure to free-market economics after it. Neither formulation is a complete explanation, and it is useful to examine the potential value of other models of population obesity for the understanding of this phenomenon. These include those of: thrifty genotypes; obesogenic behaviour; obesogenic environments; nutrition transition; obesogenic culture; and biocultural interactions of genetics, environment, behaviour and culture. At the broadest level, obesity emerges from the interaction of thrifty genotype with obesogenic environment. However, defining obesogenic environments remains problematic, especially in relation to sociocultural factors. Furthermore, since different identity groups may share different values concerning the obesogenicity of the environment, a priori assumptions about group homogeneity may lead to flawed interpretations of the importance of sociocultural factors in obesogenic environments. A new way to identify cultural coherence of groups and populations in relation to environments contributing to obesity is put forward here, that of cultural consensus modeling.

The international growth standard for children and adolescents project: environmental influences on preadolescent and adolescent growth in weight and height.

This review has two aims. The first is to identify important environmental influences on the growth of children aged 1 to 9 years and of adolescents, defined as those aged 10 to 19 years. The second is to identify possible environmentally based criteria for the selection of individuals and populations for data collection in the development of an international growth reference for these age ranges. There are many common environmental influences on the growth of children between the ages of 1 and 19 years; the examination and description of these forms the main body of this review. Subsequently, environmental factors influencing adolescent growth only are considered. In both cases, possible selection criteria are put forward. The most important inclusion criteria for both preadolescence and adolescence are good nutrition, lack of infection, and socioeconomic status that does not constrain growth. Additionally, low birthweight, catchup growth, breastfeeding, and early adiposity rebound have impacts on growth and/or body composition into puberty. Exclusion of children born at low birth and/or experiencing catch-up growth could be most realistically operationalized if populations in which secular trends in growth were either completed or minimal were selected. Although an effect of hypoxia on child and adolescent growth, independent of nutrition, is small at most, many high-altitude populations have high prevalances of low birthweight and should be excluded on this basis. Since all populations are exposed to pollutants, contaminants, and toxicants in varying degrees, they cannot be realistically excluded from the sample frame. However, it may be desirable to exclude populations that are habitually exposed to extremely high levels of environmental pollution, including air pollution, and those living in close proximity to toxic waste. It is impossible to exclude populations and individuals on the basis of their exposure to aflatoxin contamination of food. However, exclusion on the basis of low socioeconomic status or poverty may well act as a proxy for this. There are a small number of populations that show extreme patterns of growth in body size and proportion in preadolescence and adolescence, and these should be excluded from the sample frame.

Village distance from urban centre as the prime modernization variable in differences in blood pressure and body mass index of adults of the Purari delta of the Gulf Province, Papua New Guinea.

OBJECTIVE: The study examined the extent to which the geographical proximity of villages to an urban centre and other modernization variables are associated with variation in blood pressure and body mass index (BMI) of adults of the Purari delta of the Gulf Province, Papua New Guinea (PNG). METHODS: Mean BMI, systolic blood pressure (SBP) and diastolic blood pressure (DBP) of 292 adults surveyed in 1995-1997 in the Purari delta, PNG, are reported by village of residence, and related to modernization variables, including village of residence, urban life, urban connectedness, economic status and education. RESULTS: Mean BMI, SBP and DBP differ according to village of residence, there being a gradient in mean blood pressure from highest in the village closest to the urban centre, Baimuru, and lowest in the village most distant from it. The gradients in these variables across the three villages are not due to differences in age structures between the villages. Place of residence, which represents the distance from town, has the greatest impact on the BMI of males, while among the females, the number of relatives living in urban centres had a significant effect on BMI. For both males and females, place of residence has the strongest effect on SBP. While for the males, place of residence is the only significant factor associated with SBP, for the females, SBP is also associated with BMI, level of income and to a lesser extent with age. Very similar results were obtained for DBP. CONCLUSIONS: Distance to urban centre appears to have a strong effect, relative to other modernization variables, on BMI and blood pressure, this effect being far stronger for males than for females. In large part, this effect operates by way of differences in number of sources of income as well as number of close relatives of women who are resident in an urban centre. Reasons for the male-female differences observed may include gender differences in degree of mobility, and possibly greater physical sensitivity of males to the environment than females. Traditionally, there have been clear divisions of labour between males and females, the latter spending longer in subsistence activities than the former. It is speculated that males have more free time to travel to town should they wish, while women may travel to town to take produce to market, and be limited by how much time they spend in town when they are there, by the need to return to carry out household and subsistence tasks. It may also be that young adult males are more susceptible to modernization, in that they exhibit a greater degree of non-conformity than young women, and may be more favourably disposed to adopt aspects of western lifestyle.