Obesity and empowered choices

The obesity epidemic is complex and there are no easy solutions. Regulating the fast food industry could be a step in the right direction, writes the University of Auckland's Dr Milind Mandlik. 

One of the biggest concerns for human health in the 21st century is ever-increasing obesity and its associated mortality rate. Termed a 21st-century epidemic, obesity has some serious financial consequences for most nations and huge implications for national healthcare expenditures.

To put it in perspective, for the first time in the history of civilisation, the mortality rates of preventable diseases like diabetes, hypertension and stroke will outstrip those of infectious diseases which have plagued the world for hundreds of years.

In New Zealand, nearly 30 percent of our population is classified as obese, which ranks us third in the world out of the OECD countries. Despite years of research and investment in health-promoting programmes, we have failed to slow down the evergrowing epidemic. Current intervention strategies are seemingly not having the desired impact and are in desperate need of remodeling.

Meanwhile, in this free-market economy of ours there is stiff competition drawing consumers to cheap foods – high in fat, sugar, additives and at times low in, or devoid of, any nutrition. For example, imagine walking through a busy shopping arcade looking for lunch and finding a shop sign  calling you in for a fried chicken and drink combo for just under $2. Closer inspection reveals the deal is actually for fried chicken carcasses and an unbranded soda. This isn’t lunch in an impoverished nation – this is Auckland.

Still in Auckland, in one of the city’s public hospitals run by highly qualified healthcare practitioners, many of whom are treating obesity and its fallouts, the  cafeteria offers unhealthy meal choices and high-density foods – cakes, muffins, pastries. This surely is a paradoxical situation which requires reflection by those managing these institutions.

Now marketing practitioners would say of these examples ‘we sell what the market wants’, right? After all, choice is good, liberating, perhaps even empowering. Or maybe it’s a fallacy that has contributed to the very epidemic of obesity.

People who are obese frequently attempt to lose weight but often fail.  As a result, these individuals end up feeling disempowered and resigned to failure in their quest for a better quality of life.  So while calls for Government interventions on the sale of items like sugary drinks are important, there are many other factors that must be considered in obesity prevention.

The truth is we are more than consumers – we are people leading busy lives and living with personal struggles. Research shows these struggles connect to how we choose, buy, prepare and consume foods, often in an unhealthful way, leading to weight-gain and enduring levels of obesity over time. But despite expert consensus that obesity is a multi-faceted, complex issue, it is still viewed by many as an individual failing – people are judged lazy, undisciplined, even stupid.

So, what are some of the factors that impact on individuals’ ability to lose weight? One factor is our ease of access to food which is frequently highly processed, energy-rich, loaded with high levels of salt, sugar, and additives. Couple this with the notion of free will, an idea routinely advocated by the food industry. Free will promotes individual freedom to consume, without inhibitions, whatever is desired (in terms of food type and quantity) and places responsibility for choice directly on the consumer.

But western society concern with ‘individual choice’  is a false premise: our research shows multiple fast-food outlets are not a genuine choice. Food marketers have created desires and steered our choices towards their products. They market food as entertainment, opulence and indulgence with the result that almost all of our research participants talked about the pervasiveness of institutionally-driven food marketing campaigns.

Any attempts by governments to regulate the food industry are slammed as ‘nanny state’ actions reducing our choice and disempowering us. But this free-will ideology of food-related consumption choices has led us to where we are today.

Another factor impeding weight-loss is socio-cultural norms. Food, and patterns of consumption, are culturally as well as socially connected. Food plays a major role in social aspects of our lives beyond our need to satisfy hunger. It enhances social cohesion and our sense of belonging within the wider community.

How often have you found yourself in a group situation where unhealthy food is on offer? Cake and sausage rolls at work, a feast following a sports event or religious gathering, a celebration for a birthday?

This consumption acts as social “glue” that brings us together in social and structural bonds.

Consuming unhealthy foods at social events has become a socially accepted phenomenon and includes cultural expectations that you will eat even if you are not hungry. It’s a way of saying, “this is how we do things here”.

Socio-economic pressures also have an impact on our patterns of food consumption. The cost of food is a key driver of what people buy for themselves and their families. Lack of money may lead to unhealthy choices and habits of eating what is on the plate, eating when you can and not wasting food.

When you take all these factors into account, it’s easy to understand maintaining a healthy lifestyle and an appropriate level of food consumption is challenging for many individuals. But we are all in this together: With our population of 4.7 million, we cannot afford to have a third of people not living life to the fullest.

This preventable epidemic can only be stopped in its track when the whole of society understands the processes that impact our patterns of food consumption. We need a collective endeavor where individuals, communities, institutions of all kinds and policymakers genuinely work together to make meaningful improvements to our stance on obesity. There is a way out – we just have to want it.

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