Shifting the Obesity Discussion

Last November a report from the McKinsey Global Institute estimated the global economic impact of obesity to be $2 trillion, which is on par with the impacts of smoking and armed conflicts (1). This report emphasizes that a problem of this scale requires a systemic response, noting that the piecemeal responses to date, which have focused on education and personal responsibility are inadequate. It recommends adding interventions that target the environment and social norms such as reducing portion sizes, changing marketing practices, and changing urban and education environments to facilitate physical activity. Another report by The Conference Board of Canada from October of last year projected the potential economic and population health benefits if a small number of inactive and sedentary Canadians modestly improved their activity levels and reduced their sedentary activity between 2015 and 2040 (2). These benefits include $7.5 billion in gains to the Canadian economy, $2.6 billion saved by the health care system and the prevention hundreds of thousands of cases of diabetes, hypertension, heart disease, and cancer.

These reports are intended to spark policy discussion more than individual action. People aren’t motivated to change their behaviour by learning how much wide scale behaviour change can do for the economy or how many cases of disease it can prevent at the population level. And even when people are motivated to change their behaviour, this motivation is often difficult to translate into long-term change when social norms and their environments are working against them. So what will it take to make the necessary changes? It’s a good start to admit that what’s being done now isn’t working, and never will. Beyond that, nobody knows the best way to go about addressing obesity.

At this point, with obesity now a major driver of global costs and overweight and obesity rates showing no signs of slowing, the problem has already reached crisis proportions. Coupled with the depressing reality that long-term weight loss is achieved only by the smallest minority of people (3), and the powerful forces that oppose potentially wide-reaching interventions (4), it can seem like a losing battle. So far it has been, but it doesn’t have to be.

An unacceptable reason for inaction, the authors of the McKinsey Global Institute report point out, is that insufficient evidence is available. They point out that we have enough evidence to take more action than we currently are, and recommend experimenting with solutions. In many cases, they say, these interventions are low risk and almost all of the interventions they analyzed are cost-effective. We don’t have much to lose by implementing them before perfect proof of their effectiveness is available. Even if long-term weight loss is rare, physical activity, eating a healthy diet, and sitting less still have important health benefits for everyone. Interventions that make these behaviours easier or reduce the number of unhealthy temptations people are exposed to could go a long way towards preventing people from becoming overweight, and improving the health of overweight/obese people even if it doesn’t mean losing weight per se. Addressing obesity won’t be easy and can’t be done by a single sector, but it isn’t impossible.



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