Obesity Policy in the EU evaluating the options Introduction and background

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Obesity Policy in the EU - evaluating the options
Introduction and background
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The PorGrow project was conceived in Spring 2003.

In 1996 Murray the WHO said that obesity was
the major unacknowledged public health problem in
the world. In 1996 the food and health policy
community was preoccupied with BSE.
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In September 2000 WHO-Europe warned of a rapid
rise in the incidence of obesity in Europe, and a
decline in the age of onset.All MSs then
endorsed the 1st WHO-E Action Plan for Food and
Nutrition Policy, since when the incidence of
obesity has risen sharply. .the plan was
insufficient.
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That plan emphasised informational and
educational initiatives plus networking provided
by the WHO to support national nutrition
policies, plus more monitoring.A reliance on
information and education alone is evidently
insufficient.
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Science tells us that obesity is a consequence of
an excess of food calories in proportion to
energy expenditure, but it provides very few
indications as to which steps public authorities
can and should take to address the challenge of
obesity in Europe. That is the task addressed by
PorGrow.
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I apologise for the acronym. The full title is
Policy options for responding to the growing
challenge from obesity a cross-national
comparative study.Forecasting which policy
options will be effective, depends on an
understanding of which options are considered
acceptable by stakeholder groups, and their
reasons.
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The gap in our knowledge concerns which public
policy interventions are deemed acceptable and
are more positively evaluated by a majority of
stakeholders whose cooperation will be required
for their implementation and consequent
effectiveness?
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The PorGrow project therefore adopted a
Multi-Criteria Mapping methodology, because it
has enabled us to capture both qualitative and
quantitative aspects of those evaluations,
criteria and reasons.
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The aim of the PorGrow project therefore was to
gather and analyse social intelligence about how
key stakeholder groups interpreted and evaluated
a broad range of possible policy options that
were being, or that might be, under active
consideration.
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The project is not about developing or refining
ways of treating people who have become obese.
Therapeutics for obese individuals is important,
but it is not our task.
The objective of PorGrow has been to identify the
public policy initiatives that can transform
socio-economic environments to make them less
obesogenic for our population.
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One of the primary units of analysis in this
project therefore are public policy options.
The portfolio of policy-options on which the
project concentrated were those that are
available effectively be used by governments and
collective European institutions such as the
Council, the Commission, Parliament and
WHO-Europe.
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Rayner Lang have referred to a policy
cacophony surrounding the issue of
obesity.PorGrow aims to provide clarityto
the obesity policy debate in Europe.Our
findings are directly relevant e.g. to the WHO-E
ministerial conference on Counter-acting Obesity
Nov. 2006.
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The initial proposal included 6 countries,
intended to include those where obesity was
rising most rapidly, but also to be
geographically and culturally diverse. They
were UK, Finland, France, Spain, Italy and
Greece. The Commission stipulated a reduced
budget and more countries.
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Therefore teams from Cyprus, Hungary and Poland
were invited to join. The 9 participating
countries were representative of much of the
geographic, economic, social, culinary and
cultural diversity of Europe.
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9 Partner countries
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After a lengthy debate, we selected7 core
policy options and 13 discretionary options.
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• All were asked to evaluate 7 core options
• Change planning and transport policies
• Improve communal sports facilities
• Set controls on food and drink advertising
• Control sales of foods in public institutions
• Mandatory nutritional information labelling
• Subsidize healthy foods
• Tax obesity-promoting foods

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• They could also to evaluate 13 discretionary
  options
• Improve training for health professionals
• Reform Common Agricultural Policy
• Improve health education
• Introduce controls on food composition
• Set incentives to improve food composition
• More obesity research
• Require healthier catering menus

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• Include food and health in school curriculum
• Increased use of medication to control body
  weight
• Increased use of synthetic fats and artificial
  sweeteners
• Create new governmental body to co-ordinate
  policies relevant to obesity
• Control of marketing terms such as diet,
  light, lite
• Increase use of physical activity monitoring
  devices

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• Those options were clustered in 6 groups
• A. Exercise and physical activity-oriented
• B. Modifying the supply of and demand for
  foodstuffs
• C. Informational initiatives
• D. Educational and research initiatives
• E. Technological innovations
• F. Institutional reforms

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• The stakeholder groups are representatives of
• Farming industry
• Food processing companies
• Large commercial catering chains
• Large food retailers
• Small health food retailers
• Public sector caterers (eg school meal providers)
• Consumer groups
• Senior government policy makers in health
  ministry
• Senior government policy makers in finance
  ministry
• Public health professionals

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• As well as
• Town and transport planners
• Life insurance industry
• Commercial sport or fitness providers
• School teachers
• Members of expert nutrition/obesity advisory
  committees
• Health journalists
• Advertising industry
• Pharmaceutical industry
• Public health non-governmental organisations
• Public interest sport and fitness NGOs
• Trades unions

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We will therefore outline our findings, and their
implications, for each of the 9 participating
countries, and for the EU as a whole, in terms of
the appraisals of those 20 options, and the
perspectives of the groups of stakeholders.
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Many protagonists and commentators assumed that
if the incidence of obesity doubled over the past
10 years, it will take more than 10 years to half
it. That seemed like a counsel of despair, and
has not underpinned the PorGrow project.
Instead, we kept open minds, on that and many
policy issues.