Case study: obesity

1
Case study obesity

• Lord Krebs Kt FRS FMedSci
• Chair of the Working Party on Public health
  ethical issues
• Principal, Jesus College, University of Oxford

2
Background

• Obese BMI 30
• Risk factor for range of chronic diseases
• 30,000 deaths a year in England are attributable
  to obesity
• 23 of men and women were obese in 2004 trebled
  since 1980s
• Childhood obesity increased from 10 in 1995 to
  14 in 2003

3
Causes of obesity

• Highly complex causes
• Food high in fat and sugar is cheaper and more
  available
• Eating out more
• Food is lower in protein
• Bigger portions
• Advertising
• Changes to transport patterns
• More lifts, escalators
• Reduction in manual jobs
• Labour-saving devices
• Need ethical framework to determine intervention

4
Protecting children

• Obesity in children is a particular concern
• Schools are part of the bigger picture
• Conclusions
• Schools should encourage a more positive culture
  towards food, cooking and physical activity
• Weighing young children is crucial but reduce
  risk of stigmatisation
• Develop criteria for intervening in the home

5
Role of industry

• Consumer choices are influenced by availability
  and marketing
• The food industry has an ethical duty to help
  individuals to make healthier choices
• Conclusions
• Food industry should adopt the most effective
  labelling scheme, and if it does not, there is
  justification for legislation

6
Role of Government

• Energy expenditure levels have decreased
• Measures to increase expenditure
• segregating walking and cycling routes from heavy
  traffic
• car-free zones in city centre
• maintaining playgrounds

• Conclusion
• town planners and architects should be trained to
  encourage people to be active through design of
  buildings and spaces

7
Costs to the NHS

• Obesity costs the state billions each year
  should obese people be denied NHS treatment?
• Obesity has complex causes
• Unfair victim blaming and risk of
  stigmatisation
• Conclusion
• Not appropriate for obese people to be denied
  treatment
• Appeals to change behaviour could be justified if
  help offered