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A critical analysis of obesity prevention policies and strategies

  • Qualitative Research
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OBJECTIVES: Public health policies have been criticized for promoting a simplistic narrative that may contribute to weight bias. Weight bias can impact population health by increasing morbidity and mortality. The objectives of this study were to: 1 ) critically analyze Canadian obesity prevention policies and strategies to identify underlying dominant narratives; 2) deconstruct dominant narratives and consider the unintended consequences for people with obesity; and 3) make recommendations to change dominant obesity narratives that may be contributing to weight bias.

METHODS: We applied Bacchi’s “what’s-the-problem-represented-to-be?” (WPR) approach to 15 obesity prevention policies and strategies (1 national, 2 territorial and 12 provincial). Bacchi’s WPR approach is composed of six analytical questions designed to identify conceptual assumptions as well as possible effects of policies.

RESULTS: We identified five prevailing narratives that may have implications for public health approaches and unintended consequences for people with obesity: 1 ) childhood obesity threatens the health of future generations and must be prevented; 2) obesity can be prevented through healthy eating and physical activity; 3) obesity is an individual behaviour problem; 4) achieving a healthy body weight should be a population health target; and 5) obesity is a risk factor for other chronic diseases, not a disease in itself.

CONCLUSION: The consistent way in which obesity is constructed in Canadian policies and strategies may be contributing to weight bias in our society. We provide some recommendations for changing these narratives to prevent further weight bias and obesity stigma.


OBJECTIFS: Les politiques de santé publique font l’objet de critiques lorsqu’elles encouragent un discours simpliste qui peut contribuer aux préjugés liés au poids. Ces préjugés peuvent influer sur la santé des populations en augmentant la morbidité et la mortalité. Les objectifs de notre étude étaient: 1) de faire une analyse critique des politiques et des stratégies canadiennes de prévention de l’obésité pour en extraire les discours dominants; 2) de déconstruire les discours dominants et d’en étudier les effets pervers pour les personnes obèses; et 3) de formuler des recommandations pour changer les discours dominants sur l’obésité qui peuvent contribuer aux préjugés liés au poids.

MÉTHODE: Nous avons appliqué le cadre d’analyse WPR (pour «What’s the problem represented to be?») de Bacchi à 15 politiques et stratégies de prévention de l’obésité (1 nationale, 2 territoriales et 12 provinciales). Ce cadre pose six questions analytiques pour mettre au jour les hypothèses conceptuelles et les effets possibles des politiques.

RÉSULTATS: Nous avons mis au jour cinq discours dominants qui pourraient déjà avoir des conséquences sur les démarches de santé publique et des effets pervers pour les personnes obèses: 1) l’obésité juvénile menace la santé des générations à venir et doit être évitée; 2) l’obésité peut être évitée par la saine alimentation et l’activité physique; 3) l’obésité est un problème de comportement individuel; 4) l’atteinte d’un poids santé devrait être une cible de santé des populations; et 5) l’obésité est un facteur de risque pour d’autres maladies chroniques et non une maladie en soi.

CONCLUSION: La constance avec laquelle l’obésité est envisagée dans les politiques et les stratégies canadiennes pourrait contribuer aux préjugés liés au poids dans la société. Nous présentons des recommandations pour changer ces discours afin de prévenir l’intensification des préjugés liés au poids et de la stigmatisation de l’obésité.

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Correspondence to Ximena Ramos Salas MSc.

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Acknowledgements: The authors thank Dr. Rebecca Puhl, Deputy Director at the Rudd Center for Food Policy & Obesity and Professor in the Department of Human & Family Studies at the University of Connecticut; Mr. Brad Hussey, Director of Communication and External Relations at the Canadian Obesity Network-Réseau canadien en obésité (CON-RCO); and Mary-Pat Lambert, Policy Analyst, Population Health Promotion and Innovation Division, Public Health Agency of Canada for review and feedback on this paper.

Source of Funding: The corresponding author was supported by a Canadian Institutes of Health Research (CIHR) Fellowship for Population Intervention for Chronic Disease Prevention administered by the CIHR Training Grant in Population Intervention for Chronic Disease Prevention: A Pan-Canadian Program (PICDP) at the Propel Center for Population Health Impact at the University of Waterloo.

Conflict of Interest: A. Sharma declares that he receives consultancy fees from Novo Nordisk (Canada and Global Advisory Board for anti-obesity medication). He also declares receiving payment for development of educational presentations, including service on speakers’ bureau. He has had travel/accommodations expenses covered or reimbursed in conjunction with consulting and speaker bureau activities as outlined above.

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Salas, X.R., Forhan, M., Caulfield, T. et al. A critical analysis of obesity prevention policies and strategies. Can J Public Health 108, e598–e608 (2017).

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