Download Case study: obesity Lord Krebs Kt FRS FMedSci

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