A pair of thought-provoking articles published yesterday in the British Medical Journal consider the question, "Should health policy focus on physical inactivity rather than obesity?"
As a staunch believer in personal fitness, my immediate response upon seeing the headline was yes. But, after reading the articles, I began to question my convictions.
Because physical activity is associated with improved risk factors for disease even if no weight is lost, a focus on weight loss is largely misleading. In addition, drugs and bariatric surgery, which are becoming common options to deal with obesity, have serious risks. The broader long term benefits of these treatments are currently limited or non-existent, and they certainly do not have the multiple collateral health benefits of physical activity.
But a compelling argument is also made made by University of Sydney associate professor Timothy Gill and colleagues suggests it might not be that simple - that numerous other factors contribute to the obesity problem besides people being lazy:
A focus on reducing obesity through a broad range of actions is likely to be more effective in preventing chronic disease and produce larger population health gains than an approach that solely focuses on inactivity. To achieve these outcomes a broad portfolio of strategies is required. Such initiatives must include efforts to improve physical activity in addition to diet and other behavioural issues, but also require greater attention to the pervasive structural, economic, and social factors that influence our ability to change behaviours favourably. Programmes should include improved urban planning (for example, cycle lanes, more accessible and affordable public transport, increased access to green space), decreased dependence on motor vehicles, and changes in local food production, national food distribution cost structures, and food pricing strategies.
What do you think, Scope readers? What's the best way to tackle the obesity crisis?
Photo by colros