Paper short abstract:

Despite progress in thinking of obesity as being caused by wider determinants, policy in the UK tends to ‘drift’ back to changing individual lifestyles. How can we truly move beyond responsibilising and stigmatising individuals, but rather foster public action and hold government to account?

Paper long abstract:

Historically, public health approaches to reduce obesity have been in the form of media campaigns and educational interventions on diet and physical activity. In 2007, the landmark Foresight Report was published in the UK, which presented the Obesity System Map describing the factors evidenced to cause obesity and their interrelationships. The model advanced thinking about obesity simply as an energy imbalance, by not only brining to the fore the complexities of obesity but served as useful starting point for developing approaches from a whole systems perspective. Specifically, it identified factors across society, from the more individual biological and psychological factors to the distal social and infrastructural influences, with emphasis placed on the wider determinants of health and inequalities. Despite this progress, the tendency in the UK is to 'drift' back to changing lifestyles, by continuing to approach obesity with downstream, micro-level behaviour change initiatives. For example, the most recent UK government installed as one of its major efforts to address obesity the Behavioural Insights Unit, which was originally a cabinet unit but now functions as a private enterprise that advises other governments and their agencies. This paper reviews such approaches from 2007 onward in the UK, interrogates the rationales provided and attempts to understand how the seeming tension between neoliberal and social justice approaches roadblocks progress. Finally this paper asks, how can we truly move beyond responsibilising and stigmatising individuals, but rather foster public action and hold government to account.