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• W2020890908 abstract "Our current thinking on obesity mainly focuses on direct causes (i.e. genetic and behavioural determinants of caloric intake and energy expenditure). Accordingly, genetic or metabolic predisposition and unhealthy lifestyle are seen as a suitable basis of preventive and treatment strategies. However the present evidence suggests that these measures are not effective to tackle the obesity pandemic. To address populationwide obesity, we have to take into account other facets of obesity including food production and supply, income inequality, employment and quality of work, education, culture, globalization, urbanization, transition and westernization as well as economy [1]. Clearly, these determinants exceed medical thinking, and we have to enter a greater dimension of the obesity issue. This is a huge challenge for a scientific community dominated by the progress in biomedical research. We all like to believe that medicine has or is to discover effective measures to tackle obesity. However scientists have to be straightforward and open-minded. Imagine that, e.g. in Germany, we now have about 14 million obese people. There are considerable health inequalities, so are inequalities in overweight [2]. There is a clear link between social condition and obesity: the less favoured people are the higher their body weight. These health gradients exist in part independently of behavioural patterns suggesting further determinants including stress [2]. Faced with the high prevalence and the impact of socioeconomic conditions, obesity cannot be sufficiently addressed by medical thinking or any strategy of personalized medicine. Obesity is about population health, it is a public health issue. What does this mean? As the great Geoffrey Rose had already mentioned in 1992, ‘The radical strategy is to identify and if possible to remedy the underlying causes of our major health problems’ [3]. The essential determinants of health are mainly economic and social. Obviously, we need a broader view, new concepts, and new strategies to tackle obesity. Since obesity is not owned intellectually by one academic ‘constituency’, economists, ecologists, politicians, and other health scientists are welcome to enter the discussion on obesity. This is because effective strategies to stop and to reverse the obesity epidemic have to go beyond the individual and ‘require changes which involve the population as a whole’ [3]. Garry Egger’s and Boyd Swinburn’s new book entitled ‘Planet Obesity – How We Are Eating Ourselves and the Planet to Death’ is on the greater dimensions of obesity [4]. The title is provocative, and the book is an eye opener for those who are not familiar with the previous work of the authors as well as related issues. As the authors mentioned, ‘Obesity is a collateral damage in the battle for modernity, it’s an unintended, but unavoidable consequence of too much economic growth and simply a natural and inevitable biological response to living in a consumer-oriented democracy’. This is not really new [e.g. 5–7], but bringing together economic wellbeing, prosperity, human health (including population fatness and chronic disease), climate change, severe weather events, pollution and greenhouse gas emissions shifts our thoughts from the biological causes and health consequences of obesity to the cause of the causes of individual as well as environmental health damages. Following the author’s view, obesity is the negative side of success and prosperity in our modern Western world. More consumption of food contributes to economic growth but also to overweight. To avoid the negative consequences does not mean fighting against economic growth, capitalism and its benefits. There is a positive relationship between growth and health up to a certain point, but excess consumption has negative effects. However, the present problem is about too much capitalism and its devastating effects on health and environment. Conceptually, obesity is not only due to positive energy balance but also reflects a loss in the balance between benefits and disadvantages of economic growth. From a population point of view disadvantages now exceed benefits, questioning the value of unfettered economic growth. How could these ideas be converted into prevention of overweight? Going back the line of economic growth seems" @default.
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• W2020890908 date "2010-01-01" @default.
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• W2020890908 title "The Greater Dimensions of Obesity" @default.
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• W2020890908 doi "https://doi.org/10.1159/000323262" @default.
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