Public and experts differ on cause of the obesity epidemic

Members of the public believe that individual decisions about diet and exercise have caused the obesity epidemic, while experts instead highlight environmental causes – how the modern world makes it hard to eat healthily and get enough exercise.

The study, carried out by the ESRI’s Behavioural Research Unit, compared perceptions of 2,400 adults across Ireland, the UK and the US with those of 51 experts working in obesity healthcare, research and policy. It reveals a substantial gap, not only about what has caused the obesity epidemic, but also who is responsible for addressing it and what policies may be most effective.

While most members of the public did recognise at least one environmental cause, such as greater availability of unhealthy food, they rated individual choices as just as important or more so. By contrast, experts pointed the finger at changes to food production and availability, marketing, portion sizes and car-dependent neighbourhoods. The public in Ireland were the least likely of the three countries to identify such environmental causes.

Both the public and experts perceive obesity to be a serious public health issue. The public have good knowledge of obesity rates and the consequences of it. However, the public believe individuals are much more responsible for the obesity epidemic than businesses or governments. Experts instead attribute significantly more responsibility to governments and businesses, aligning with scientific evidence that the epidemic is largely driven by environmental causes.

The public tend to support policies they think would be fair and effective, including information campaigns and subsidies for healthier foods. By contrast, experts view more interventionist policies, such as taxes and regulations on the fat, salt and sugar content of certain foods as both fairer and more likely to be effective. Those members of the public who do recognise responsibility of businesses and governments also have views on policies that are closer to expert views.

“These findings show that while people believe obesity is a serious public health issue, many are not aware of the strength of environmental influences,” said Dr Deirdre Robertson, lead author of the report. “The individual choice narrative contributes to stigma and can undermine public health efforts to reduce rates of obesity.”

Prof Mary Horgan, Chief Medical Officer, Department of Health said: “This research shows the need for a shift in the public dialogue around obesity – this disease is not a personal failing. Obesity is a complex, multi-faceted problem and needs a multi-pronged solution, with every sector of society playing its part. The Department of Health is currently working on the next Obesity Policy Action Plan which will seek to transform the food environment, look for ways to modify the built environment to encourage physical activity as the default position, and to address the social and commercial determinants of obesity.”