‘FAT’ OR FICTION: EXAMINING THE ROLE POLITICAL AND ECONOMIC FORCES PLAY IN DRIVING THE CONCERN OVER OBESITY

1 Acknowledgement . 2 Introduction . 3 Main Purpose . 4 Added Value of this Paper . 6 Conceptual Frameworks . 8 Evidence on the Health Effects of Obesity . 12 Obesity within Canada . 17 The School Food and Beverage Policy . 18 Food Production and Obesity . 21 Mind the Gap: The Disconnect Between Research and Practice . 21 Methodology . 22 Social Determinants of Health Approach . 23 Political Economy Approach . 24 The Various Ways in which Obesity is Framed . 26 Method . 29 Study Inclusion Criteria . 29 Search Plan . 30 Findings and Analysis . 31 Clear and Present Danger or All Hype? Critical Analysis of the Literature on Obesity . 31 Review of the Critiques Regarding the Discourse on Obesity . 36 Sizing Up the Competition: Emerging Themes in the Fight Against Obesity. 38 Running head: ‘FAT’ OR FICTION: EXAMINING THE ROLE Corporate-Level Interventions . 39 School-Level Interventions. 41 Government-Level Interventions . 42 Fat Chance: Significant Gaps in Existing Knowledge . 44 Plan of Attack: Use of Clinical Practice Guidelines in Healthcare . 46 Table 1: Steps in devising and implementing CPGs . 47 Table 2: Noneducational variables affecting adoption of CPGs . 48 Table 3: Attributes of guidelines that affect adoption . 48 Clinical Practice Guidelines Across Selected Liberal Welfare States . 52 Australia . 52 Canada . 53 United States of America. 54 Weighing Our Options: The Shortcomings of the Selected Clinical Practice Guidelines . 55 Discussion . 58 Trimming the Fat: Alternative Approaches to Address Obesity . 58 Implications . 60 Supersized Obsession: Impact of the Hyper-Concern with Obesity. 60 Food for Thought: Implications of Reviewed Literature . 61 A Recipe for Success: Recommendations for the Future . 62 Conclusion . 63 References . 65 Appendices . 73 Appendix A . 73 Appendix B . 74 Running head: ‘FAT’ OR FICTION: EXAMINING THE ROLE Appendix C . 75 Appendix D . 81 Appendix E . 82 Appendix F . 83 Appendix G . 84 Appendix H . 85 Appendix I . 86 Running head: ‘FAT’ OR FICTION: EXAMINING THE ROLE 1 Abstract This paper attempts to examine the present focus on obesity by government officials, the private sector, and the general public. More specifically, this paper argues that there is a hyper-concern with obesity that stems more from well-established power dynamics and societal structures than a result of medical concern over public health. The role of political and economic forces is argued as being the reason for this hyper-concern. A critical analysis of the literature is presented to identify the underlying relevant factors that drive this hyper-concern with obesity. Finally, this paper considers the implications this hyper-concern with obesity can potentially have on the distribution of wealth, power, and influence within the public and private sector. This paper will also attempt to critically assess the clinical practice guidelines created to address obesity by the Registered Nurses' Association of Ontario, the Canadian Medical Association, the American Medical Association, and the Australian government. The argument that these clinical practice guidelines lack the breadth and depth to adequately and effectively address obesity will be put forth and highlighted in the context of six specific concerns.This paper attempts to examine the present focus on obesity by government officials, the private sector, and the general public. More specifically, this paper argues that there is a hyper-concern with obesity that stems more from well-established power dynamics and societal structures than a result of medical concern over public health. The role of political and economic forces is argued as being the reason for this hyper-concern. A critical analysis of the literature is presented to identify the underlying relevant factors that drive this hyper-concern with obesity. Finally, this paper considers the implications this hyper-concern with obesity can potentially have on the distribution of wealth, power, and influence within the public and private sector. This paper will also attempt to critically assess the clinical practice guidelines created to address obesity by the Registered Nurses' Association of Ontario, the Canadian Medical Association, the American Medical Association, and the Australian government. The argument that these clinical practice guidelines lack the breadth and depth to adequately and effectively address obesity will be put forth and highlighted in the context of six specific concerns.