Challenges of healthy citizenship in an obesogenic environment
Creators: name: Davies, Anna
Publisher: name: The Australian National University
Year: 2018
Subjects: subject: RA395.A8 D38 2011
subject: Obesity HistoryAustralia
subject: Obesity PreventionAustralia
subject: Lifestyles Health aspectsAustralia
subject: Well-being Australia
subject: Public health Australia

description: Over the last 40 years Australia has experienced a growing prevalence of obesity. This trend carries with it an expectation that associated burdens of disease and health care costs will be incurred. Thus far, the dominant response to the growth in obesity has been to focus on individuals' personal responsibility to resist weight gain. This approach assumes that all individuals have the capacity to incorporate knowledge about health into their lives and make appropriate behavioural changes. An alternative explanation is the obesogenic environment theory, which positions individual choices within the constraints of their physical, social, cultural and political environment. It has been adopted by many public health experts but has had limited influence on personal and policy responses to obesity. This thesis assesses whether the healthy citizenship approach to obesity can be effective in an obesogenic environment by exploring life narrative interviews with 60 related Australians from three generations. Firstly, it examines the emergence over the 20th century of diet and exercise as key 'technologies of the self' for shaping a healthy self and healthy weight in order to conform to norms of healthy citizenship. Secondly, it demonstrates how at the same time major social changes have dramatically reshaped diet and physical activity patterns in Australia. The narratives of the three generations are contextualised within Australian social history literature concerning three time periods - the Great Depression and World War Two (WWII), post-WWII decades, and the turn of the 21st century. This thesis illustrates how by the 1990s Australians were feeling the effects of an obesogenic environment in which food was readily available, life had become increasingly sedentary and maintaining an energy balance required effort. This sharply contrasted to life in the earlier to mid-20th century. Although I show that individuals subscribe to the norms of healthy citizenship, the obesogenic environment presents obstacles to successful conformity. All participants strived to conform and felt that they were doing the best they could within the context of their lives, but generally felt there was more they could do. Having a level of control to negotiate healthy choices was essential for resisting the obesogenic environment. However, not all participants had the cultural, economic or social resources to make these 'choices'. Additionally, the focus on weight as signifying conformity to healthy citizenship is problematic as practices undertaken to create a socially desirable body did not always align with those required to be healthy, and in some cases may even be detrimental to health. This thesis illustrates how the current healthy citizenship approach to preventing and managing obesity is limited by the constraints of the obesogenic environment and by the level of control individuals have over shaping their health. Although individuals are ultimately responsible for their own diet and physical activity, citizens must be enabled to make healthy choices. Hence, in order to shape a successful response to rising obesity rates governments, industry, communities and individuals need to work together to create an environment that fosters healthy, rather than unhealthy, choices.