Why Governments Dither on Addressing Obesity

It is no secret that the current obesity epidemic is poised to break the back of the Canadian public healthcare system.

Yet, with all the talk, few policies have been enacted at central or provincial levels to address this crisis – Canada lacks a National Obesity Strategy and there is no indication that we can expect one in the foreseeable future.

In an insightful article published in the latest issue of CMAJ, Nola Ries and Barbara von Tigerstrom, both affiliated with with the University of Alberta Health Law Institute (amongst other institutions), examine why Canadian governments appear reticent in passing appropriate legislature to promote healthy eating and physical activity.

Their analyses point to three possible factors for this lack of action: concern about legislative authority, ideological opposition to government regulation, and questions about the impact of legislation.

The paper summarizes some of the sparce and decidedly half-hearted attempts at policy level interventions to promote healthy eating and physical activity across Canada.

The authors conclude that the current epidemic of chronic disease (including obesity) are largely due to the fact that modern environments promote overeating and sedentary behaviour.

Ries and von Tigerstrom have little doubt that legal measures can be policy tools to promote healthier eating and more physical activity.

As they point out:

Taxation and spending powers can be used by both levels of government: they could offer tax credits for physical activity but tax food and beverages that are high in calories and low in nutritional value. Advertising can be restricted through federal authority over broadcast media and provincial authority over business regulation and consumer protection. With constitutional authority over education, the provinces can use school legislation to impose mandatory requirements for nutrition and physical activity. Provincial public health statutes also confer power to protect and promote health; notably, Under its criminal law jurisdiction, the federal government can prohibit or regulate health hazards and impose labelling requirements or advertising restrictions that discourage the consumption of hazardous products.

According to the authors, it appears that in Canada, jurisdictional wrangling, the threat of legal challenges, ideological opposition, and questions about effectiveness are stalling the adoption of new legislation.

What can only be described as dithering on the issue of obesity prevention unfortunately also applies to the access of treatments for those struggling with excess weight.

Currently obesity management continues to be largely left to the vast poorly regulated commercial weight loss industry, which has little to show for in terms of proven long-term benefits.

Clearly, the time to begin implementing policies to promote healthy eating and activity and to provide better access to treatments for obesity is now.

Edmonton, Alberta

Ries NM, & von Tigerstrom B (2010). Roadblocks to laws for healthy eating and activity. CMAJ : Canadian Medical Association journal = journal de l’Association medicale canadienne, 182 (7), 687-92 PMID: 20159896