In any Public Health programme that entails a change in life style it is important that the population at risk should need to recognise that their life style is contributing to real or potential ill health. This applies to alcohol, social behaviour , excessive sized families , smoking and drugs.
Alternatively there is the prospect of a charge of the Nanny State where Big Brother overlooks the population and dictates their way of life.
However if people who have lived in a particular way then throw themselves on the general population and expect help for their past life then the genera population has a .
This is difficult. Some people have been forced or connived into a life threatening and health damaging life, coal miners, fishermen , armed forces who have worked for society in general and require support when the load is too much
However those who have lead a life devoted to alcohol, social behaviour , excessive sized families , smoking and drugs who may not justify the same support.
It is wrong to discriminate against any sufferer so there is a dilemma. Furthermore our concern about treating fat people with knee replacement is misplaced, the operation yields the same long term benefits as normal weight individuals. ( News 2008 Obesity does not limit benefits of knee replacement BMJ vol 337 p 2552 )
A interesting paper in the BMJ of 2nd August 2008 shows that in general perceived and reported weight do not accord and has deteriorated in he last 12 years
Most people believe that obesity is related more to personal behaviour than to broader society.
Perhaps nutritionists have inadvertently contributed to the current attitudes by emphasising hormones and genetics rather than self indulgence.
The problem may well be one of Public Health programmes
Editorial 2009 Public perception of overweight, underestimation has important implications for public health programmes BMJ vol 337, pp 243-4
Johnson et al 2008 Changing perceptions of weight in Great Britain : comparison of two population surveys BMJ vol 337 pp 270-272
- Martin Eastwood