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23 April 2012

Ethical Objections Against Programs Aimed at Preventing Overweight And Obesity

Keywords: diet, health, intervention, Western Europe,

Intervention programs aimed at reducing overweight and obesity have a number of social and ethical objections which may mitigate their effectiveness, according to this study reported in Obesity Reviews. The objections relate to negative side-effects of the programs and issues concerning disregard of personal and cultural values.

Take aways

  • Intervention programs aimed at reducing overweight and obesity have a number of social and ethical objections related to:
    • negative side-effects for wellbeing
    • disregard of personal and cultural values 
  • To increase the effectiveness of overweight and obesity prevention programs, these potentially problematic ethical issues should be taken into account when creating new programs. 

Study information

  • The question?

    What kind of ethical issues occur in programs aimed at preventing overweight and/or obesity? 

  • Who?

    Not reported

  • Where?

    Broad range of countries (e.g., The Netherlands, Germany, UK, USA, Singapore) 

  • How?

    The researchers selected 60 overweight and obesity prevention programs (e.g., educational, financial, medical, legal) from the Internet, the media, and scientific literature. The interventions were all implemented after 1980 and focused on stimulating a healthy diet or increasing physical exercise. Potential ethical problems associated with these programs were identified by two of the researchers and then discussed in a group of experts (e.g., policymakers, physicians, and representatives from health insurance companies).

Facts and findings

  • There is no convincing evidence for the effectiveness of overweight prevention programs.
  • There are potential negative side-effects for wellbeing (e.g., increased risk of eating disorders, unwarranted concerns among people of normal weight, portrayal of overweight people as victims)
  • Inequalities between higher and lower educated people (more risk of being overweight and less access to prevention programs) were worsened.
  • Information offered in prevention programs was often unclear or incomplete, which made it difficult for people to make a well-considered choice.
  • Personal and cultural values were not taken into account and, therefore, people may have felt offended when they were pressured to change their eating behaviors. 
  • There were some privacy issues (e.g., people are pressured to provide personal information, such as BMI, life style, etc.). 
  • Some programs put the blame for the overweight problem fully on one single party (e.g., the individual, the school, the parents). People may perceive this as unfair.
  • The freedom to make personal choices was violated.
  • These potentially problematic ethical issues were, on the one hand, caused by conflicting interests, beliefs, and principles of people, and on the other hand, by a narrow focus of the creators of the intervention programs. 
  • Critical note: This study does not show how often these potentially problematic ethical issues occur in intervention programs.