Understanding what makes people obese

Sir — Niamh Horan’s coverage (Sunday Independent, February 19) of “concerns about the move to normalise models who are overweight and obese” is symptomatic of a misguided and outdated view of obesity which sees the irresponsible and reckless behaviour of affected individuals as a burden on society, while at the same time congratulating the multinationals that are driving the obesogenic environment.

The notion that making it socially acceptable to be overweight will unleash a run on hamburger restaurants belies a misunderstanding of the complex neurobehavioral determinants of body weight.

Stigmatising excess body fat rather than the unhealthy dietary behaviours which cause obesity is like stigmatising lung cancer rather than smoking, or liver disease rather than excess alcohol consumption. It is missing the public health point.

Rather than complaining about the distasteful appearance of overweight children, we should tackle the environmental factors making them fat. Such an approach won’t be good for the coffers of our broadcast media, which rely on the sale of advertising space to fast-food restaurants, confectioners, brewers and wineries while at the same time trying to “transform” the health of the nation. Is it any wonder that a pejorative, regressive and inaccurate “personal responsibility” narrative is given so much prominence?

Though well meant, efforts to constrain the social acceptability of being overweight do nothing to enhance public health and instead shift the focus away from meaningful, if politically unpopular strategies, to encourage healthier lifestyle behaviours in us all.

Moreover, mixed messages about the extent to which obesity is a personal choice perpetuate a widespread misunderstanding of the obesity issue by policymakers, legislators and the general public as well as a complete lack of investment and strategy for treating patients affected by obesity.

Dr Francis Finucane, Consultant endocrinologist, Galway University Hospitals, and honorary senior lecturer in

medicine, NUI Galway