A matter of weight? Anti-obesity strategies in Spain

Abstract

This chapter discusses some of the results of a broader study 1 based on the analysis of anti-obesity policies developed by Spanish health authorities at the national, state, and local levels. Here, we present a critical analysis of the NAOS Strategy (2005), the broad policy framework that has guided all the anti-obesity actions implemented in Spain up to date. In particular, it is argued that focusing on the responsibility individuals and their food and exercise behaviours bear for ill health – as the NAOS Strategy does – is inadequate to grasp the contextual complexity and structural factors that are involved in weight gain. An example of this complexity has been evidenced by the recent economic crisis and its effects on the daily lives of the most vulnerable people. Spanish epidemiological sources and statistics for this period indicate that obesity rates have increased most quickly among individuals of low socioeconomic status and with a low level of education, particularly women. However, paradoxically, most of the anti-obesity measures adopted have excluded, or minimized, the social determinants of health. This chapter argues that, in the process of translating international guidelines into national action plans, there has been a failure to address the effects of recent socioeconomic changes – job insecurity, reduced wages, social programs cuts – through them. This lack of attention on their impact challenges the adequacy of certain anti-obesity measures. It is suggested that Spanish policymakers should rethink diagnosis and interventions and consider the health effects of their own economic policies in the increase of poverty and social inequality.