Obesity Seen as Self-Inflicted

Representative survey in Germany, the UK, and the US

February 05, 2018

Although experts attribute the worldwide increase in obese people primarily to environmental changes, the general public lays the blame on individuals. In their opinion, those suffering from obesity should pay for any resulting medical expenses themselves. This is shown in a current study by the Max Planck Institute for Human Development and the University of Mannheim, published in Annals of Behavioral Medicine.

Nearly one third of the world's population is overweight. Researchers already view this as a global health crisis, and the World Health Organization has, for instance, called for a 20 percent tax on sugar-sweetened drinks. The expert consensus is that the increase in obesity is primarily due to environmental changes: People in industrial nations consume many more calories today than before, while being less physically active. “For centuries we've dreamt of a land of milk and honey, with food virtually floating into our mouths without any effort. Today we live in a modern land of milk and honey—which opens up new problems,” says Jutta Mata, Professor of Health Psychology at the University of Mannheim and adjunct researcher at the Max Planck Institute for Human Development.

Societal support for policy measures and regulations that focus on environmental conditions remains, however, sparse. Most people hold the individual to blame for obesity. This was shown in a survey of representative samples from Germany, the UK, and the US. The researchers wanted to know whom the respondents considered responsible for obesity, who in their opinion should pay for medical treatment costs, and which policy measures they considered effective. To better interpret the results, the researchers asked the same questions with respect to alcohol and nicotine dependence. For one, these illnesses bear similarities to obesity. It is currently under debate, for instance, whether obesity is the result of an “addiction to food”. At the same time, successful preventive and interventive measures have been implemented for alcohol and nicotine dependence.

In all three countries, most respondents held individuals accountable for obesity, as well as for alcohol or nicotine dependence. In general, the higher individual responsibility was deemed to be, the more strongly respondents endorsed making individuals bear their treatment costs themselves. This opinion was shared by a good third of the respondents in Germany and the UK, and by nearly 45 percent in the US. Household income had no effect on respondents' statements.
In addition, respondents evaluated the effectiveness of preventive measures to combat obesity—such as high taxes, limited availability, regulated marketing and advertising, and labeling and warnings—in comparison to such policies for alcohol and nicotine dependence. In sum, they rated policy measures as less effective in preventing obesity than in preventing alcohol and nicotine dependence. Moreover, in all three countries they believed that high taxes would be least effective in preventing obesity, even though taxation was considered to be effective for alcohol and nicotine dependence. In their view, the most effective measure is understandable nutritional labeling. Such labels focus on personal dieting decisions. More comprehensible nutritional labels are considered to be even more effective than graphic warnings about health risks on alcohol and tobacco products.

“Understandable nutritional labeling is one measure to prevent obesity that already enjoys widespread public support. It can strengthen people's competence in making decisions and would be easy to implement,” says Ralph Hertwig, Director of the Center for Adaptive Rationality at the Max Planck Institute for Human Development.

Original Publication
Mata, J., & Hertwig, R. (2018). Public beliefs about obesity relative to other major health risks: Representative cross-sectional surveys in the USA, the UK, and Germany. Annals of Behavioral Medicine. Advance online publication. doi:10.1093/abm/kax003

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