The Social Construction of Obesity in an Australian Preventive Health Policy

Abstract

In Australia obesity is constructed by governments as a leading risk factor for major, preventable, non-communicable chronic disease. To investigate the failure of obesity policy to stop or reverse the prevalence of obesity in Australia over the last two decades calls have been made to better theorise obesity as a problem. Social constructionism is identified as a useful theoretical approach to analyse entrenched and socially complex policy problems. Based on social constructionism a Critical Social Constructionism methodology is created for use in this thesis and is based on aspects of Bacchi’s critical policy analysis methodology, ‘What’s the problem represented to be?’. The Critical Social Constructionism methodology is a practical and effective tool to critically analyse the policy problem representation of obesity. A specific example of obesity policy, the Australian Government Measure Up campaign along with the historical and broader policy context of that campaign are analysed. This analysis is assisted by the production of a schema of obesity representations that differentiates biomedical and social representations of obesity and by interviews with experts in obesity and preventive health issues. It is widely agreed in critical literature that the biomedical paradigm which was developed in response to acute and infectious diseases constructs health problems in a reductionist and individualistic way. The first major conclusion of this thesis is that the current dominant obesity problem for policy is constructed in a biomedical model with important underexplored effects. A second major conclusion holds that changing what the problem is represented to be from a biomedical representation of obesity to a social health representation faces extraordinary barriers that make such a project both impractical and improbable. Therefore this work explores the possibility of a radical disruption of the representation of the problem as obesity in policy. Alternative, ‘weightless’ representations of the problem within current research, public programs and medical practice are described and proposed for consideration in future policy making aimed at more effectively reducing the rates of major, preventable, non-communicable chronic diseases in Australia