Together with Marcel Canoy, I wrote an article for the Nederlands Tijdschrift voor Geneeskunde in which we argue that obesity is a form of structural injustice. Large groups of vulnerable people are disadvantaged and discriminated against while their vulnerable position is facilitated by a sick market cycle that mainly benefits the food industry, retail and pharmaceutical companies. At the same time, prevention programs are failing. For many reasons, we continue to view overweight and obesity as a matter of individual responsibility. Scientific methodology also has a crucial role in this. Of course, obesity is often also something people can take responsibility for themselves, but that does not diminish the responsibility of society, government, industry and science.
The topic combines earlier work I did with Beatrijs Haverkamp on socioeconomic health disparities and injustice, and with Tjidde Tempels and Vincent Blok on the food industry's responsibility for healthy eating. The theme also features in the upcoming Els Borst lecture, on September 18, 2024 in The Hague.
Unfortunately, the paper is in Dutch, but at least the abstract is English:
Obesity as structural injustice: towards a radically different social contract for a healthier society
The prevalence of obesity in the Netherlands has been on the rise for decades and recent preventive efforts of government and other societal actors appear insufficient to reverse this trend. The development of food technologies neutralizing the impact of fat and sugar, and medicines that might help individuals losing weight could be seen as part of a solution. We argue however that these also reinforce three fundamental societal problems underlying the obesity crisis: a vicious market cycle, the framing of overweight as a problem of individuals, and an epistemological dilemma in science. Together these problems constitute a vicious circle that is especially harmful for socioeconomically disadvantaged groups. Many societal actors are involved in these problems and share moral responsibility for taking away the causes of injustice, including food industry, retailers, health care, and government. Effective prevention of obesity may require developing avenues to legally enforce these responsibilities.
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