Larger Than Life: The Root Causes of Obesity

Angst ridden 30-something Bridget Jones starts each day on the scale, obsessively tracking her weight against social expectations. She vows to become svelte, only to confide her personal dieting failures to her diary the next morning.

Author Helen Fielding’s Bridget Jones’ Diary resonated with women near and far, even catapulting her London-based heroine onto the cinematic screen.

Like Bridget, Sara Kirk hails from the United Kingdom and could be described as being fascinated with weight management. If they ever had the chance to meet over coffee (or given Bridget’s lifestyle, a martini) Sara would have some comforting advice: “It’s not all your fault, Bridget.”

If Bridget is taken aback at the suggestion, she wouldn’t be alone — it runs contrary to conventional wisdom.

“For many years, we’ve looked at weight as an individual problem. It’s a personal responsibility — willpower, call it what you will. The general consensus still is that it is an individual problem, one that should not be medicalized,” says Dr. Kirk. “Actually, there’s a huge body of literature that’s coming out now that says we need to look at the culture and the environment.”

Dr. Kirk is a former registered dietician and an expert on the management and prevention of obesity. The new Canada Research Chair in Health Services Research is with Dalhousie’s School of Health Services Administration and is cross-appointed with the IWK Health Centre.

“In my research I’m trying to understand what it’s like for the person who has a problem to go to a doctor and then be told it’s your own fault — just eat less and do more activity — because that’s how we treat obesity. But we must also recognize that there are other things at the core, our policies need to change,” she says.

Daily life has changed so dramatically in the past 50 years that most people have little opportunity for built in activity. The western ‘driving and convenience culture’ is seductive. “As humans, we want to take the easy way and it’s very hard to go against that,” she says.

Even the pace of change offers cause for concern. In the past 15 years, the number of people who are overweight or obese in Atlantic Canada has doubled — and Nova Scotia now has one of the highest rates of obesity in Canada. “If I look at Nova Scotia, slightly over 60 per cent of adults, and one in three children, are overweight or obese — and it takes about a thousand lives a year,” she says. “Certainly, with people developing a weight problem, it’s so easy to do now that it’s almost becoming normal.”

Her first Halifax-based study, funded through the IWK Health Centre, and focusing on the ‘obesiogenic environment’ in childhood, is up and running. The study is looking at the factors in the environment — access to green spaces, access to food — that may contribute to obesity in children in Nova Scotia. The next step is to measure the body mass index (BMI) of children and map this according to the characteristics of the environment. “We’re going to identify factors in the environment that actually contribute to childhood obesity, and then ask ‘can we do something to change the way that people respond to the environment?’”