Samenvatting

Since the start of the 21^st century, most nations have followed the lead of the World Health Organization and developed specific policies to tackle the ‘global obesity epidemic’. The medical reasoning is that non-contagious diseases are the most important causes of mortality and morbidity, especially in prosperous nations. As these diseases are conceptualized as ‘caused’ by ‘unhealthy lifestyle choices’, there is dire need for preventive lifestyle policies that help people make ‘the healthy choice’. Seen from this perspective the distribution of responsibilities between governments and their citizens is made in accordance to the ‘intervention ladder’, which has been developed from a stewardship model.
Regarding the ‘obesity epidemic’, this contribution tests the basic medical claims behind this science policy complex. We find that the knowledge base for these claims is highly uncertain and that interventions lack efficacy. Furthermore, research points to increased levels of stigmatization of ‘fat people’, leading more discrimination. All this changes the status of the policies from preventive (i.e. proportionate) to precautionary (i.e. disproportionate). Further analysis of the preventive medical and policy paradigms shows both are by default biased towards precaution. Combined with the notion that citizens of democratic societies are entitled to trustworthy and transparent information, this contribution concludes that a reorientation of both paradigms is called for.