Preventing obesity: challenges and pitfalls for health promotion.
OBJECTIVE
To explore challenges to health promotion strategies against obesity, with special attention to the Scandinavian context.


METHODS
Analytic induction, a procedure for verifying theories and propositions, based on purposefully selected literature references, with subsequent critical reflection.


RESULTS
Health promotion efforts against obesity face challenges related to the unequal distribution of vulnerability to weight gain within the population, and to the complex neuroregulatory determinants that explain why obesity is not just a simple matter of lifestyle. Cultural understandings of identity and morality may create victim blaming and disempowerment, thus obstructing clinical health promotion strategies for weight control. Finally, the conceptual validity of obesity measurements and their predictive power deserves attention.


CONCLUSIONS
Preventing obesity is difficult. Awareness of individual vulnerability and neurobiological mechanisms that lead to weight gain must be taken into account when strategies for health promotion are developed. These strategies must transcend a simplistic energy balance view.


CONCLUSIONS
Clinical health promotion needs to be highly individualized and tailored. Preventing weight gain requires attention to the person's sociodemographic, cultural and genetic characteristics. Cultural trends such as sedentary lifestyles and the nutrition transition should be counteracted without turning body weight control into a question of morality and inferior identity.
Malterud
Kirsti
K
Research Unit for General Practice, Unifob Health, Bergen, Norway. Kirsti.malterud@isf.uib.no
Tonstad
Serena
S
D001828:Body Image; D015992:Body Mass Index; D005247:Feeding Behavior; D015438:Health Behavior; D006293:Health Promotion; D006801:Humans; D008019:Life Style; D008962:Models, Theoretical; D009664:Norway / Q000453:epidemiology; D009752:Nutritional Status; D009765:Obesity / Q000453:epidemiology / Q000517:prevention & control*; D012307:Risk Factors; D012931:Social Environment; D012938:Social Perception; D012959:Socioeconomic Factors; D015430:Weight Gain