Weighing it up: The missing social inequalities dimension in Australian obesity policy discourse

Issue addressed: Debate on obesity spans complex health and social issues drawing on varying representations of fat bodies. This paper seeks to determine whether the recent public health focus on social inequalities is reflected in broader policy debate on obesity. Methods: We reviewed public submissions to the 2008 Australian House Standing Committee on Health and Ageing inquiry into obesity. Using a qualitative framing approach we categorised the 95 submissions, analysing a sample of 20 of them, thereby, elucidating attitudes to obesity held by a range of interested stakeholders. Results: Two primary frames and one lesser frame were identified. While it was common for contributors to situate obesity as a problem of individuals, it was equally common for contributors to draw on environmental level arguments where obesity is located in structural forces outside of the individual. The range of attributing factors reflects disagreement as to the causes of obesity, although adherents to both the individual and environmental frames called for more government regulation and financial support. Only two submissions directed policy reform to issues of inequality. Conclusions: Empirically, this study represents a novel investigation of the role of public health ethics in obesity debate and policy. Politically, we highlight the relative lack of explicit attention given to inequality in the debate, even though social inequalities are demonstrably relevant.