Global Forum on Food Security and Nutrition (FSN Forum)

Member profile
Browse all members

Ms. Ximena Ramos Salas

Member since
Organization: Canadian Obesity Network
Country: Canada
Field(s) of expertise:
I am working on:

I am a PhD candidate at the University of Alberta’s School of Public Health and Managing Director of the Canadian Obesity Network based in Edmonton, Alberta. As a public health researcher, I am exploring the unintended consequences of obesity prevention policies for people with obesity. My goal is to spark solutions that will prevent the perpetuation of weight bias and obesity stigma and create more effective population health approaches. Through my role at the Canadian Obesity Network, I implement strategic research and knowledge translation initiatives in order to improve the health of Canadians affected by obesity.

This member contributed to:

    • Dear Discussion Facilitators,

      Thank you for the opportunity to share our experiences and knowledge on this topic. 

      In Canada, the responsibility for obesity health services (prevention and management) lies with provincial and territorial governments. Population level data indicating rising levels of childhood obesity have prompted Canadian federal, provincial and territorial (FPT) governments to make childhood obesity a collective priority. The Curbing Childhood Obesity: A Federal, Provincial, and Territorial Framework for Action to Promote Healthy Weights was signed by all provinces (except Quebec) and territories in 2010.  The Public Health Agency of Canada is responsible for monitoring the implementation of activities that fall within that framework.http://www.phn-rsp.ca/thcpr-vcpsre-2015/index-eng.php Note: Despite having this framework in Canada, there have not been any comprehensive efforts to implement these policy recommendations. 

      Unfortunately, the dominant narrative in this public health policy framework is highly simplified, indicating mainly that obesity is caused by unhealthy eating and lack of physical activity. This simplistic view of obesity is also a driver of policy recommendations that focus on individual-level approaches rather than broader societal-level policy solutions. This is despite evidence suggesting that a focus on individual-level solutions rather than on changing the broader societal level factors that have created obesity in the first place (e.g. food industry practices, agricultural policies, food pricing, etc.) have not been effective.

      This simplistic view of obesity has also the potential to harm people with obesity because it contributes to weight bias and obesity stigma.  The narrative that people with obesity choose to eat unhealthy and to not exercise is not only simplistic but also lacks evidence. Science has demonstrated that obesity is not simply a matter of energy-in and energy-out and that there is a rather complex biological system that regulates and defends body weight. 

      The dominant cultural narrative around obesity, which fuels assumptions about personal irresponsibility, has led to a shadow epidemic of weight bias and obesity stigma. There is now extensive evidence that obesity stigma affects a person’s mental health, interpersonal relationships, educational achievements, employment opportunities, leads to avoidance of preventive health care, can hinder weight management efforts, and can increase overall morbidity and mortality.

      Therefore, the Canadian Obesity Network recommends that all policies addressing nutrition and physical activity be framed as general measures to improve population health rather than as measures meant to reduce obesity. This approach is prudent considering there is little evidence that any of the suggested food or activity policies can noticeably reduce obesity at the population level and/or in vulnerable populations.  We also recommend that before declaring a public policy or measure as targeting obesity, one would need clear evidence of effectiveness and perform a comprehensive analysis of potential harm, including promotion of weight bias and obesity stigma. Such policies must take into consideration the voices of people living with obesity (especially women) and include experts on weight bias and obesity stigma.

      Ximena Ramos Salas, Managing Director, Canadian Obesity Network

      Arya M. Sharma, Scientific Director, Canadian Obesity Network

      www.obesitynetwork.ca