Rethinking public mental health: learning from obesity

This commentary piece written in the Lancet Psychiatary, reviews Stanley J Ulijaszek’s new book, Models of Obesity. It argues that the field of mental health could learn a lot from the challenges of obesity and the approaches used to tackle it. It first argues that the obesity debate has been reframed in a way that presents it as a chronic relapsing-remitting condition. This has shifted the approach to the treatment of obesity and would be a useful if implemented in mental health.

Next, it highlights the standard unit of measurement that exists in obesity; BMI. Despite its faults, this practice has meant that it’s far easier to make sense of population obesity through epidemiological studies. Mental health researchers often use confused terminology, meaning that it is difficult to perform population studies and so to grasp the scale and nature of the issue.

Third, the field of obesity considers the complex systems that create public health problems better than that of mental health. This means that considerations for environmental factors and psychopathogenic factors are much better integrated into obesity care than in mental health.

Fourth, there is a polyrational approach in obesity that frames obesity public health in a field of competing interests and behaviours, such as between corporations and governments. This means that there is a better understanding of the rationalities and their relationship to each other.

Finally, “viable clumsy solutions” are used to address obesity; these are “a combination of single rational policies towards a particular problem”. This follows from the polyrational approach of understanding obesogenic environments. It involves bringing individual stakeholders together to find solutions, which combine to advise policy.