Shiell Alan
Alberta Heritage Foundation for Medical Research Health Scientist, Canadian Institutes of Health Research/Public Health Agency of Canada.
Healthc Pap. 2008;9(1):42-5; discussion 62-67. doi: 10.12927/hcpap.2008.20179.
One's weight is the outcome of a complex interplay of factors within which the choices we make about diet and activity are constrained and shaped by systemic forces - biological, social and economic - that fall increasingly beyond our control. "Simple" solutions that ignore the complex, systems-level characteristics of the obesity epidemic will generally fail as counter-veiling forces act to negate and undermine whatever action is taken. Selling the prevention message is not enough if politicians can choose conservative options that give the appearance of action but fail to tackle the issue. They need instead to be convinced that there is no alternative other than the multi-sector, multi-level, whole-of-government approach that is being adopted by enlightened jurisdictions such as California and the United Kingdom. As Dr. Havala Hobbs argues, this requires transparency, public participation, accountability and politically astute leadership of the sort demonstrated in the fight against tobacco.
一个人的体重是多种因素复杂相互作用的结果，在这些因素中，我们在饮食和活动方面所做的选择受到生物、社会和经济等系统性力量的限制和塑造，而这些力量越来越超出我们的控制范围。忽视肥胖流行的复杂系统层面特征的“简单”解决方案通常会失败，因为反制力量会采取行动来否定和破坏所采取的任何行动。如果政治家可以选择看似采取了行动但却未能解决问题的保守选项，那么仅仅宣传预防信息是不够的。相反，他们需要相信，除了加利福尼亚和英国等开明司法管辖区所采用的多部门、多层次、政府整体参与的方法之外，别无他法。正如哈瓦拉·霍布斯博士所指出的，这需要透明度、公众参与、问责制以及在抗击烟草斗争中所展现出的那种具有政治敏锐性的领导力。
