Instituto de Saúde Coletiva, Universidade Federal da Bahia, Canela, Salvador, Brazil.
Faculdade de Odontologia, Universidade Federal da Bahia, Salvador, Brazil.
Nutr Rev. 2023 Nov 10;81(12):1653-1664. doi: 10.1093/nutrit/nuad028.
Obesity is a multicausal social problem and a pandemic, and it presents a public health challenge in many countries. Hence, public health interventions have been used in an endeavour to prevent and/or control increased obesity among populations.
This review study aimed to provide an overview of the academic literature and to analyze the strategies involved in the main public policies focused on preventing and controlling obesity in a number of countries.
MEDLINE/PubMed, Web of Science, and LILACS databases were searched.
Original studies were included for which the core objective was related to real-life public policy interventions for obesity.
The studies were organized according to their characteristics, and the qualitative analysis was based on the categorization proposed by the author Poulain. The review included 41 studies and identified 15 types of interventions focused on obesity; the largest proportion of actions were developed in school and city environments and were geared toward behavioral change, supported by direct or indirect government action. It was observed that many strategies focused on environmental line through regulatory and legislative measures, and health promotion geared toward the individual was based on the dissemination of information as a means for behavioral change. A smaller focus was given to individual care and treatment, and participative actions in the community.
The design of public health strategies applicable to obesity as proposed by Poulain provides a valid model for evaluating interventions. The behavioral approach involving guidance through health education toward a healthy lifestyle prevails in public policies, indicating a movement toward accountability of individuals. However, it is necessary to deepen the debate on the social structures that determine obesity (and which limit possibilities of choice), aligned with cultural change regarding its occurrence, and to employ care strategies based on scientific evidence and which focus on the needs of the subjects.
肥胖是一个多因社会问题和大流行病，在许多国家都构成了公共卫生挑战。因此，公共卫生干预措施已被用于预防和/或控制人群肥胖的增加。
本综述研究旨在提供学术文献的概述，并分析主要公共政策中涉及的策略，这些政策旨在预防和控制多个国家的肥胖。
MEDLINE/PubMed、Web of Science 和 LILACS 数据库进行了搜索。
纳入了核心目标与现实生活中的肥胖公共政策干预措施相关的原始研究。
根据研究的特点进行了组织，定性分析基于作者 Poulain 提出的分类。该综述包括 41 项研究，确定了 15 种针对肥胖的干预措施；大部分行动是在学校和城市环境中开展的，旨在改变行为，并得到了直接或间接政府行动的支持。研究观察到，许多策略侧重于通过监管和立法措施进行环境干预，针对个人的健康促进以信息传播为改变行为的手段。对个人护理和治疗以及社区参与性行动的关注较少。
Poulain 提出的适用于肥胖的公共卫生策略设计为评估干预措施提供了一个有效的模型。通过健康教育引导健康生活方式的行为方法在公共政策中占主导地位，表明个人责任的转变。然而，有必要深化关于决定肥胖（和限制选择可能性）的社会结构的辩论，与对其发生的文化转变相一致，并采用基于科学证据且关注对象需求的护理策略。
