Nutritionists as Policy Advocates: The Case of Obesity Prevention in Quebec, Canada

Objective A core function of the public health nutrition workforce is advocacy. Little is known of the nutritionists’ role in policymaking from a policy process theory perspective. This study analyzes the nutritionists’ role in advocating for a six-year governmental plan on obesity prevention in Quebec, Canada. Design We conducted qualitative research using Quebec´s obesity policy as a case study to understand the role of nutritionists in advocating for obesity prevention policies. A conceptual framework combining the Advocacy Coalition Framework with a political analysis model based on the Theory of the Strategic Actor was developed to analyze the beliefs, interests, and strategies of policy actors including nutritionists. Data sources comprised semi-structured open-ended interviews with key policy actors (n=25), including eight nutritionists (32%), and policy-related documents (n=267). Data analysis involved thematic coding and analysis using NVivo 11 Pro. Setting Quebec, Canada Participants Key policy actors including nutritionists Results Nutritionists formed the core of the dominant public health coalition. They advocated for an inter-sectoral governmental plan to prevent obesity through enabling environments. Their advocacy, developed through an iterative process, comprised creating a think tank and reinforcing partnerships with key policy actors, conducting research and developing evidence, communicating policy positions and advocacy materials, participating in deliberative forums and negotiating an agreement with other coalitions in the policy subsystem. Conclusion Nutritionists’ advocacy influenced agenda-setting and policy formulation. This research may contribute to empowering the public health nutrition workforce and strengthening its advocacy practices. It informs practitioners and researchers concerned with obesity policy and workforce development.

No Appetite for Change: Culture, Liberalism, and Other Acts of Depoliticization in the Australian Obesity Debate

There is wealth of evidence that points to the pernicious ways in which inequities in food, bodies, and health are disproportionally borne. Equally, there is a wealth of evidence that critiques the role of neoliberal imperatives for individuals to take responsibility for their health, and how this tenet reproduces inequity. However, health interventions and public policy remain immune to addressing social determinants of health and ignore the cultural dynamics of power in food systems, interventions, and policy. Drawing from ethnographic research in an Australian community that has high levels of socioeconomic disadvantage and obesity, and the Australian Government’s response to the ‘obesity epidemic’, this article examines the processes and tactics of depoliticization that are used to elide political and sociocultural phenomenon. I leverage the work of Brown and Povinelli to argue that liberalism’s hold on universalisms, autonomy, and individual liberty in obesity discourses subjugates a comprehension of political relations, positioning liberal principles and culture as mutually antagonistic. It is precisely this acultural positioning of liberalism that makes it possible to remove recognition of the power that produces and contours the ‘metabolic rift’ between food systems, public health, and equity priorities. In conclusion, I consider how obesity policy might be different if we paid attention to this culturalization of politics.

Empowering People to Make Healthier Choices: A Critical Discourse Analysis of the Tackling Obesity Policy

In response to the heightened risk that coronavirus disease 2019 (COVID-19) poses to the health and lives of people with obesity, in 2020 the U.K. government launched a new package of policies intended to stimulate weight loss among the country’s population. In this article, I present a critical discourse analysis of the policy paper which announced these new measures. I identify the discourses that are used to represent things, people, and processes in this policy text. These discourses are interpreted in terms of broadly neoliberal ideologies of public health management. Taken together, the discourses identified contribute to a broadly neoliberal ideology of public health management. It is argued that the policy paper represents an instance of “lifestyle drift,” as it initially appears to engage with social and economic determinants of health but ultimately neglects these in favor of focusing on individual lifestyle factors, particularly in the shape of individuals’ “choices.”