Martin McKee, London School of Hygiene and Tropical Medicine
23 May 2012
The important paper by Ginsberg and Rosenberg (1) demonstrates the enormous cost of obesity to the Israeli economy. They also show that implementation of a series of interventions would be highly cost-effective in tackling it. However, as Cecchini and Sassi note, in their accompanying commentary (2), the drivers of obesity are in the environments we inhabit. A visitor from space might consider that we had designed our modern environments with the main aim of increasing our body mass, giving primacy to the automobile rather than other forms of transport, and creating a food industry that promotes energy dense, and often micro-nutrient free, products at low price. Indeed, such environments have now been termed ¿obesogenic¿ (3). Consequently, while there is a strong argument for the Israeli sickness funds to invest in the interventions examined by Ginsberg and Rosenberg, this should only be the beginning. There is now a wealth of evidence about those aspects of the environment that influence our body weight and the benefits of tackling them (4), including that showing how the act of moving to Israel (in this case from Ethiopia) leads to a substantial increase in body mass (5). This demands a comprehensive response from across government, rather than leaving it to the health system to pick up the pieces as usual.
Martin McKee
Professor of European Public Health
London School of Hygiene and Tropical Medicine, UK
1 Ginsberg GM, Rosenberg E. Economic effects of interventions to reduce obesity in Israel. Israeli J Health Pol Res 2012, 1:17
2 Cecchini M, Sassi F. Tackling obesity requires efficient government policies. Israeli J Health Pol Res 2012, 1:18
3 Swinburn B, Egger G, Raza F. Dissecting obesogenic environments: the development and application of a framework for identifying and prioritizing environmental interventions for obesity. Prev Med 1999; 29:563-70.
4 Chow CK, Lock K, Teo K, Subramanian SV, McKee M, Yusuf S. Environmental and societal influences acting on cardiovascular risk factors and disease at a population level: a review. Int J Epidemiol 2009; 38: 1580-94.
5 Regev-Tobias H, Reifen R, Endevelt R, Havkin O, Cohen E, Stern G, Stark A. Dietary acculturation and increasing rates of obesity in Ethiopian women living in Israel. Nutrition 2012; 28: 30-4.
Israel Journal of Health Policy Research
Looking beyond the individual
23 May 2012
The important paper by Ginsberg and Rosenberg (1) demonstrates the enormous cost of obesity to the Israeli economy. They also show that implementation of a series of interventions would be highly cost-effective in tackling it. However, as Cecchini and Sassi note, in their accompanying commentary (2), the drivers of obesity are in the environments we inhabit. A visitor from space might consider that we had designed our modern environments with the main aim of increasing our body mass, giving primacy to the automobile rather than other forms of transport, and creating a food industry that promotes energy dense, and often micro-nutrient free, products at low price. Indeed, such environments have now been termed ¿obesogenic¿ (3). Consequently, while there is a strong argument for the Israeli sickness funds to invest in the interventions examined by Ginsberg and Rosenberg, this should only be the beginning. There is now a wealth of evidence about those aspects of the environment that influence our body weight and the benefits of tackling them (4), including that showing how the act of moving to Israel (in this case from Ethiopia) leads to a substantial increase in body mass (5). This demands a comprehensive response from across government, rather than leaving it to the health system to pick up the pieces as usual.
Martin McKee
Professor of European Public Health
London School of Hygiene and Tropical Medicine, UK
1 Ginsberg GM, Rosenberg E. Economic effects of interventions to reduce obesity in Israel. Israeli J Health Pol Res 2012, 1:17
2 Cecchini M, Sassi F. Tackling obesity requires efficient government policies. Israeli J Health Pol Res 2012, 1:18
3 Swinburn B, Egger G, Raza F. Dissecting obesogenic environments: the development and application of a framework for identifying and prioritizing environmental interventions for obesity. Prev Med 1999; 29:563-70.
4 Chow CK, Lock K, Teo K, Subramanian SV, McKee M, Yusuf S. Environmental and societal influences acting on cardiovascular risk factors and disease at a population level: a review. Int J Epidemiol 2009; 38: 1580-94.
5 Regev-Tobias H, Reifen R, Endevelt R, Havkin O, Cohen E, Stern G, Stark A. Dietary acculturation and increasing rates of obesity in Ethiopian women living in Israel. Nutrition 2012; 28: 30-4.
Competing interests
None declared