Sobrepeso y obesidad en Chile: Consideraciones para su abordaje en un contexto de inequidad social

Abstract

With 3 out of 4 people living with overweight or obesity, the national prevalence of high BMI is among the highest on the continent, thus showing an inequitable distribution pattern mediated by structural determinants that shape health behavior (social security, socioeconomic status, education, gender, among others). The socioeconomic features of the country, a high-income nation with marked inequity, are unusual and represent an additional challenge when designing health interventions. A high concentration of wealth allows it to be classified as a high-income country even though most of the population would belong to a vulnerable social class, whose income is accompanied by social and symbolic resources that make it doubly challenging to adopt a healthy “lifestyle”. Despite the multiple nutritional strategies implemented, the prevalence of overweight and obesity continues to increase. The insistent use of models based on individual choice and responsibility, which seek to modify behavioral risk factors (sedentary lifestyle and high caloric intake) without neutralizing the structural determinants predisposing this behavior, is postulated as highly responsible. Favorably, the latest National Nutrition Policy recognizes the “social determination of food”, representing a paradigm shift that confers some optimism and whose effectiveness has to be evaluated in the coming years.