Principles of precaution and of circumspection. Elements for a strategy of obesity prevention

1. Principles of precaution and
of circumspection
Elements for a strategy of obesity prevention
Prof. Jean Pierre Poulain
Chair of « Food Studies » Taylor’s Toulouse University Center,
CERTOP UMR CNRS 5044

2. Plan
• Beyond the denial of failure and
untenable promises. How to justify the
fight against obesity?
• Principle of precautionary & Principle of
circumspection
• To pilot fight again obesity by evaluation

3. Diet failure
"Most obese people do not
continue their weight loss
program. Among those who do,
the majority do not lose weight
and among those who do lose
weight, most regain their
weight". Albert Stunkard

4. Promises… of nutrition
transition model

6. Causality networks

7. • US = 36,3
• UK = 26,9
• AUSTRALIA 27,9

8. Plan
• Beyond the denial of failure and untenable promises.
How to justify the fight against obesity?
• Principle of precaution & Principle of circumspection
• To pilot fight again obesity by evaluation

9. The justification of the fight again
obesity
• Classic approach of public health consists in taking
action only when validated and safe knowledge is
available to support it.
• However, when a risk trend is inexorably
spreading, the application of the precautionary
principle can suffice to justify interventions.
• In this case, they should be grounded in up-to-
date knowledge and the actions should be
systematically evaluated.

10. Science-Based Policies: Principles of sciences
Founding Principles of Science (Merton)
• Universalism: Science aims to produce
universal knowledge (E=MC2)
• Communalism: scientists constitute an expert
community (networks) which produce both
knowledge and its evaluation (peer control)
• Disinterest: interests’ connections between
scientists and industrials or individual
interest should be avoided or, at list,
monitored
• Organized Scepticism: Well-reasoned and
argued doubt, plan for refereeing (expertise,
consensus conferences, controversies)
“Science is a normed discourse
based on its critical
rectification”
Canguilhem
10

11. “Organised scepticism"
Knowledge management. Two complementary
techniques
1. Consensus conferences that establish what is
agreed
2. Arbitration of controversies, to point out
• the lines of disagreement and sharing of
knowledge
• underlying logics of interest
11

12. Plan
• Beyond the denial of failure and untenable
promises. How to justify the fight against
obesity?
• Principle of precaution & Principle of
circumspection
• To pilot fight again obesity by evaluation

13. Evaluating actions
• Shift from rhetoric to
evaluation
• Formulate actions in terms of
objectives and
• Putting in place evaluation
mechanisms
• But evaluation,
• Takes time and
• Coasts a lot
• Poses methodological
questions
• Develop a toolkit for project
leaders.
• Invest in the evaluation
methodology
• State of the art through a
collective expertise on
methodologies
• Guide of good practices
• Investments to develop tools
adapted to the different types of
project
13

14. Effectiveness of actions
1. By measuring
• Reception of a message
• Adaptation and relevance of a message to the
target
• Link between message and behaviour
• Link between behaviour and health objectives
• Isolating confounding factors
2. Performance in terms of cost/benefit
3. Absence of counter-productive effects
14

15. Putting fight again obesity policies
under control of evaluation
1. Steering operation
2. Stop what is counterproductive
3. Use action of prevention to produce
new knowledge
4. To publish both
• what works, but also
• What doesn't work to analyse the
reason of failure

16. Experiences in obesity in France
1. Participation to INSERM Expertise on Obesity
2. National Nutrition and Health Plan
3. Co-chair of the working group of CNA (National Council of Food)
“110 measures to face the development of childhood obesity”
(Ministry of Health, Ministry of Agriculture and Ministry of
Economy) Avis 54 & 55
4. Co-chair of the mission on “Body image and eating disorders”
(Ministry of Health)
5. Member of the Integrated Center for Obesity Toulouse University
and Hospital

18. https://www.researchgate.net/profile/Jean_Pierre_Poulain
18
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