Body size, body norms and some unintended consequences of obesity intervention in the Pacific islands

Background: Pacific Islanders have experienced over 50 years of obesity interventions—the longest of any region in the world. Yet, obesity-related non-communicable diseases (NCDs) continue to rise.‘Traditional’body norms have been cited as barriers to these interventions.
Aim: In this study, we ask:‘What is the relationship between health interventions, body norms and people’s experience of“fatness”? How–and why–have these changed over time?’We study two nations with high rates of obesity: Nauru and Samoa. Subjects and methods: Ethnographic fieldwork with people in everyday and clinical settings in Samoa(2011–2012; 2017) and Nauru (2010–2011).
Results: Body norms are not a single or universal set of values. Instead, multiple cultural influences—including global health, local community members and global media—interact to create a complex landscape of contradictory body norms.
Conclusions: Body norms and body size interventions exist in an iterative relationship. Our findings suggest that Pacific Island obesity interventions do not fail because they conflict with local body norms; rather, they fail because they powerfully reshape body norms in ways that confuse and counteract their intended purpose. Left unacknowledged, this appears to have (unintended) consequences for the success of anti-obesity interventions.