Obesity is an epidemic occurring predominantly in the western world.
Obesity is an epidemic occurring predominantly in the western world. The phenomenon is closely associated with changing lifestyles and the consumption of fast food and soft drinks. However, the fast-food companies and the Coca Cola company are major contributors to obesity research.

Discuss the different ethical positions that various stakeholders are taking in the use of corporate funds for research into obesity

This report will first discuss the major stakeholder fast food and Soft Drink Corporation ethical positions in making decision in funding researcher into obesity,

Business main motive is to earn profit, most of the businesses are mainly profit motivated, they only care about the income they can earn to sustain and grow, company follow ethical learning and growth, it cares only about itself. Soft drink and fast food has the same motivation of earning profit for which they produces the product that are on major demands or create the demand by making advertisement and other promotional activities to attract people towards their product. To have a successful business support of all stakeholders are required. Funding research for the research is one of the strategies of company to support that. Funding helps in building image in public, which help in generating goodwill for the company at the same time it helps the researcher.

A Typology of Stakeholder Attributes: Legitimacy, Power, Urgency
How do managers decide which stakeholders deserve their attention? Stakeholders have attributes including legitimacy, power, and urgency. A typology of stakeholders has been developed based on these three attributes.17 When these three attributes are superimposed, as depicted in Figure 3-4, seven stakeholder categories may be seen. The three attributes of legitimacy, power, and urgency help us see how stakeholders may be thought of and analyzed in terms of their characteristics. The stakeholders are more or less salient depending on these factors.

Legitimacy refers to the perceived validity or appropriateness of a stakeholder’s claim to a stake. Therefore, owners, employees, and customers represent a high degree of legitimacy due to their explicit, formal, and direct relationships with a company. Stakeholders that are more distant from the firm, such as social activist groups, NGOs, competitors, or the media, might be thought to have less legitimacy.

Power refers to the ability or capacity to produce an effect—to get something done that otherwise may not be done. Therefore, whether one has legitimacy or not, power means that the stakeholder could affect the business. For example, with the help of the media, a large, vocal, activist group such as the People for the Ethical Treatment of Animals (PETA) could wield extraordinary power over a business firm. In recent years, PETA has been successful in influencing the practices and policies of virtually all the fast-food restaurants regarding their suppliers’ treatment of chickens and cattle.

Urgency refers to the degree to which the stakeholder claim on the business calls for the business’s immediate attention or response. Urgency may imply that something is critical—it really needs to get done. Or it may imply that something needs to be done immediately or on a timely basis. A management group may perceive a union strike, a consumer boycott, a contaminated product, or a social activist group picketing outside headquarters as urgent.

Egoism has two variants, descriptive or normative. The descriptive (or positive) variant conceives egoism as a factual description of human affairs. That is, people are motivated by their own interests and desires, and they cannot be described otherwise. The normative variant proposes that people should be so motivated, regardless of what presently motivates their behavior.

Teleological theories focus on the consequences or results of the actions they produce.
Utilitarianism is the major principle in this category. It recommends taking the action that results in the greatest good for the greatest number.
Deontological theories, by contrast, focus on duties. For example, it could be argued that managers have a duty to tell the truth when they are doing business.

Business is interrelated with the different stakeholder and has responsibility to every stakeholder, without the support of one stakeholder; it is not possible to run business successfully

. Therefore maintaining a good relationship with every stakeholder is required

Fast food and soft drink corporation has different responsibility, its responsibility towards society is to provide the
.

Any action taken by organisation has a responsibility and accountability for the affect that occur due to the action.

Morally researcher, sponsor and consumer all are responsible for their action and need to be more cautious making decision which might affect in other decision making process (Richard, 2014).

Food & beverage and Soft Drink Corporation fall into the definitive stakeholders, which has power to produce the product as per the demand of the consumer,

Companies generates various product to suite consumer choice, they constantly upgrade and makes changes to match the consumer demand. They advertise their product to have a more sale, to attract more people towards their product. To constantly continue sustainability, they add different flagship with their main product to provide wide range of choice, which eventually help them in building better image of company. Company takes part in different social activities or sponsor research to provide positive image. However their activity is actively opposed, they only care about the profitability and organizations success under the immortal management.

This report will firstly introduce the process of the captain’s decision-making process. Hartman, DesJardins and MacDonald (2013, p. 37) indicated that first step in making decisions that are ethically responsible is to determine the facts of the situation. It is vital to distinguish the facts of the situation. According to ‘South Korea Ferry Disaster News’ (2015), the captain did not rush to the driving cab until the vessel body 60 degrees tipped. And he was told that the ship was leaking, which means the situation became dangerous. As the captain, he must make decisions at once.

1. Facts and Assumptions. What are the central facts of the case and the assumptions you are making on the basis of these facts?

People constantly adopting as per the new changing environment resulting health issue, world is rapidly changing along with the new technology and new life style, people are constant need of quick services due to competition and fast phase life. One doesn’t have sufficient time to cook their own meal or wait longer time for the food to get prepared; people have changed their lifestyle according to necessity. They often prefer fast food and soft drinks which they could get it just waiting few minutes. Continuing the process for longer period of time has resulted in declining health condition; people are suffering from various different health issues as obesity, high blood sugar, heart diseases and many more. Obesity can be seen in all age group, health problem especially in children and adolescents are identified more.

People following Deontological approach of ethics, they adopt as per the necessity and consume fast food and soft drinks to full fill their necessity without thinking of the result in future, takes easy solution which result in health issue letter period of their life. They are aware that eating junk food will lead to those problems, but for their convenient they ignore the fact continuing the consumption.

Businesses are profit motivated and they only care about the income, they required earning income to support their expanses, the major motive of most company is purely earning profit to sustain and grow, it cares only about itself. Companies generates various product to suite consumer choice, they constantly upgrade and makes changes to match the consumer demand. They advertise their product to have a more sale, to attract more people towards their product. To constantly continue sustainability, they add different flagship with their main product to provide wide range of choice, which eventually help them in building better image of company. Company takes part in different social activities or sponsor research to provide positive image. However their activity is actively opposed, they only care about the profitability and organizations success under the immortal management.

Research is a long process which has huge expenses and usually required sponsors; researcher being sponsored by the product company has a more chances of being more flavourful and coming up with the result which is more beneficial to the sponsor. However being ethical sponsored they should not aspect any flavour from the researcher and should allow researcher to produce the actual date to public to make aware. Researcher with being coming to the influence doing the right thing should publish the actual date to help general public. Both researcher and sponsor should follow deontological ethics doing what is correct

2. Major Overriding Issues/Problems. What are the major overriding issues in this case?
(What major questions/issues does this case address that merit(s) their/its study in this course and in connection with the chapter/material you are now covering?)

Obesity is increasing worldwide rapidly and this is mainly because of the urban life with less exercise and lot of junk food consumption. Obesity can be seen in all age group, health problem especially in children and adolescents are identified more. Fast-food and soft drinks are getting popular choices of the western world, as a result of fast phase life. This life style is resulting to different health problem and people are more aware about the health issue and becoming more concern about their health. As well in additional various article and reports published worldwide, informing the cause and impact of obesity, it has made challenges to increase sale of fast food and soft drinks. To overcome this situation fast food and soft drink company has come up with the different advertisement campaign. They have come up with the colourful attractive advertisement featuring popular actors, rock stars, sport stars etc which eventually is attracting many new and old consumer. They have also sponsor researcher to know about the adverse effect of the obesity and who are the major cause of it. Researcher coming up with the different perspective and publishing the various fact of obesity, letting people knows the main reason not being the eating fast food and soft drinks. Rather eating more calories than person can burn and advising the average calories average consumer can consume, has started to turn back the head towards the company.
Everyone is responsible for their own action and also responsible and accountable for affect that occur due to the action. Morally researcher, sponsor and consumer all are responsible for their action and need to be more cautious making decision which might affect in other decision making process (Richard, 2014). Fast food and soft drink organisation being a corporate social responsible they need to provide the healthy options with the correct information about eating or drinking. They need to inform people the actual causes of obesity and other health problem rather than advertising their product using celebrities.
Sponsorship is usually philanthropy in most of the case and should not have any expectation of benefits; it is a mutual benefit business arrangement, where any of the party should not have any extra expectation. Researcher receives the financial benefiting to complete its research and on the other hand it helps to built company image.

a advertisement and also sponsors researcher. Researchers following teleological ethics publish the research slightly in flavour of sponsor, providing various other information’s

• Brief description of the project. An account of the background/history of the project (where it came from), who was involved, what its aims were, what happened, what was achieved and any other relevant information needed by readers as contextual background to understanding the ethical issues.
• Ethical issues anticipated in the project. What ethical issues were embedded in the project (e.g a partnership by its very nature entails agreements or assumptions - whether implicit or explicit - about roles, responsibilities, power, control). How we these taken into account in the planning of the project?
• Ethical issues emerging and developing. What ethical issues/challenges arose (some of which might have been anticipated, some unexpected or more complex than envisaged). How were these issues acknowledged, handled or worked with?
• Learning from the experience of working with these ethical issues. Reflections on what worked and what didn’t, what could have been done differently, what recommendations might be made to other projects.

3. Sub issues and Related Issues. What subissues or related issues are present in the case that merit consideration, discussion, and action?
Analysis/Evaluation

4. Stakeholder Analysis. Who are the stakeholders in this case, and what are their stakes? (Create a stakeholder map to depict relationships.) What challenges, threats, or opportunities does each stakeholder face? What stakeholder characteristics are at work
(legitimacy, power, urgency)?

Stakeholder is a group or individual who has one or more stakes in the organisation, who can affect or get affected by the decision, system, policy, practice and action of the organization (Archie & Ann, 2012). In this case there are mainly three stakeholders: Average Consumer, Fast Food &Soft Drink Corporation and researcher

In today’s hypercompetitive, global business environment, any individuals and groups may be business’s stakeholders. From the business point of view, certain individuals and groups have more legitimacy in the eyes of management; that is, they have a legitimate
(authentic, justified), direct interest in, or claim on, the operations of the firm. The most obvious of these groups are shareholders, employees, and customers. However, from the point of view of a highly pluralistic society, stakeholders include not only these groups, but other groups as well. These other groups include the community, competitors, suppliers, special-interest groups, the media, and society (the public at large). Regulators, activists, and geographic communities also have been identified as stakeholders.9
Charles Holliday, former chairperson and CEO of DuPont, stated, “We have traditionally defined four stakeholder groups important to DuPont—shareholders, customers, employees, and society.”10 But, the list of relevant stakeholders obviously extends beyond these major groups.

5. CSR Analysis. What CSRs (economic, legal, ethica, /philanthropic) does the company have, and what exactly are the nature and extent of these responsibilities to the various stakeholders? 6. Evaluations. If the case involves a company’s or manager’s actions, evaluate what the company or manager did or did not do correctly in handling the issue affecting it. How should actions have been handled?

Recommendations
7. Recommendations and Implementation. What recommendations would you make in this case? If a company’s or a manager’s strategies or actions are involved, should they have acted the way they did? What actions should they have taken? What actions should the company or manager take now, and why? Be specific and include a discussion of alternatives (right now, short-term, and long-term). Identify and discuss any important implementation considerations.

CSR

This paradox relates to the concept of corporate social responsibility (CSR), whereby organizations have responsibilities beyond profit maximization (Carroll, 1979, 1999; Moir, 2001), namely social and environmental responsibilities in business operations and in interactions with stakeholders (van Marrewijk, 2003). As evidenced in the research, the corporate motives for sponsorship have changed over time. Whereas the early motives were primarily philanthropic in nature, along with an image and awareness focus, emphasis has shifted to motives associated with more quantifiable business objectives, namely, sales and market share (Lough, Irwin, & Short, 2000). However, within the last decade, another shift has occurred where CSR has taken on greater importance (Dean, 2003). For many organizations, this has extended into the sponsorship realm, as evidenced by market research conducted by Sponsorium, which reported that there has been an increase in the attention paid by sponsors to CSR elements of their deals in the last two years (Sport Business, 2009).
This emphasis on CSR is also related to purchase intentions and loyalty. For example, in GlobeScan research done for Hewlett-Packett Canada Co. in 2007, 92% of survey respondents indicated that they are more likely to purchase products that come from companies that are socially and environmentally responsible. Further, 91% of respondents indicated that they prefer to work for these same types of companies. Similarly, Marin, Ruiz, and Rubio (2009) found that CSR initiatives were linked to consumer loyalty because of a more positive evaluation as well as a stronger identification the consumer has with a company that chooses to engage in CSR practices. They noted that consumers might evaluate an organization based on consistency in which the entity supports the greater welfare of the community and society.
Although they commented that criteria such as price, quality, and brand familiarity are most important to consumers, their findings suggest that CSR is less of a short-term profited minded strategy and more of a relationship that develops over time helping to create brand loyalty. These findings support the notion that companies must embrace CSR and make it part of their brand message.

Sport organizations are no exception and may similarly engage in CSR initiatives because of the belief that such efforts help foster perceived consumer value for their brand (Babiak & Wolfe, 2007). Though this study does not examine CSR from the perspective of organizations engaging in direct initiatives (e.g., charitable donations, cause-marketing activities), it does suggest that the "strategic choice" in sport sponsorship can "fit" within a CSR framework. The active choice of organizations to take a stand against forming relationships with organizations or other brands that may not be in congruence with their own values is arguably a "strategic marketing perspective" that lends support to being socially responsible.

Technoligical advance and every people wants to go a head of other, dosent have much time to spend for food preparation looking for the alternative resource to get easy meal which is fast food, which is resulting to obesity (Ethical Learning and Growing)

Researcher required source of fund to do research which busiess is providing, Researcher thinking about their cost that they have to endure to complete the research, Research is funded by one of the reason obesity is occurring, However cocacola is just one of the many junk food provider.

Providing the fund obeasly will help orginisatoin to gain positive feedback from the researcher since they are the major source of income for theire research

Researcher are following Teleological Ethics if lying in a particular situation leads to greater happiness than not lying, it is good to lie in those circumstances: the liar is good (in those circumstances) and the truth-teller bad. The second thing is that, in principle, this system can give an answer to any circumstances in which a person finds themselves – there is no dilemma, no situation where the good thing is impossible – simply calculate the various amount(s) of happiness which would result then do the one that leads to the greatest.

Case Analysis Guidelines
The guidelines presented below have been designed to help you analyze the cases that follow. The guidelines are presented in three stages, but they are not intended to be a rigid format. Each question is designed to elicit information that will help you in analyzing and resolving the case. Each case is different, and some parts of the guidelines may not apply to every case. The questions for discussion at the end of each case should be addressed in any complete case analysis. Use the Issue/Problem Identification and Analysis/
Evaluation steps to focus on generating and defending the most effective set of recommendations possible, because the objective of case analysis is making recommendations.
In all stages of the case analysis, use the stakeholder, ethics, sustainability, and corporate social responsibility (CSR) concepts presented in the text.
Issue/Problem Identification

Immoral Management
Using immoral and unethical as synonyms, immoral management is defined as an approach that is devoid of ethical principles or precepts and at the same time implies a positive and active opposition to what is ethical. Immoral management decisions, behaviors, actions, and practices are discordant with ethical principles. This model holds that the management’s motives are selfish and that it cares only or primarily about its own or its organization’s gains. If the management’s activity is actively opposed to what isand yet chooses to do wrong; thus, its motives are deemed greedy or selfish. In this model, the management’s goals are profitability and organizational success at virtually any price. The management does not care about others’ claims to be treated fairly or justly.
What about the management’s orientation toward the law, considering that law is often regarded as an embodiment of minimal ethics? Immoral management regards legal standards as barriers that the management must avoid or overcome to accomplish what it wants. Immoral managers would just as soon engage in illegal activity as in immoral or unethical activity. This point is illustrated in a popular Dilbert comic strip. Dogbert, the VP of Marketing, announces at a meeting: “It’s my job to spray paint the road kill.” In panel 2 he says: “I’ll use a process the experts call ‘dishonesty.’ ” In panel 3, Dilbert concludes:
“My motto is, ‘If it isn’t immoral, it probably won’t work.’

Operating Strategy The operating strategy of immoral management is focused on exploiting opportunities for corporate or personal gain. An active opposition to what is moral would suggest that managers cut corners anywhere and everywhere it appears useful.
Thus, the key operating question guiding immoral management is, “Can we make money with this action, decision, or behavior, regardless of what it takes?” Implicit in this question is that nothing else matters, at least not very much. Figure 7-7 summarizes some of the major characteristics of immoral managers

Primary and Secondary Stakeholders
A useful way to categorize stakeholders is to think of them as primary and secondary as well as social and nonsocial; thus, stakeholders may be thought of as follows15:
Primary social stakeholders include: Secondary social stakeholders include:
• Shareholders and investors • Government and regulators
• Employees and managers • Civic institutions
• Customers • Social pressure/activist groups
• Local communities • Media and academic commentators
• Suppliers and other business partners • Trade bodies
• Competitors

Obesity and health problem are increasing; obesity can be seen in all age group, health problem especially in children and adolescents are identified more. According to International Obesity Task Force, 2004, worldwide 155 million of adolescent and school age children show overweight or obesity symptoms. 30 – 45 million obese children and adolescent are between 5 – 17 years, which mean every tenth child worldwide is overweight. Current ratio of childhood obesity is 10 times higher than 1970 and its steadily continue growing annually. The obesity rate is increasing throughout the world’s population with the different ratio. From 1980 to 2000, the prevalence of obesity rose from 12% – 20% in US, Australia has one of the highest growth of obesity from 8 % to 20 %,UK experience increment of 7% -16% , Netherland experience of smaller increment of 5- 8% Sedentary lifestyle, Low physical work and consuming of junk food are the major causes for obesity.
The prevalence of obesity is increasing throughout the world’s population. But the distribution varies greatly between and within countries. In the US, over the past 30 years, the prevalence of obesity rose from about 12–20% of the population from 1978 to 19908. The UK has experienced an increase in the prevalence of obesity from 7% in 1980 to 16% in 19958 . Other countries, such as The Netherlands, have experienced much smaller increases from a low baseline of about 5% in the 1980s to about 8% in 19979. In Asia, the prevalence of obesity has rapidly increased. In the last 8 years the proportion of Chinese men with a body mass index (BMI) .25 kg/m2 has tripled from 4 to 15% of the population and the proportion in women has doubled from 10 to 20%10. Pacific populations have some of the world’s highest prevalence rates of obesity. The proportion of men and women with a BMI .30 kg/m2 in Nauru was 77% in 199411 and for Pacific people living in New Zealand in the early 1990s the prevalence rates were about 65–70%12. The obesity epidemic moves through a population in a reasonably consistent pattern over time and this is reflected in the different patterns in low- and high income countries. In low income countries, obesity is more common in people of higher socioeconomic status and in those living in urban communities. It is often first apparent among middle-aged women. In more affluent countries, it is associated with lower socioeconomic status, especially in women, and rural communities13,14. The sex differences are less marked in affluent countries and obesity is often common amongst adolescents and younger children. How obesity is effecting

The annual increase in childhood obesity has been steadily growing, and the current rate is 10 times higher than in the 1970s [3]. Obesity can be effectively counterbalanced with physical activity (PA). Physical activity reduces the increase of the fat tissue [38], body fat deposits or the size of fat cells [23, 28, 40].

According to the report publish by International Obesity Task Force
On the other hand low physical activity and a sedentary lifestyle are related to prevalence of obesity [10, 12-15, 18, 44]. According to this, obesity and low PA may be effectively counteracted with physical education. There are several international programs aimed at development of children’s and adolescents’ health awareness through changes in physical education at school. A good example of such an initiative is the project Health(a)ware: An experienced-based learning and teaching approach for physical and health education (128737-CP-1- 2006-1-DE-Comenius-C2), funded by the European Commission in the Socrates-Comenius Program and carried out in six European countries: Austria,
Czech Republic, Germany, Norway, Poland and Spain
In this regard the increasing prevalence of obesity in all age groups, and specifically in children and adolescents is seen as one of the main health problems in Europe [11, 24, 35]. According to reports of the International Obesity Task Force [19] 155 million school-age children and adolescents worldwide show symptoms of obesity or overweight. Among those 30-45 million are obese children and adolescents aged 5-17 years, which means that every tenth child worldwide is overweight [22] (Table 1). The annual increase in childhood obesity has been steadily growing, and the current rate is 10 times higher than in the 1970s [3]. Obesity can be effectively counterbalanced with physical activity (PA). Physical activity reduces the increase of the fat tissue [38], body fat deposits or the size of fat cells [23, 28, 40].

In the following part some selected aspects of the health status of children and adolescents in Austria are outlined, first of all, the BMI of Austrian youth. In 2006, about 12.4% of all Austrian pupils had an increased BMI (boys 16.6%; girls 8.3%), and 3.1% were labeled “obese”. 35.9% of the pupils think that they are too fat (boys 28.9%, girls 42.8%), the feeling of being too fat increases especially among girls as they get older (11-year old girls: 33.6%; 15-year-old girls: 49.4%). Compulsory P.E. lessons comprise four hours a week in the 1st and 2nd grades (10- and 12-year-old pupils), and three hours a week in the 3rd and 4th grades (13- and 15-year-old pupils) [2]. Kleiner [21] assessed PA by means of the “sport activity index” comprising seven items.

There is agreement that obesity rates, and associated health problems are increasing worldwide2–4. Ahmad5 claims that obesity across adults and children accounts for 40 billion of total treatment costs for heart disease, diabetes, high blood pressure, gallbladder problems and some types of cancers in the USA alone.

There is however, little agreement regarding the exact causes of the growing ‘obesity epidemic’, although there is a growing recognition that there may be a number of inter-related genetic and environmental factors that contribute to the problem.6 Further, the widespread assertion that obesity is responsible for a number of deaths annually (some 300,000 annually in the USA alone) may not be as clear-cut as often reported.7,8 There is a very real danger however that, in criticising the current focus on weight loss, obesity and its associated dangers will be trivialized. Nevertheless, the body of evidence supporting the significant health risks of excess weight in the context of overall poor quality lifestyles should not be ignored.9 The quote below perhaps sums up some of the frustrations experienced by those searching for effective solutions.

The prevalence of obesity is increasing throughout the world’s population. But the distribution varies greatly between and within countries. In the US, over the past 30 years, the prevalence of obesity rose from about 12–20% of the population from 1978 to 19908 . The UK has experienced an increase in the prevalence of obesity from 7% in 1980 to 16% in 19958 . Other countries, such as The Netherlands, have experienced much smaller increases from a low baseline of about 5% in the 1980s to about 8% in 19979 . In Asia, the prevalence of obesity has rapidly increased. In the last 8 years the proportion of Chinese men with a body mass index (BMI) .25 kg/m2 has tripled from 4 to 15% of the population and the proportion in women has doubled from 10 to 20%10. Pacific populations have some of the world’s highest prevalence rates of obesity. The proportion of men and women with a BMI .30 kg/m2 in Nauru was 77% in 199411 and for Pacific people living in New Zealand in the early 1990s the prevalence rates were about 65–70%12. The obesity epidemic moves through a population in a reasonably consistent pattern over time and this is reflected in the different patterns in low- and high income countries. In low income countries, obesity is more common in people of higher socioeconomic status and in those living in urban communities. It is often first apparent among middle-aged women. In more affluent countries, it is associated with lower socioeconomic status, especially in women, and rural communities13,14. The sex differences are less marked in affluent countries and obesity is often common amongst adolescents and younger children. How obesity is effecting

Obesity and health problem are increasing; obesity can be seen in all age group, health problem especially in children and adolescents are identified more. According to International Obesity Task Force, 2004, worldwide 155 million of adolescent and school age children show overweight or obesity symptoms. 30 – 45 million obese children and adolescent are between 5 – 17 years, which mean every tenth child worldwide is overweight. Current ratio of childhood obesity is 10 times higher than 1970 and its steadily continue growing annually. The obesity rate is increasing throughout the world’s population with the different ratio. From 1980 to 2000, the prevalence of obesity rose from 12% – 20% in US, Australia has one of the highest growth of obesity from 8 % to 20 %,UK experience increment of 7% -16% , Netherland experience of smaller increment of 5- 8% Sedentary lifestyle, Low physical work and consuming of junk food are the major causes for obesity.
The prevalence of obesity is increasing throughout the world’s population. But the distribution varies greatly between and within countries. In the US, over the past 30 years, the prevalence of obesity rose from about 12–20% of the population from 1978 to 19908. The UK has experienced an increase in the prevalence of obesity from 7% in 1980 to 16% in 19958 . Other countries, such as The Netherlands, have experienced much smaller increases from a low baseline of about 5% in the 1980s to about 8% in 19979. In Asia, the prevalence of obesity has rapidly increased. In the last 8 years the proportion of Chinese men with a body mass index (BMI) .25 kg/m2 has tripled from 4 to 15% of the population and the proportion in women has doubled from 10 to 20%10. Pacific populations have some of the world’s highest prevalence rates of obesity. The proportion of men and women with a BMI .30 kg/m2 in Nauru was 77% in 199411 and for Pacific people living in New Zealand in the early 1990s the prevalence rates were about 65–70%12. The obesity epidemic moves through a population in a reasonably consistent pattern over time and this is reflected in the different patterns in low- and high income countries. In low income countries, obesity is more common in people of higher socioeconomic status and in those living in urban communities. It is often first apparent among middle-aged women. In more affluent countries, it is associated with lower socioeconomic status, especially in women, and rural communities13,14. The sex differences are less marked in affluent countries and obesity is often common amongst adolescents and younger children. How obesity is effecting