The alarming increase in obesity in recent decades constitutes a formidable public health challenge (Henry 2001). But the increasing weights of the population have implications beyond clinical impact of obesity for a public-health approach to prevention. This paper will argue that substantial reductions in the prevalence of obesity are more likely to come from structural and policy related changes to the environment than from medical interventions targeted to the individual.

Caribbean people are eating too much for their level of activity. But the problem is not merely at the individual and group level. Yet current Caribbean focus is on promoting changes in dietary and physical activity behavior at the individuals and group level. It would be a mistake to continue focusing only on this narrow perspective. This is because exhalting people to change their behaviors to improve the quality of their diet and their physical activity level is unlikely to succeed in an environment in which there are plentiful inducements to engage in opposing behaviors that can lead to a chronic positive energy imbalance. The proposal here is therefore on environmental and population strategies , not in opposition to individual strategies, but in support of them.

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