Obesity policy in Portugal: epidemiology, sociology and the limits of prevention

Abstract Obesity prevention has become a prominent public health priority in Portugal, yet policy responses continue to engage unevenly with the social conditions through which obesity is produced and distributed. This paper examines Portuguese obesity policy through an integrated sociological and epidemiological perspective, arguing that its limitations are fundamentally sociopolitical rather than technical. Drawing on sociological theories of embodiment, class, gender, stigma, and power, it conceptualises obesity as an embodied expression of social inequality rather than solely an outcome of individual behaviour. The paper has three interrelated aims: first, to examine how epidemiological and sociological perspectives conceptualise obesity and its determinants, and the implications of these perspectives for prevention policy in Portugal; second, to analyse how recent obesity policies frame responsibility and address structural determinants through their strategies and instruments; and third, to explore how class, gender, and stigma shape the implementation and effects of these policies, and how alternative sociological framings might support more equitable prevention. Using Portugal as a case study, the paper analyses how welfare arrangements, political dynamics, and institutional framings shape national obesity strategies, including recent regulatory and environmental interventions. While these policies signal a shift towards upstream action, dominant discourses still prioritise personal responsibility, often misaligned with the economic, temporal, and social realities that structure everyday practices, particularly among women and socioeconomically marginalised groups. The analysis shows that obesity-related stigma arises not simply from interpersonal attitudes, but from institutional and political processes that legitimise culpability narratives and depoliticise structural determinants of health. More equitable obesity prevention requires moving beyond technical policy instruments towards a Health in All Policies approach that challenges moralised framings of responsibility and addresses the broader social, economic, and political conditions shaping obesity risk and lived experience