The government has decided that we must stop being so obese. We are putting the National Health Service under strain by going around having obesity-related health problems, particularly by making ourselves susceptible to covid.
The government has therefore announced a “war on obesity”, which includes:
- Banning junk-food advertising on TV before 9pm
- Ending buy-one-get-one-free offers on foods high in sugar, salt and fat
- Displaying calories on menus
- Bombarding us with propaganda about how being thinner will make us so much happier as well as making us good citizens
Raise your hand if this bothers you a bit. Actually, raise your hand if it bothers you a lot.
(You may wish to note that the anti-obesity strategy was announced mere days before the launch of the Eat Out To Help Out initiative, which aims to boost the stricken restaurant industry by offering discounts at restaurants including McDonald’s and Burger King.)
Here are some things the government might have done well to reflect on before launching a crusade against our curves:
WHAT DO YOU WANT – A THIN POPULATION OR A HEALTHY POPULATION?
I read an article recently by a doctor who was struck by the fact that the medical gospel compelled her to instruct her overweight patients to control what they ate and exercise more, yet at the same time she was trying to help her patients with eating disorders disengage from the same behaviours. In effect, she was supposed to encourage her overweight patients to behave in ways associated with eating disorders.
This disturbed her. She realised that the health benefits associated with weight loss mostly came not from the weight loss itself but rather from healthy habits. She then adjusted her treatments to focus on healthy lifestyle rather than weight.
This doctor was alert enough to work out that what she was trying to achieve was not thin patients but healthy patients.
Boris Johnson and his government have not worked this out. Yes, maybe the National Health Service is under strain that it wouldn’t be under if the prevalence of obesity in the population were lower.
That does not mean that the problem you’re trying to solve is that too many people are fat. The problem is that too many people are unhealthy. And although there may be some correlation between these two things, they are not one and the same. As this article explains:
Studies have found that anywhere from one-third to three-quarters of people classified as obese are metabolically healthy. They show no signs of elevated blood pressure, insulin resistance or high cholesterol. Meanwhile, about a quarter of non-overweight people are what epidemiologists call “the lean unhealthy.” A 2016 study that followed participants for an average of 19 years found that unfit skinny people were twice as likely to get diabetes as fit fat people. Habits, no matter your size, are what really matter. Dozens of indicators, from vegetable consumption to regular exercise to grip strength, provide a better snapshot of someone’s health than looking at her from across a room.
And here’s the other thing: if you do succeed in bullying an entire cohort of citizens into losing weight but also into developing eating disorders in the process, then you have not only failed to solve a public-health problem but also created an additional one.
WHAT DO YOU THINK YOU’LL ACHIEVE BY MAKING PEOPLE FEEL BAD ABOUT THEMSELVES?
Does Boris Johnson think that overweight people don’t know they’re overweight? Does he think society doesn’t give them enough negative messaging about it? Does he think many of them aren’t exasperated and perhaps even traumatised by repeatedly trying and failing to lose weight? Does he think moralising at people about how they are damaging their health and putting the NHS under strain is going to solve anything?
As James Corden says at 4:13 in the clip below, “Fat-shaming is just bullying, and bullying only makes the problem worse”:
A newly trim Boris Johnson, who was briefly hospitalised with covid, tries to soften the message by saying “I was too fat. But now I start the day by going for a run. With the dog” as if to say “I’m like you!” (see the clip below). But that doesn’t make it OK. Maybe he can go for a run every morning with the dog; that doesn’t mean that everyone can or that everyone would miraculously go thin and healthy even if they could.
BEFORE TELLING PEOPLE TO “JUST EAT LESS AND MOVE MORE”, MAYBE LOOK AT THE BIGGER PICTURE
We are far too quick to judge people who are overweight and assume it’s because of their choices: they must choose to eat too much or exercise too little, right?
No. You never know why someone is overweight, and it’s worth bearing in mind that it may be for reasons that they have little control over.
Perhaps they have a health issue that causes them to gain weight.
Perhaps they have been raised on an unhealthy diet and don’t know how to eat any differently.
Perhaps they don’t know how to cook.
Perhaps they can’t afford good-quality food.
Perhaps they can’t afford any food at all and rely on tinned, processed food from food banks.
Perhaps they don’t know how to exercise without guidance.
Perhaps the only fitness options available to them are unaffordable.
Perhaps they suffer from chronic pain or have a physical disability that makes exercising difficult.
Perhaps they are too exhausted to look after themselves because they are working long hours at minimum wage to support their families.
Perhaps they don’t have any time to themselves because childcare is so prohibitively expensive.
Perhaps they have all sorts of responsibilities, about which you know nothing, which leave them no time to exercise or prepare proper meals.
Perhaps they are depressed and can’t bring themselves to make the effort of cooking or exercising.
Perhaps they have been through some sort of trauma and deal with it by overeating.
Perhaps the “you should be thin” messages have damaged their sense of self-worth to the extent that they don’t believe there’s any point in investing in themselves.
In all of these cases and more, telling people to “eat better and exercise more” is completely unhelpful.
And, yes, perhaps in some cases someone’s weight issues are simply because of bad habits, but that doesn’t mean they can “just eat better and exercise” just like that. Have you ever tried to change a habit?
Here’s the thing:
When lots of individuals have the same problem, perhaps the problem is societal.
Please look once more at the list above and ask yourself: how many of these issues say something about the individual and how many say something about society?
Now look through the list again and ask: how many of these problems could the government tackle without resorting to bullying or nannying?
Imagine if we were taught to view obesity as a result of health problems not as a cause of them.
Imagine if healthy food were the cheapest and most accessible food.
Imagine if cooking were taught in schools, producing citizens who know how to feed themselves and their families healthily.
Imagine if every neighbourhood had a gym or sports centre that was free for local residents to use.
Imagine if childcare were more affordable, giving parents breathing space to look after their own needs.
Imagine if wealth were more evenly distributed.
Imagine if job security and decent wages were the norm, easing people’s money-related stress and allowing them to work fewer hours and invest more in their and their families’ wellbeing.
Imagine if more people had access to secure housing, allowing them to put down roots in one place and build strong communities, alleviating the health issues – physical and mental – caused by stress, insecurity and isolation.
Please look at the following graph and tell me if obesity is an issue of individuals or an issue of society:
CAN WE STOP TALKING ABOUT OBESITY NOW?
If you want to slow the spread of coronavirus and take the strain off the NHS, Mr Johnson & company, may I suggest that you start by:
(a) developing a clear strategy for dealing with the pandemic;
(b) rethinking the complex and expensive obstacle course that immigrant medical and social-care workers must navigate in order to come into the UK and keep the health and social-care system afloat;
(c) looking at ways to build a society in which people are genuinely supported when they have difficulties, not made to feel guilty?
Thank you. I have nothing more to say on the matter.
Except: please watch the talk below (or at least read the transcript):
And please read this article: Everything you know about obesity is wrong.