Fighting Fit
ResPublica's Sandra Gruescu on just how we deal with a problem like obesity
It might be an epidemic, a time bomb or just a trend, but we know for sure that more people will be obese in the future. There is no example anywhere in the world where the obesity trend has been reversed. And Britain, or rather its people, are bang on trend.
Today there around 525 million obese people globally, a figure that outstrips the incidence of under-nutrition and implies catastrophic medical costs for hundreds of millions. The prevalence of obesity is particularly relevant in Britain, where the combined rate of obesity across age ranges and sexes is the highest of Europe. The harmful consequences associated with obesity are widely documented. Obesity and physical inactivity may account for 25 to 30 percent of several major cancers and current levels of overweight and obesity could lead to around 19,000 cases of cancer each year. There are also increased risks of developing Type 2 diabetes, of coronary heart disease, osteoarthritis and back pain. As a result of general physical problems, an obese individual is likely to die 11 years earlier than a healthy-weight individual, and more frequently suffer social stigma and psychological consequences such as depression and low self-esteem can be caused by being very overweight. These factors demonstrate how being overweight or obese can cause both physical and psychological hardship.
The difficulty that obesity poses to politics and society is that, in a similar fashion to climate change, the problem stems from the structural aspects of society as these have evolved over the past years. Research has emphasised the predominant role of social variables in the creation of an ‘obesogenic environment': the prevalence of labour-saving technology, the characteristics of the urban lifestyle, and the open encouragement of food buying and consumption, have created an environment which facilitates and encourages individuals to live in an unhealthy manner. These factors and their impact on the weight and health of community members are not evenly distributed across society, as access to technology, the built environment, opportunities for physical activity, food and drink availability, and food purchasing capacity do not present themselves to each individual in the same way.
However, most of the approaches to tackling the issue either arrive at the problem from the perspective of personal choice involving consumption of food, or a diverse range of indirect social factors. Within the political sphere, responsibility for obesity is placed at the feet of individuals. Alan Johnson, the (then) Secretary of State for Health, has commented that ‘the core of the problem is simple – we eat too much and undertake too little physical activity', and Gordon Brown, the Prime Minister, has corroborated this by stating that ‘there should be no doubt that maintaining a healthy weight must be the responsibility of individuals first'. Similarly the Conservatives have concentrated on the personal choices of those overweight or obese members of society, commenting in their Policy Green Paper on ‘A Healthier Nation' that ‘we need to promote more responsible behaviour and encourage people to make the right choices about what they eat, drink and do in their leisure time'. The question is – how do we promote the development of this desired behaviour change in so many of the population? And what kind of choice do you have when you live in an area where there is virtually no fresh food available but plenty of chips and crisps and crap shops?
Obesity is a complex issue that will require a multifaceted response capable of covering the individual, community and national levels while giving direct benefits in the short and the long-term. It won't be enough to introduce fitness test in schools and to simply send letters to parents berating them for doing a bad job because their children have failed (not the SATs, the fitness test). Current politicians love to blame the parents, but politicians and local authorities could also take at least a (big) part of the blame by not providing better and cheaper sport facilities, having more sports clubs and more green spaces for kids to run around in, and encouraging the opening of shops with fresh, healthy and economical food available for all.
Finally, common sense might also help. Baby food manufacturers are banned from using artificial sweeteners and preservatives in their products, but this does not apply to food served in nurseries where the quality can be poor, a new report by the School Food Trust has found. So now Ed Balls believes we need to throw some money at a “national review of nursery food” where a panel of experts will consider whether unhealthy food, widely known as ‘junk food' should be banned in nurseries. This focuses only on one aspect of the problem and fails to account for the varied, complex nature of Britain's obesogenic environment. But then again, maybe the name of the food should already give a clue and render this review obsolete?