The UK has a growing obesity problem. According to the annual Health Survey for England in 1980 6 per cent of men were obese – that is they had a Body Mass Index of over 30. By 1993 this had more than doubled to 13.2 per cent and by 2011 23.6 per cent of men were obese. The medical problems associated with obesity are well known – Type 2 Diabetes, Coronary Heart Disease, hypertension, respiratory problems, stroke and certain cancers. The Government’s 2007 landmark Foresight report estimates that by 2050 obesity and being overweight could cost the NHS £9.7 billion, with the wider cost to society estimated at £49.9 billion.
So who or what is to blame for the rise in obesity? “Ultimately it comes down to will”, argued Eastern Daily Press columnist Steve Downes recently. “What can society do to change people’s habits? Nothing, really.” You might expect the author of the best-selling memoir My Mad Fat Teenage Diary to have a wider lens of analysis. If so you’d be wrong. Writing in The Guardian last month Rae Earl noted people are often obese because of “deep-rooted psychological factors.” As adults, Earl concluded, “our weight is our personal responsibility.”
We shouldn’t be too hard on Downes and Earl – they are simply repeating popular arguments that blame obesity on the individual. As a 2010 article in the peer-reviewed journal Health Affairs explains “studies demonstrate repeatedly that judgments about obesity are linked to values of individualism, self-determination, political conservativism, and secular morality.”
There are many problems with focussing on individual behaviour when discussing obesity. First, a culture that points the finger at individuals can stigmatise, leading to bullying, discrimination and mental health problems such as depression. Research shows overweight patients sometimes delay visiting the doctor because of fear of embarrassment or judgment. Second, blaming personal choices does not help to explain obesity levels when one considers obesity has substantially increased since the 1970s and its prevalence differs considerably across national borders and social classes.
As the Foresight report notes “People in the UK today don’t have less willpower and are not more glutoness than previous generations.” And, I would add, British people are not lazier than many of their less obese European neighbours, and middle-class people do not take more personal responsibility than generally heavier working-class people. Discussing the Foresight report, the former Chief Scientific Advisor to the Government Sir David King notes “individuals have much less choice in the matter of their weight than they would assume”. This is especially true for the poorest members of society, who tend to have much less control and choice over how they live their lives. So rather than obesity being down to personal willpower the Foresight report explains society “has radically altered over the past five decades with major changes in work patterns, transport, food production and food sales.” These changes have resulted in what experts call an "obesogenic environment", where the political and economic structures of society end up actually encouraging obesity among the population
Some of these societal shifts include: a huge increase in the availability and affordability of calorie-dense but nutrient-poor processed foods; an increase in private car use and a corresponding decrease in the level of cycling and walking; the selling off of school playing fields; a lax planning system that has led to out-of-town supermarkets and fast food outlets being placed close to schools; healthy food ‘deserts’ in poor areas. In addition there has been a massive increase in the level of food advertising. With the UK having the dubious distinction of being the advertising capital of Europe, Food Analyst Cindy van Rijswick notes “the impact of promotions, advertising and marketing from the processed food industry is higher than in other countries.”
Arguably, many of these causes can be traced back to the neoliberal turn the country took with the election of Margaret Thatcher in 1979 and the pro-business and individualistic rhetoric and policies that followed. In a letter to The Guardian earlier this year, the Secretary of The Equality Trust explained that research “shows more people are obese in more unequal countries”. And sure enough the US, UK and Australia – arguably the three Western nations where the grip of neoliberal thinking is strongest – have some of the highest levels of obesity in the Western world.
If an individualistic analysis can’t explain the rise in obesity, it’s unlikely to be useful in solving the problem either. In fact personalising the problem makes solving the crisis harder, according to Dr Rebecca Puhl of the Rudd Center for Food Policy & Obesity at Yale University: “As long as we have this belief that obese people are lazy and lacking in discipline, it will be hard to get support for policies that change the environment, which are likely to have a much larger impact than trying to change individuals”.
So if the rise in obesity is due to a wholesale transformation of society, then the solutions will also have to be on the same scale – led by strong government action. Radically changing the transport system so it discourages private car use and builds infrastructure to encourage cycling and walking would be a first step. The planning system needs to be altered so it encourages health living, rather than working to maximise profits for the food industry. Advertising of unhealthy foods, especially to children, needs to be highly regulated as it is in Sweden where TV advertising aimed at children under 12 has been banned since 1991. And taxes could be levelled on unhealthy foods, as Mexico is about to do.
All this, of course, would require the Government to take on corporate power. However, Professor Tim Lang and Dr Geof Rayner from the Centre for Food Policy at City University point out “there is a powerful temptation in Government to limit actions to a choice-based, personalization approach, in part because this style of intervention is aligned to the commercial sector’s own customer management and marketing methods.”
Indeed corporate influence on Government policy is so great that in 2010 The Guardian made the eye-popping revelation that “The Department of Health is putting the fast food companies McDonald's and KFC and processed food and drink manufacturers such as PepsiCo, Kellogg's, Unilever, Mars and Diageo at the heart of writing government policy on obesity.”
“Either you have democracy or you have private power – you can’t have both”, wrote Robert Newman in his 2003 novel The Fountain At The Centre Of The World. I’d like to amend Newman’s wise words in terms of obesity: Either you have a healthy population or you have private power – you can’t have both.
Ian Sinclair is a freelance writer based in London and the author of The March That Shook Blair: An Oral History of 15 February 2003, published by Peace News Press. He can be contacted at firstname.lastname@example.org and https://twitter.com/IanJSinclair.