How far should we go in tackling the ‘obesity epidemic’?
In the UK obesity is fast becoming public health enemy number one. Around one in ten five-year-olds and one in four 11-year-olds in England are obese, according to a survey carried out in 2012/13. Based on current trends, at least half of the UK population are expected to be obese by 2050. Obesity may already be the cause of more ill health than smoking in this country.
While few doubt that obesity is a health issue for individuals and society more generally, what can – or should – be done about it is less obvious.
Is it a matter for individuals? Or the government? Should the food industry take any responsibility?
Obesity is a deceptively complex issue. Our bodies have physiological systems to maintain body weight, with the hypothalamus playing a critical role in assessing the body’s energy needs and regulating appetite and exercise.
Yet the body’s response to weight gain – rare before the 20th century – is much less powerful than its response to weight loss.
Obesity’s causes are simple enough – people consume more calories than they burn off. The obvious solution, then, is that people eat less and exercise more. Yet a strong genetic component to weight and a highly obesogenic environment make this solution far harder to achieve in practice than it sounds.
Some health experts have pointed out that it is actually very difficult not to put on weight in the current environment. The ready availability of food, much of it rich in calories and heavily marketed, together with reduced opportunities for physical exercise, have created an obesogenic environment. A 2014 report by the National Institute for Health and Care Excellence suggested the government could be doing more to limit the availability of unhealthy foods.
Attitudes to obesity are generally negative – a judge on ‘Dragon’s Den’ has publicly said that he would not employ a fat person, while a 2012 study found that employers rated obese job applicants’ CVs lower when photos that were taken before weight-loss surgery were attached, as opposed to when post-surgery photos were attached.
NHS advice on obesity states that “while there are some...genetic conditions that can cause obesity...there is no reason why most people cannot lose weight”.
But while exhortations to eat less and exercise more might be well-intentioned, there is a risk that they send negative messages to those struggling to contain their weight. There is already evidence that the overweight are stigmatised and discriminated against. Constant messages that obesity is a ‘bad thing’ run the risk of reinforcing negative attitudes.
Many people would argue that our weight is wholly within our power to control – we just need to exercise some willpower. The evidence all around us, and from biology, suggests this is an unrealistic and unreasonable presumption.