How far should we go in tackling the 'obesity
In the UK, obesity is fast becoming public health enemy number
one. Almost one in four five-year-olds and one in three
11-year-olds is overweight or obese, according to a recent national
survey. On current trends, 60 per cent of men, 50 per cent of women
and 25 per cent of children could be obese by 2050. This century,
obesity could supersede tobacco as the greatest cause of premature
death 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?
Does the food industry have any responsibility? (See
Big Picture on Obesity.)
Obesity is a deceptively complex issue. Its 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.
A report from the Nuffield Council on Bioethics in 2007 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, has created an obesogenic
As detailed in 'Big Picture on Obesity', the body has
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.
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 survey of HR professionals in 2007 found that, all
other things being equal in a two-horse race, 93 per cent would not
employ a fat candidate.
And 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.