Monday 2 June 2014

Some things the world needs to remember about obesity


I take the view that obesity is the fat person's problem and not a consequence of some wider problem with society. But this aside, the end of our great binge means that rates of obesity (and drunkenness and drug-taking) are falling. Not surprisingly the first evidence of this change is coming from the current cohort of young people.

So I thought I'd share a little evidence about obesity and a few of the myths (and downright lies) that the advocates of more control put about.

1. There aren't good calories and bad calories (although a balanced diet is about a lot more than just total calorie intake). Getting fat means, very straightforwardly, that you are consuming more calories that you need in your daily life. So if you want to lose weight you need to consume fewer calories and expend more energy.

2. Obesity, certainly in the developed world, is inversely related to income and 'social class' - in essence the poorer people are the more likely it is that they will be obese. Referring to the point above, this isn't because they are more exposed to an 'obesogenic' environment (or any other pseudo-scientific sociological claptrap) but because they are consuming more calories than they are using. As developing countries get richer this pattern is being repeated.

3. Carbohydrates are the dominant source of our calorific intake. People from lower socio-economic and income groups consume (on average per capita) significantly more carbohydrates than the rest of the population. This is because the evolution of our food business has emphasised the production of carbohydrates because they are by far the cheapest reliable source of food energy.

4. Sugar is not the main guilty party in obesity (although obese people do consume more sugar than non-obese people). World sugar consumption has doubled but this is almost entirely explained by two factors - population increase and reduced poverty in the developed world. In the UK per capita sugar (non-dairy extrinsic sugars - that's all the sugar we add plus honey) consumption has fallen.

5. Definitions of obesity (typically 'body mass index' or BMI in excess of 30) do not relate well to the actual health risks associated with weight. There is little evidence to support the contention that a BMIof 30-35 is an indicator of future health problems.

It seems reasonable to assert that being very overweight - 'morbidly obese' - is pretty unhealthy and contributes to a host of health problems including diabetes, liver disease, coronary heart disease and chronic joint problems. And the best advice to the one-in-twenty women and one-in-fourty men who fall into this category is to lose weight (and we should provide support to that weight loss through our health system). But, by problematising weight levels that are not a significant (or indeed identifiable) health risk, we are encouraging those who see weight as an all population problem rather than a problem for a minority. This is a disservice to that minority (as it detracts from our response to their problem) and results in ineffective policy initiatives such as fat taxes, advertising restrictions and limits on fast food businesses.


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