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Leave the fat alone state bullying won't curb obesity
Minette Marrin
http://www.timesonl ine.co.uk/ tol/comment/ columnists/ minette_marrin/ article4641974. ece
Fat is not a feminist issue, despite what feminists used to say. It is
a class issue. Well-to-do, well educated people are rarely fat, still
less obese. You see few fat children in private schools. Fatness and
obesity are directly related to low income and low education.
A fat map was published last week by Dr Foster Intelligence, showing
the areas with the fattest populations, and sure enough the poorest
industrial areas in the north of England and in Wales produce the most
obese people. The problem seems to be getting worse, fast.
You hardly need expert medical data analysis to understand that. You
need only to go to a few supermarkets. At a Tesco in western Scotland
this summer I was astonished by the number of horribly obese shoppers
waddling round the aisles with their elephantine children, who could
not possibly have squashed themselves into an ordinary one-person
chair. Young women, with eyes reduced to slits by the pressure of the
fat on their faces, laughed grimly with each other as they scanned the
shelves. And this is a rich country.
Even though the vast Oban Tesco is full of good food, the trolleys at
the checkout were heaped with stuff that is either useless or
positively bad to eat crisps, snacks, swizzlers, twizzlers and
guzzlers, cheesy dips and fatty whatsits, cakes puddings and pies,
heavily dusted in additives. The obese seem to fill their carts
regularly with several times their own weight in eatables that can
make them only fatter, that they shouldn't eat and that nobody should
produce, as if they were determined to lay down yet more adipose
tissue. Yet you rarely see such bloated people and trolleys in smart
supermarkets in rich areas. These days you can easily tell people's
precise socioeconomic bracket and body weight by the contents of their
trolleys.
Obesity seems to be the issue of the day, possibly because we are
still in the silly season. Coincidentally last week, Andrew Lansley,
the Tory health spokesman, spoke against obesity in a long speech to
the Reform think tank. He was widely understood as saying that fatties
have only themselves to blame; they must take responsibility for
themselves and their weight because "we all have a choice". And while
that is a slightly unfair take on his speech, he does seem to mean
something of the sort. Yet at the same time he offers what's now
called a whole raft of measures to stop people getting fat. This is
awkward for Conservatives; either you interfere with people's choices
or you don't. Empowerment, a word he used, is often just a weasel word
for state intervention.
The question is why a Conservative government should interfere at all
in people's inalienable freedom to choke on deep-fried Mars bars if
they choose to. The argument is that the fat and the obese (people
with a body mass index over 30, which is something you could spot
without a calculator) cost the country squillions in lost productivity
and increased National Health Service costs. The obese tend to develop
serious illness, particularly heart disease and diabetes, and are,
generally speaking, crocked up and expensive to look after.
Somebody somewhere has come up with a figure for the cost of all this,
which Lansley quotes £7 billion a year, for what it's worth. Last
year's Foresight report said this cost could go up by six times by
2050. And fat is getting fatter so fast. According to NHS figures, the
proportion of obese men in the population rose during Labour's time in
office from 13.2% in 1993 to 23.1% in 2005. Among women it was even
worse, from 16.4% to 24.8%. That is nearly a quarter of all women. If
you consider people who are not obese but overweight (with a BMI of
25-30), 46% of men in England are overweight and 32% of women.
Fat is also an ethnic issue. According to NHS figures published in
2006, Irish and black Caribbean men had the highest incidence of
obesity (25% each) and among women black Africans had 38%, black
Caribbean 32% and Pakistani 28%. So, with migration trends and
immigrant fertility, the costs of obesity are going to rise fast as well.
However, I wonder how much, if anyone knew the facts, the final cost
of obesity would be to the taxpayer. For fat people die sooner and
obese people die much sooner than others, thus relieving the NHS and
the economy of their needs. It's true that obese people need expensive
treatment for diabetes and heart disease before they die, but that
might easily be offset if they had significantly shorter lives and
they do. Current thinking seems to be that the obese die between five
and seven years earlier than otherwise they would.
Few papers I've looked at on this subject discuss the possible
cost-benefit of obesity, although one from an insurance company coyly
mentioned the advantage to pension providers if a person died before
he reached pensionable age. For years I used to argue that smokers
were a net benefit, purely financially speaking, to the exchequer,
because they died early. I still feel rather proud of being the first,
I believe, to get a known expert (Professor Richard Peto in 1993) to
agree publicly to this idea, now accepted. Might not the same be true
of obesity? The real drain on the NHS is geriatric medicine; the obese
might not reach old age.
If the only reason for interfering with what fat people eat is how
much it costs the rest of us, perhaps we should leave them alone. It's
well known that obesity (and fatness) are associated with poor
education, poor housing, poor employment or none, low expectations,
low opportunities and all the rest. These are all social ills that
this government has been trying to deal with for more than a decade.
Yet little has improved and obesity as an indicator of that fact
has swollen vastly while Labour has been in office. What prevents
obesity is a good income, a good education, good opportunities and the
kind of background that develops self-confidence. Prosperity, in short.
Obesity cannot be defeated by taskforces, better labelling on packets
or investing in health accreditation schemes. This has all been tried
and has failed. In the presence of a complex problem, and in the
absence of a workable solution, perhaps it is better to leave people
to their own devices. Nobody can pretend they don't know what they're
doing. They should be left alone to do it.
minette.marrin@ sunday-times. co.uk
Minette Marrin
http://www.timesonl ine.co.uk/ tol/comment/ columnists/ minette_marrin/ article4641974. ece
Fat is not a feminist issue, despite what feminists used to say. It is
a class issue. Well-to-do, well educated people are rarely fat, still
less obese. You see few fat children in private schools. Fatness and
obesity are directly related to low income and low education.
A fat map was published last week by Dr Foster Intelligence, showing
the areas with the fattest populations, and sure enough the poorest
industrial areas in the north of England and in Wales produce the most
obese people. The problem seems to be getting worse, fast.
You hardly need expert medical data analysis to understand that. You
need only to go to a few supermarkets. At a Tesco in western Scotland
this summer I was astonished by the number of horribly obese shoppers
waddling round the aisles with their elephantine children, who could
not possibly have squashed themselves into an ordinary one-person
chair. Young women, with eyes reduced to slits by the pressure of the
fat on their faces, laughed grimly with each other as they scanned the
shelves. And this is a rich country.
Even though the vast Oban Tesco is full of good food, the trolleys at
the checkout were heaped with stuff that is either useless or
positively bad to eat crisps, snacks, swizzlers, twizzlers and
guzzlers, cheesy dips and fatty whatsits, cakes puddings and pies,
heavily dusted in additives. The obese seem to fill their carts
regularly with several times their own weight in eatables that can
make them only fatter, that they shouldn't eat and that nobody should
produce, as if they were determined to lay down yet more adipose
tissue. Yet you rarely see such bloated people and trolleys in smart
supermarkets in rich areas. These days you can easily tell people's
precise socioeconomic bracket and body weight by the contents of their
trolleys.
Obesity seems to be the issue of the day, possibly because we are
still in the silly season. Coincidentally last week, Andrew Lansley,
the Tory health spokesman, spoke against obesity in a long speech to
the Reform think tank. He was widely understood as saying that fatties
have only themselves to blame; they must take responsibility for
themselves and their weight because "we all have a choice". And while
that is a slightly unfair take on his speech, he does seem to mean
something of the sort. Yet at the same time he offers what's now
called a whole raft of measures to stop people getting fat. This is
awkward for Conservatives; either you interfere with people's choices
or you don't. Empowerment, a word he used, is often just a weasel word
for state intervention.
The question is why a Conservative government should interfere at all
in people's inalienable freedom to choke on deep-fried Mars bars if
they choose to. The argument is that the fat and the obese (people
with a body mass index over 30, which is something you could spot
without a calculator) cost the country squillions in lost productivity
and increased National Health Service costs. The obese tend to develop
serious illness, particularly heart disease and diabetes, and are,
generally speaking, crocked up and expensive to look after.
Somebody somewhere has come up with a figure for the cost of all this,
which Lansley quotes £7 billion a year, for what it's worth. Last
year's Foresight report said this cost could go up by six times by
2050. And fat is getting fatter so fast. According to NHS figures, the
proportion of obese men in the population rose during Labour's time in
office from 13.2% in 1993 to 23.1% in 2005. Among women it was even
worse, from 16.4% to 24.8%. That is nearly a quarter of all women. If
you consider people who are not obese but overweight (with a BMI of
25-30), 46% of men in England are overweight and 32% of women.
Fat is also an ethnic issue. According to NHS figures published in
2006, Irish and black Caribbean men had the highest incidence of
obesity (25% each) and among women black Africans had 38%, black
Caribbean 32% and Pakistani 28%. So, with migration trends and
immigrant fertility, the costs of obesity are going to rise fast as well.
However, I wonder how much, if anyone knew the facts, the final cost
of obesity would be to the taxpayer. For fat people die sooner and
obese people die much sooner than others, thus relieving the NHS and
the economy of their needs. It's true that obese people need expensive
treatment for diabetes and heart disease before they die, but that
might easily be offset if they had significantly shorter lives and
they do. Current thinking seems to be that the obese die between five
and seven years earlier than otherwise they would.
Few papers I've looked at on this subject discuss the possible
cost-benefit of obesity, although one from an insurance company coyly
mentioned the advantage to pension providers if a person died before
he reached pensionable age. For years I used to argue that smokers
were a net benefit, purely financially speaking, to the exchequer,
because they died early. I still feel rather proud of being the first,
I believe, to get a known expert (Professor Richard Peto in 1993) to
agree publicly to this idea, now accepted. Might not the same be true
of obesity? The real drain on the NHS is geriatric medicine; the obese
might not reach old age.
If the only reason for interfering with what fat people eat is how
much it costs the rest of us, perhaps we should leave them alone. It's
well known that obesity (and fatness) are associated with poor
education, poor housing, poor employment or none, low expectations,
low opportunities and all the rest. These are all social ills that
this government has been trying to deal with for more than a decade.
Yet little has improved and obesity as an indicator of that fact
has swollen vastly while Labour has been in office. What prevents
obesity is a good income, a good education, good opportunities and the
kind of background that develops self-confidence. Prosperity, in short.
Obesity cannot be defeated by taskforces, better labelling on packets
or investing in health accreditation schemes. This has all been tried
and has failed. In the presence of a complex problem, and in the
absence of a workable solution, perhaps it is better to leave people
to their own devices. Nobody can pretend they don't know what they're
doing. They should be left alone to do it.
minette.marrin@ sunday-times. co.uk
