A shocking report landed on my desk this week, concerning the obesity epidemic gripping Britain. The Brits, it argues, are the fattest people in Europe: a race afflicted by gluttony, corpulence, and the attendant miseries of ill-health, early death, and national embarrassment. “It has been conjectured by some that for every one fat person in France or Spain, there are an hundred [sic] in England,” reads the report. It makes for rather glum reading—not least because it was printed in 1816.
It is more than 200 years since the distinguished surgeon William Wadd wrote his short treatise (the first edition was published in 1810), entitled Cursory Remarks on Corpulence or Obesity Considered as a Disease, which laid out the health risks of obesity, estimated its prevalence in England, and suggested some cures. The text was a hit, and was reprinted many times before Wadd’s death in 1829. Much of it echoes spookily today.
Drawing on his medical career, which began in the late 18th century, Wadd described the fates of the scores of tubby patients he had encountered, treated, and heard about: from a university fellow at Cambridge who could not go out without “exciting the astonishment of the common people, the fat on his legs overhanging his shoes,” to a Mr. Benjamin Bower of Dorset, 480 pounds when he died in a room that had to be semi-demolished in order to remove his corpse.
Even when Wadd was writing, fatness had been considered a national problem for close on a century. “It is not a little singular,” he mused, “that a disease which had been thought characteristic of the inhabitants of this island, should have been so little attended to.”
This week—on February 18, 2013—a similar conclusion was reached in another report about obesity in Britain. The Academy of Medical Royal Colleges, which represents most of the medical doctors in the U.K., described Britain as the “fat man” of Europe.
It noted that latest figures showed two thirds of British adults are overweight and one quarter are obese. One in three British children is obese. More than 1 million British adults are morbidly obese—basically, so fat you’re about to explode in a hail of fat globules and soda-stream.
The very size of Britain’s collective waistband is proof that food policy is one area where hands-off policymaking doesn’t work.
The result, the report said, was poor health and lower quality of life for the fat, and a bill of £5.1 billion ($7.9 billion) per year to the State for treating obesity-related illnesses. It called the government’s program so far to tackle obesity as “largely piecemeal and disappointingly ineffective.”
In short: Britain is dangerously, expensively, fatally fat. The way things are going, we’ll soon have caught up with you Americans. So what are we planning to do about it?
On an individual level, it’s easy to say that being fat is the result of personal choices. Even in Wadd’s time it was known that the basis of any weight-loss regime was “abstinence and exercise” and “the three principal points … in the removal of obesity are diet, exercise, and sleep.” But an obesity epidemic on the chronic scale that we see today is not simply the result of a collective weakness when faced with the biscuit tin.
There are millions more obese people today than there were in Wadd’s time—and the expanding figures are a direct result of the nature of modern, mass-produced, processed food, loaded with sugar, trans fat, and salt. An article in the medical journal The Lancet puts the blame squarely at the door of the companies who make processed food loaded with empty calories, sugar, trans fat, and salt. “Transnational corporations are major drivers of the global epidemic of NCDs [non-communicable diseases],” said the researchers. McDonald’s, Kellogg’s, Coca-Cola, Mars: we’re looking at you.
Most British observers outside Big Food, both lay and medical, are coming around to a similar position. The problem is so bad, and so costly, that regulating the content of food should become an urgent matter of public policy.
The British government, however, is remarkably skittish. Obesity policy rests with the Department of Health’s Public Health Responsibility Deal. Whereas tobacco or alcohol policy is driven heavily by the Treasury, which imposes punitive taxes on these unhealthy products, food is managed by a voluntary scheme in which food manufacturers, local authorities, retailers, restaurant chains, schools, colleges, and so on sign up to a variety of “pledges” under which they agree to improve food standards, increase physical activity in the workplace, monitor staff health, or control alcohol. All companies who sign up get a pat on the head and a nice certificate signed by the health secretary, Jeremy Hunt.
There is no compulsion and no mandatory regulation—it is a softly-softly, all-join-hands-together sort of approach. And there is widespread suspicion that it has about as much substance and all the health benefits of a large bag of candy floss. The report in The Lancet was scathing about partnership schemes like the Responsibility Deal. They’re a con. “Unhealthy commodity industries should have no role in the formation of national or international NCD policy,” it said.
So it would seem. Kellogg’s—the company that makes unhealthy breakfast cereals like Frosties (37 percent sugar)—is signed up to nine separate pledges with the Department of Health. None of them have anything to do with reducing sugar in breakfast cereals. When they were criticized recently a Kellogg’s spokeswoman said “Frosties has been on sale for more than 60 years and by now we think people know there’s sugar in them … we believe parents, and not the government, should choose what their kids eat.”
These are weasel words, when more than 200 years of experience also tells us that most individuals (including parents) are very weak agents of rational choice when it comes to what they put in their mouth. The very size of Britain’s collective waistband is proof that food policy is one area where hands-off policymaking doesn’t work.
The Academy of Medical Royal Colleges report suggests getting tough. It recommends that policy toward junk food and sugary drinks should be modeled on the smoking legislation that has virtually removed tobacco advertising from public view in Britain and has used the tax system to make the habit prohibitively expensive. The report recommends a ban on advertising unhealthy foods before 9 p.m., a 20 percent tax hike on soft drinks, a clampdown on fast-food outlets near schools and leisure centers, and the removal of junk-food vending machines from hospitals.
Sadly, the chances of the government taking any notice are pretty close to nil. Their barometer policy: the Department of Education has just reintroduced cookery to the national curriculum, but at the same time it sells off school playing fields and has allowed its flagship “free schools” (parent-run schools with state funding) to opt out from nationwide nutritional standards for their school meals.
Essentially, the British government lacks the stomach for a fight with Big Food. The 2012 London Olympic Games were a junk-food haven, with McDonald's, Coca-Cola, and the chocolate giant Cadbury monopolizing catering at venues. The horsemeat scandal has shown just how lackadaisical we are toward the content of processed food here. Policy is, at its heart, depressingly platitudinous: one health minister this week described it as “working together to get results.”
Well, those “results” as things stand are an adult obesity rate of 26 percent and rising, a burden on the NHS that will soon hit £6 billion a year and a reputation for being international lardy-asses that has bedeviled the country since the Napoleonic era. It looks like Britain is set to remain the “fat man” of Europe for some time yet.
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