To Tackle Obesity, Fight Inequality

By shifting the blame for obesity onto individuals, the government is covering up its own contributions to the structural causes – from shutting leisure centres to supporting low wages and longer working hours.

According to the National Health Service, obesity is generally caused by consuming more calories than you burn off through physical activity. Having first been mentioned in the English language in the 17th century, the so-called lifestyle disease went from relative obscurity to a formally recognised global epidemic in a matter of decades. Coexisting with a growing hunger crisis which is broadly believed to be worsening, obesity has rapidly evolved into one of the foremost public health problems of the 21st century.

In Britain, the ‘fat man of Europe,’ the prevalence of obesity is said to have contributed to the exceedingly high Covid-19 death toll. Not forgetting the government’s abhorrent management of the pandemic, this finding has inspired an attempt to tackle the expansion of our national waistline ahead of an anticipated second wave. On Monday, in a supposed personal u-turn, Boris Johnson launched an anti-obesity strategy complete with an X-Factor style personal promo video: the prime minister can be seen pacing an expansive green lawn with his dog, celebrating his one stone weight loss to mildly emotive music.

But his apparent volte-face, formalised in the ‘Better Health’ strategy, is less revolution and more repackaging. Complete with mandatory calorie displays at restaurants, a ban on junk food adverts before 9pm and weight watcher discounts, it extends to new marketing with the headline ‘make healthier choices.’ However, this insinuates once again that obesity is driven by poor personal decisions (with the minor concession that the issue is made worse by the scourge of advertising). 

Essentially, it is an attempt to inspire healthier lifestyles without fundamentally altering the obesogenic system under which we live. As a result, it misses the mark. To reduce the prevalence of obesity we need to restructure our work-life balance and address poverty and inequality, not count calories.

The causes of obesity, are of course, complex and multilayered. However, as the government policy admits, the prevalence of obesity is highest among the socio-economically disadvantaged. In comparison to their most privileged peers, children in the most deprived areas are more than twice as likely to be obese. The fattest UK region – the North East, where 68% of middle-aged men are considered ‘overweight’ – also happens to be the poorest. 

Captains of the food industry would have you believe that this a result of poor personal choice alone. This is a libertarian falsehood. Obesity is a population health problem connected to social, economic and environmental factors. In higher-income countries, it is associated with lower socio-economic status, poverty and inequality. It does not exist in a vacuum.

It has been reported that the government’s long-term aim is to ‘get the nation moving,’ and combine healthier diets with more physically active lifestyles. This is not a bad idea, but it is illusory to present it as universally possible in the context of worsening working and living conditions, as well as stagnating wages and rising unemployment.

To put it simply, healthy lifestyles are not very accessible. Certain sections of the public don’t have the money or the means to make ‘good choices’ so easily. It isn’t difficult for those with time, knowledge and Nutri bullets to prescribe personal remedies and a ‘can do’ attitude. But in the face of abject poverty and crushing working weeks, privatised solutions are unobtainable to millions across the UK.

Healthier food costs more and consumes more time than a diet of on-the-go, processed food, but the latter is more compatible with the kind of lifestyle that many are forced to lead at the behest of the punishing capitalist system. To cook nutritious food, you need time and money. But with employment law that permits working weeks of 48 hours, paychecks that barely cover the bills and a lack of access to affordable childcare, this is a precious resource that a significant proportion of the working population does not have. 

In July 2017, a YouGov survey found that almost one in eight people never or hardly ever cook meals from scratch. The most common reason for this? Busy schedules: 46% of people attributing their reliance on pre-prepared processed food to lifestyles that do not afford for slowly roasted aubergines. 

And for those that struggle to put food on the table week in week out, cheap, easy to prepare food wins. To be able to worry about fat and sugar content and adjust your diet accordingly is, relatively speaking, a privilege. It doesn’t extend to all.

What about exercise? The Department of Health and Social Care recommends that adults do 150 minutes of moderate-intensity aerobic activity every week, while children should ‘aim for an average of at least 60 minutes of moderate-intensity physical activity a day across the week.’ But for those that cannot afford gym memberships and lack the space to do Les Mills at home, an exercise regime is difficult to forge.

Over the last decade, the government presided over the decimation of public sector provisions for sports and recreation. While homelessness, soaring food bank dependency and cuts to the NHS have been (rightly) at the forefront of the critiques of Tory-led austerity, too little attention has been paid to the closure of leisure centres, sports venues and swimming pools. Authorities depleted funding for these ‘non-essential’ services, depriving communities opportunities to participate in physical activity. Consequentially, the Action People Survey covering the period 2008 to 2013 showed that participation in sport and physical activity decreased significantly.

And what of the children whose parents can’t shoulder the financial burden of after-school activities? A 2019 Social Mobility Commission report laid bare the huge participating gap in sports, with 46% of children from the lowest-income families taking part – compared to 64% from the highest-income families. Add to that the devastating cuts to youth services (nearly £1bn in real terms) and it becomes clear that soaring levels of child obesity are not disconnected from the sad reality of a decade of Conservative leadership.

‘Better Health’ is a skin-deep solution fraught with ignorance and missed opportunity. Far from ‘giving everyone a fair deal,’ it fails to face up to the structural causes of the issue it claims to be keen to tackle. It is also uncreative; with the climate crisis looming, it seems that now would be a good time to push the benefits of plant-based food, but it is impossible to conceive of this government advocating policies that would increase vegetarianism or veganism. While it’s not necessarily the case that a meat-free diet is automatically healthier, vegetarians and vegetarians tend to have lower BMIs than their carnivorous counterparts. Back in 2010, the NHS supported the notion that a “decrease in meat consumption may improve weight management.”

However, we arrive back at the monetary and time limits placed on society by capitalism. The financial exploitation of the explosion of veganism by the food industry and the time needed to prepare nutritionally sound, plant-based food is a barrier that the obesity strategy also fails to address. If junk food remains cheaper and easier and time remains of the essence for working people, meat-free Mondays will be a luxury that many can afford.

Then there is the issue of mandatory calorie counting. Calorie counting, a core facet of ‘Better Health’, is not tantamount to either a healthy diet or sound relationship with food. There are 245 calories in a Snickers, the UK’s favourite chocolate bar, meaning an adult female could eat eight and remain within the daily recommended calorie allowance. 

And it is not merely ineffective: it is dangerous and damaging. As one of the millions of British people that suffer from an eating disorder, I can emphasise that the addition of calorie information is a trigger so significant that I and others like me will rarely venture to a restaurant again. Eating out can be hard in normal circumstances, but this would make it impossible.

Actually achieving better health thus flies in the face of the scheme launched by Rishi Sunak. Eat out to help out, but also watch that calorie intake. Go to your favourite fast-food haunt to save Britain, but order the salad and skip the dressing. This, coupled with the attempt to create shame over high-calorie meals in environments where food is supposed to be enjoyed, while pushing privatised, inaccessible remedies, is a poor excuse of a way forward.

A balanced diet with regular exercise is the key to reducing the prevalence of obesity. This is only feasible when fresh food, time and recourse to participation in physical activity are accessible to all. In 2020, in Britain, that is simply not the case.