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Tell people to eat less? Yes, that’ll sort out obesity

The government's package has little chance of successfully tackling our greatest single public health problem.

"Worthless, patronising rubbish" was how TV chef Jamie Oliver described the government's new obesity strategy in Thursday's Guardian. Not a doctor, admittedly -- although the BMA also weighed in -- but someone who cares passionately about the subject and has taken considerable pains to try and reverse the bad eating habits of British schoolchildren. He's also got a point. And, ironically, at least part of the problem is traceable back to a Tory-driven policy from the early 80s.

How do I know this? I was there. Overnight, the move from a set menu to a cafeteria system in my Yorkshire comp changed many of my friends' diets from a fairly balanced diet to one of chips, pizza and doughnuts, because, unsurprisingly, that was what they liked. Consumer choice was important, wasn't it? Except that it wasn't. Choice is not an automatic, universal social good. And those who paid for this particular schoolboy error were mostly the kids from the rougher estates, who didn't eat well at home, either.

Fast-forward to today, and there's a sense of déjà vu. Obesity. It's just about people eating too much and not getting enough exercise, isn't it? I mean, why can't they just cut the calories and get off their fat backsides?

Surprisingly this, in a nutshell, is Andrew Lansley's breathtakingly subtle and innovative strategy to combat obesity. Eat less, move around more. Rather than getting people to understand healthy eating, we are back in the 1970s, cutting calories. In other words, if you eat a diet comprised of nothing but chips, as long as you eat few enough to stay within your calorie limits, you're healthy, as far as the government's concerned.

Lansley's comments have, unsurprisingly, found approving echoes in the right-leaning press: "fat people have only themselves to blame", runs one Telegraph comment piece. But obesity is simultaneously a public health and an educational problem, not just a medical condition. And, patently, if it were that simple we would have cracked it a long time ago.

Ilona Catherine, health correspondent for the Independent, writes: "Telling an obese person to consume less...is like telling an alcoholic to have one glass of wine rather than a bottle or two." Just read this fine, brave and personal piece by blogger Emma Burnell, if you really want to understand both the daily struggle and the politics that underlie obesity.

Now, I am not, I think, one to sign up to that twenty-first century, Oprah-style craze for converting every slight human condition into an illness. But I take exception to this.

Lansley's wrong-headedness derives from four errors: his dogma that what Labour has done is nanny-state and must be reversed; that a coercive, do-as-I-say approach will work in this area, for which there is little evidence; that central government edicts are undesirable per se and do not work (er, smoking ban, anyone?); and a fatal succumbing to food industry interests -- highlighted last year by former Downing Street adviser John McTernan in the Telegraph -- in proposing that self-regulation, instead of government control, is a large part of the answer. Yes, that worked well in the City, and the press, didn't it?

It is perhaps true that Labour's attempts have not solved the problem as quickly as anyone would have liked, although it is also difficult to prove how effectively one is turning around a long-term problem which often starts in childhood. But this package, according to most interested parties, is simplistic, unambitious and has precious little chance of successfully tackling our greatest single public health problem.

Worthless? Perhaps I wouldn't go that far. But not worth much.

Rob Marchant is a political commentator and former Labour Party manager who blogs at The Centre Left.

 

Tags: andrew lansley  obesity

33 comments

Lox's picture

OK, Jacques, so you can't answer the question I asked earlier. Do you have a problem with freedom of choice? Like someone else to make decisions for you, do you?
Mcquade, no you're wrong. It's not my business if someone chooses to drink themself to death. I'm a heavy smoker, I know there's a good chance my habit will kill me, but that's my decision. Sure, I'm addicted to it: but I've enjoyed every fag I've ever lit. But I'm sure you know better than me how I should live.

Philiprealfood, you do less you don't get so hungry. Have you very done a manual job?

Mcquade, by your logic we should legislate to stop people hillwalking or playing football, or having unprotected sex. All that public money spent on those needless broken ankles and chlamydia....

JacquesOuze's picture

Well I did answer it, but I think you failed to understand the answer. Read it again and try really really hard to get those neurons firing. The answer is in there. I promise.

Better still, have another fag and forget it.

Lox's picture

Jacques, you did imply that the state should limit food choice and make people more active, didn't you? And you didn't really try to explain how that's possible, or even desirable. Don't worry about that, though-we all say stupid things sometimes.

And thanks: I thoroughly enjoyed the fag I've just finished, after my meal of red meat and stodgy carbohydrates. Fortunately I've got enough self-respect to stop pigging out if I feel that I'm eating too much. How about you? You've clearly got a modicum of intelligence-enough to grasp the concept of cause and effect. But perhaps you think that obese people are too dim to make the connection between too much food and rolls of fat, or lack the self-discipline to turn that awareness into action. Without someone like you to tell them what to do, that is.

Anon's picture

Speaking as a smoker. Why should bloody fat people not be taxed and pursued to stop them too. Fizzy drinks should not be pennies a litre. Who needs them that cheap.

Anon's picture

And why is alcohol taxed?

Philiprealfood's picture

So Lox, you propose (unlike the Govt.) that we should eat less and do less? Even those who still believe there is a law of thermodynamics that says energy in equals energy out can see that this is no solution to the obesity crisis. And another thing - all this talk about freedom of choice really is a naive platitude that large corporations are happy to promote. Advertising is the sunshine of growth as someone once said and literally thousands of product categories that we don't need and are not good for us would not exist were it not for advertising. It may be that you are one of those who believe that you are not influenced by advertising, if so I'm afraid you are wrong. Consequently the food industry has to be more firmly regulated by the government to address obesity. Expecting the public to make the right choices in the face of the sophisticated appeal to our emotional needs that advertising makes is exactly what this pro business government wants as it means that it will be business as usual for the corporations peddling us their food like substances.

Rob Marchant's picture

@swatantra: agree that self-regulation is a non-starter. As the piece says, it didn't work for press or the City, so why should it work here?

@Lox, @Fraziel1: that's right, shout at people, "you're fat and it's all your fault". That'll work.

@JacquesOuze: nice observation. The problem is the same, just that poorer people tend to be overweight rather than skinny nowadays.

@Lox: it's ironic. You speak like freedom of the individual and low taxation were the main basis for your argument. But we are all paying for obesity in increased health costs, like we will probably pay for your medical care when you get sick from smoking. Not a good result, really, is it? This "freedom" has pa price, doesn't it?

Lox's picture

Philip, I don't believe we should eat less and do less. I'm not quite sure how you inferred that. And I think you should do what you want. If you really believe that freedom of choice is a naive platitude, then you're the one that's been brainwashed into believing that other people are more qualified to make decisions for you than you are.

And I'm afraid that you're both wrong and patronising to tell me that I'm inevitably influenced by advertising. Tell me, what stuff that you don't need does advertising make you buy?

Your last paragraph is condescending nonsense. People can choose to do what they like: perhaps you think that people need someone as clever and perceptive as you to make the right choices for them.

Lox's picture

Rob, you won't pay for my healthcare. After smoking for thirty years, I've paid a massive amount in extra tax. Also, since I doubt I'll be claiming a state pension for very long, there's another benefit to you. No need to thank me.
And nowhere have I mentioned low taxation: but you're right about freedom of the individual. You refer in your last paragraph to a Tory coercive, do as I say approach to obesity. But you appear to believe that the problem should be addressed by government edict. What form will that take? An increased tax on fatty foods? People on low incomes will be very grateful, I'm sure, that they have nice middle class people like you taking the hard decisions for them.
Of course freedom has a price. It's responsibility for your own fate, and I wonder if you have a problem with that.

Lox's picture

Sorry, Jacques-your last sentence is slightly cryptic. Should we make driving more expensive?

My simplistic libertarian worldview makes me think your penultimate paragraph is kind of naive: we can tolerate a certain amount of individual freedom, you say. Unfortunately, you seem to believe that whoever sets that limit is going to be capable of making the right choices for you. I'd say we can tolerate a certain amount of infringement of individual freedom, and that should be absolutely minimised. I know that I'm capable of making what appear to be the right decisions for me: maybe in time they'll turn out to be the wrong decisions, but that's life, isn't it? Personally, I think it's inhumane to shield people from the consequences of their decisions.

I accept that corporate interests infringe on our individual freedoms, but they can only do so via government intervention. Weaken government, and you weaken the ability of corporate interests and cartels to direct the behaviour of individuals. An example: the EC decides to subsidise European farming interests, and hence the European food industry. Consumers then pay an artificially low price for food, and African farmers fail because they can't compete. It's not an extreme libertarian view that sees government intervention in the form of agricultural subsidies as leading to two undesirable consequences: fat Europeans and undernourished Africans.

I think you're very mistaken if you identify libertarianism as being in the interests of big business. Libertarianism identifies the creative destruction of capitalism as vital: big business wants to use government intervention and regulation as a life support system.

JacquesOuze's picture

I didn't think it was that cryptic, but well done for decoding. In addition to reducing pollution in central London by a fragment, the congestion charge has got a lot of people taking public transport and walking and cycling to work. The health benefits will be relatively small, but this is the kind of social consequence of public policy that is likely to have an impact on obesity in the medium to long term.

The rest of your argument is truly bizarre and I don't even know where to begin with it. And as I'm off on holiday for a week, it will have to wait.

Mike (Paleo) Oliver's picture

Though I cannot endorse everything Jamie Oliver says he is almost there much of the time, however on this occasion he is right on the money. As I previously wrote in an article on this matter on the 7th October, this advise is not only wrong but down right dangerous as it will and can only result in continuing misery for the millions affected by this travesty. For more detail on this and the reasons we believe are behind the current policy go to: http://paleoworks.wordpress.com/2011/10/07/government-obesity-solution-w...

JacquesOuze's picture

Lox has raised a good point (no really) about individual freedom. Obviously most of us understand that in practice such freedom has to be compromised for a greater good and a lot of politics is about deciding where the line is drawn. I would have less of a problem if the government came out and said that individual freedom was paramount and if the price of that is rampant obesity, diabetes, smoking, drinking and carnage on the roads then so be it. At least that would be honest and they would get voted out pretty quickly. Instead they're showing the same kind of dissembling and spinelessness that Labour did in office by mouthing cheap platitudes whilst avoiding doing anything material to tackle the problem. The differences between this and whatever a Labour govermnemt would have concocted is marginal.

But addressing Lox's point head on: I believe it's right to tackle obesity for the greater good and that individual freedom should give way to that goal. The only way to achieve that is a long-term programme of behaviour change that includes legislation to restrict the availability of certain types of food and which makes people take more exercise as part of daily life.

Unless people are prepared to grasp these nettles, they have no business hand wringing about the problem of obesity.

Lox's picture

Thanks for a considered response to my last post, Jacques. But I still don't agree with you: individual freedom is paramount, and it should be compromised only to the extent necessary to protect individual's lives and property. Where you and I differ, I think, is that I believe that the state is a necessary evil to protect most people from the vicious. Extension of state power beyond that is much, much more harmful than obesity. And I honestly cannot see how you can legislate to make people exercise more: that really is pure fascism.

swatantra nandanwar's picture

Sometimes the simplest solutions are the best. And don't wrap it up in any psuedo-psycho-socio-jargon.
Andt requires Govt regulation; voluntary and self-regulation never works. Half a plate more fruit and veg and less meat, less fat sugar and salt. People like Jamie Oliver and nutritionists have been knocking their heads against a brick wall, and its not fair. Cut out the mumbo-jumbo; tell them, tax those foods. Years of education campaigns have failed, in drugs smoking acohol and food. Its time to get real.

Lox's picture

But obese people do have themselves to blame. If you're comfortable with being overweight, good for you: it's your life. If you're not, eat less and do more. It's as simple as that.

I doubt the validity of the comparison between overeating and alcoholism, but let's assume that it's fair. If you choose to drink yourself to death, then again that's your business. Not mine, not the government's, not Rob Marchant's.

Is there anyone in the UK who doesn't know that fresh fruit and veg is good for you, and big macs might make you fat if you eat lots of them? How much more education is needed?

JacquesOuze's picture

For a considered analysis of why it is that people don't always choose to eat the right kind of food, it's worth going back to The Road to Wigan Pier. The issues of obesity were not the same, but Orwell's analysis of what influences people's food choices is intelligent, nuanced and precient. He's particularly good on the influence of class on motivation and decisions.

On the strength of this we can say that certainly since the 30s, poor people tended to make poor food choices. The only thing that has really changed is the type and volume of food available and the amount of activity that people have to do. By refusing to legislate, the goverment is refusing to tackle either of these key variables. The consequences are entirely predictable.

Fraziel1's picture

Telling people to eat less is not going to solve the problem but it's a start. We need to stop molly coddling fat people and being scared to offend them, and tell it like it is. They are fat, not obese and the best way to lose weight is to eat less, eat more healthily and exercise.

Lox's picture

Jacques, how should the government legislate? You describe two key variables-food choice and people's activity. So do you think that the government should legislate to reduce choice and to make people move around more? Seriously?

Ian5's picture

Whoa, you mean you can't get more energy out of something than you put in....You mean obese people must have eaten more than they needed for a fair bit of time to get to that stage,,well I'm dumbfounded , for heavens sake its the simplest, most honest piece of information to come out of any government Dept. in years.

Your fat because you want to be.... and gastric bands are just a lazy way out not a cure for greed.

JacquesOuze's picture

Lox is again on the money in terms of the motivations of the pivate sector - its raison d'etre is profit and not with the social consequences of

that unless its compelled to do so. Historically, there's plenty of evidence of where this leads without adequate mandatory regulation, but obesity is one that has emerged recently. In terms of the food industry, you need to read Fast Food Nation to see where things are heading. That's why nudging and social responsibility deals are such arrant nonsense.

The problem for people like Lox with a simplistic libertarian worldview is that their arguments plays straight into the hands of these commercial

interests (as I think Philip pointed out), which is why they are so happy to support and propagate these views.

But the thing about public health is that it is a numbers game. It's OK if a a relatively small number of people like Lox smoke themselves to an early grave, so long as enough people don't. And with obesity, we can tollerate a few Eric Pickles or Nigel Lawsons (in terms of size not personality) so long as the social impact is contained. So as a society we can tollerate a certain amound of individual freedom, but there comes a point when society has to concern itself with controlling the more extreme social consequences of profit in the best interests of the majority rather than pandering to narrow commercial intersts to extreme libertarians.

I could respond at length to Lox's question about how to legislate to encourage physical activity, but I'll just say congestion charge to start with.

Rob Marchant's picture

@Lox: well, at last you are talking a bit more sense. Freedom of the individual is an interesting point. If people could kill themselves through eating or smoking with no impact on other individuals, I would say go ahead. Unfortunately there is what economists call a negative externality: what you do has a negative side-effect on me. In this case it's my increased healthcare costs. So, it's not individual freedom alone, it's that freedom weighed against the impact on others. Smoking at work, for example was a very clear example of this, which has now thankfully stopped (I smoke, by the way, although not heavily, so this is not an anti-smoker vendetta).

But you cannot for a moment think that all that tax money will automatically cover your healthcare costs. That, sadly, ain't the way it works.

Edicts versus govt approach: the government edict (e.g. on composition of school dinners) works. On the coercive approach of "do as I say", it doesn't. The argument's that simple. And you haven't even mentioned self-regulation or the unhealthy influence of the food lobby on Lansley.

I have no problem with personal responsibility, by the way. It's ultimately a big part of the solution, but it's how you get people to engage with that, and shouting at them, a la Lansley, is not the answer.

mcquade's picture

"If you choose to drink yourself to death, then again that's your business. Not mine"

But it is your concern considering the amount of public money spent treating these people.

mcquade's picture

How should government legislate, Lox?

An easy one. Stop supermarkets, who purportedly subscribe to Lansley's self-regulation, from displaying sweets at child level at checkout counters and replace them with healthy options. My local Wilkos has just had a refit and now done the same thing at checkouts. They weren't there before. Self-regulation is a cop out because it is not implemented not checked up on.

Flashbuck's picture

The author this kneejerk blog tells us he or she went to a comprehensive school. It shows.

Lox's picture

Rob, people can kill themselves through overeating or drinking with no effect on other people, if the other people are content with allowing individuals to live as they see fit. If you had the option to opt out of my healthcare costs, fine: I don't have a problem with that. After all, why should I expect you to pay for the consequences of my fags, booze and unhealthy diet?

Your second paragraph? Bit of an Aunt Sally. I don't believe that every time I buy a packet of cigs the treasury takes 80% or so and puts it in a piggy bank marked "Lox's quadruple bypass fund". My point was-as I'm sure you're aware-that my total contribution to state revenues over my lifetime as a smoker is significantly higher, simply because I smoke.

Your third paragraph-sorry, but I've got a real aversion to the state telling people, this is how you will eat: this is how you will behave. As for self-regulation, why on earth should the food industry regulate itself? It's raison d'etre is to make money, not to assist in producing a nation of toned athletes. Your point about any influence it might have on Lansley is fair enough: but to avoid politicians being corrupted, you should make them not worth corrupting-by keeping them as weak as possible.

Philiprealfood's picture

It really is depressing to read comments by the likes of Ian, Fraziel1 and Lox. Eat less, do more doesn't work - you do more you get hungry, you eat less, you get hungry and hunger is one of the most powerful drives a human experiences. And even if you could live with constant hunger, the science is so so clear that your body will adjust - if you eat less and do more, it will shut down doing key jobs like repairing cells, or building bone density and you won't have the energy to do as much. And by the way Lox, where is your evidence about fresh fruit and veg being good for you - surely everyone knows that the 5 a day mantra was a marketing exercise based on no scientific evidence whatsoever...

northwest nutrition's picture

We feel the same....some dietitian's views on http://www.northwestnutrition.co.uk/articles/dietitians-nutritionists-on...

Rob Marchant's picture

@Flashbuck. Thank you for your thoughtless snobbery. For the record, I went to an excellent comprehensive school although, unlike you, I prefer not to judge people for better or worse on which school they attended.

Not something I'd normally mention but, for the record, I also have a Masters from Oxford, another from London and an MBA from IESE, Barcelona.

@everyone else: thanks vm for your comments. Will come back to you tomorrow morning.

Lox's picture

Thanks Jacques. I'm flattered by your praise. Anyway, as you say the health benefits of the congestion charge will be small, but it's worth it for the sheer pleasure of regulating, isn't it?

I didn't think the rest of my last post was bizarre, but never mind.
I hope you enjoy your holiday: and hopefully you'll have someone with you to tell you what you should eat and drink, and when to get up, and when it's time for a nap. That kind of thing seems to appeal to you-little Jacques wouldn't want to do anything silly that he might have to take responsibility for, would he?

Lady J's picture

Here we go again. Tory policy, how can we describe it?

DO IT YOURSELF.

1. How will you reduce immigration Cameron?
Cameron Answers; I will impose a cap and limit student and workers visa's. Oops, That is not working. My policies are actually incresing immigration. Oh sud it. You do it yourself. You go and look for the Illegal Immigrants.

2. Cameron, what are you going to do about the predatory practices of the energy companies.
Cameron answers; Well as you know, I simply cannot be seen to be telling the 1% to reduce their prices and stop their predatory practices. You do it yourself. You look for bargains because we, the rich are alright Jack. You make sure you switch off your lights. yes Cameron, we will switch off and wears two layers of woolies.

3. Cameron what are you going to do about Obesity?
Cameron; Stop eating.

4. Cameron, what should we do about the economy?
Cameron's answers; Those bloody Europeans should do you do something about economy. We are too busy looking for someone to blame.

We are the 'do nothing' government, friends of the 1%.

GET IT. NOW SUD OFF. OUR LOBBYIST ARE WAITING FOR US.

Eddy S's picture

1) tax stuff that is bad for you (too high in fat/sugar). andy burnham on question time felt this would affect the poor disproportionately but there were members of the audience that disagreed and i do to, an apple can be cheaper than a bar of chocolate (even better use the tax revenue to lift the tax free threshold helping the lower/middle income ranges).

2) ban the really bad stuff like trans fats, that stuff is toxic.

3) if number 1 is too controversial then use traffic light labeling (red, then green and amber) on food high in fat/sugar.

4) keep the message simple !

JacquesOuze's picture

Well Lox, I can see it might be a bit controversial give the success we've had cutting smoking by avoiding any nasty legislation, maintaining freedom of choice and working with our partners in the tobacco industry on voluntary responsibility deals.

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