Vintage cereal boxes: breakfast cereals have been especially implicated in childhood obesity. Photo: Getty
Show Hide image

How the lessons of the long war on tobacco can help us shape up on our new front line: obesity

The NHS is gradually waking up to the need to provide structured support to people keen to lose weight, just like smoking cessation services.

Last month, Dame Sally Davies, the Chief Medical Officer for England, published her annual report on the nation’s health. I was struck by her assertion that two-thirds of adults are now either overweight (body mass index over 25) or obese (BMI over 30). The statistic reminded me that in the 1960s, the peak of the UK smoking epidemic, 70 per cent of men and 40 per cent of women were smokers.

At such levels of prevalence, cultural perceptions alter. It appears normal for people to smoke, a conclusion subliminally supported by the ready availability of tobacco; by the provision of ashtrays in planes, trains and cars; by adverts in every form of media. We are witnessing a similar “normalisation” of obesity, with shop mannequins getting larger, “inflation” in clothing sizes and furniture design being altered to accommodate the new norms.

The historic smoking prevalence data came to mind because in February, figures from 2013 were published showing that the proportion of smokers in the English population had fallen below 20 per cent for the first time. The campaign waged against tobacco over the past 50 years tells us everything we need to know about effecting a similar reduction in rates of obesity.

The prerequisite is information. The tide started to turn against smoking following the publication, in 1962, of the first study to demonstrate persuasively the unequivocal link with lung cancer. The drip-drip of new health information gathered pace and by the 1970s the inexorable rise in smoking prevalence had begun to reverse. The strong links between obesity and conditions such as heart disease, stroke, diabetes and three of the four most common cancers (bowel, breast and prostate) are well established but have yet to lodge in the public consciousness. Most people are aware that being overweight is somehow not good for you but have only a vague idea as to the extent of the problem. I have several obese patients who have been shocked to learn that their weight poses comparable risks of disability and premature death to being inveterate smokers.

Information alone is insufficient. Losing weight is, for most, at least as challenging as quitting nicotine. Research is making clear that large “hits” of sugar, be it “off the spoon” or “hidden” in processed food, have addictive potential. The same may be true of fried foods. The NHS is gradually waking up to the need to provide structured support to people keen to lose weight, just as it devotes considerable resources to smoking cessation services.

The experience of tackling smoking suggests that wider measures will also be needed. Stiff taxation has made tobacco much less affordable. Advertising and shop display prohibition and stark health warnings on packaging have contributed to the message that tobacco use is no longer normal behaviour. Bans on smoking in public places – and soon in cars with children – also serve to marginalise the habit further.

The situation is more complex for obesity. Eating and drinking are normal activities and there is no single culprit product on which the government can train its sights. Having said that, there is good evidence that ministers could get to work on. Sugar in soft drinks (and added almost routinely to processed foods) makes a major contribution to overall calorie intake. There should be an immediate ban on any product being marketed as “low” or “no fat” – or, indeed, trumpeting its freedom from “artificial flavourings and additives” – when it is stuffed full of sugar instead. Breakfast cereals, particularly those aimed at children, are by and large a national scandal.

Several European countries have already introduced a “sugar tax” and the UK should follow suit, though the industry will resist it with vigorous lobbying.

Junk food is also under the spotlight. A neat piece of research published recently in the British Medical Journal established clear links between obesity rates and the density of fast-food outlets around people’s homes and workplaces and along their commuting routes. Will there come a time when diners consuming reasonably priced, healthy whole foods sit comfortably inside warm restaurants, while shame-faced burger munchers huddle beneath a shelter in the windswept car park?

In our efforts to tackle the obesity epidemic, we must take care not to stigmatise the overweight. A small proportion of obesity is genetically determined. For the rest, outward appearances are rarely indicative of simplistic so-called failings such as gluttony. Excess weight is driven by ubiquitous low-cost, energy-dense food, by time- and exercise-poor lifestyles and by a failure of education and information to keep pace with the rapid changes that food technology has brought about over the past three decades. Obesity can also be a manifestation of the same emotional wounds that drive more conventional addictions.

We need compassion for ourselves and for each other. But as the smoking epidemic smoulders towards its conclusion, we need to face the public health crisis that has grown in its wake – and we need to shape up fast.

This article first appeared in the 09 April 2014 issue of the New Statesman, Anxiety nation

Photo: Getty
Show Hide image

Ken Livingstone says publicly what many are saying privately: tomorrow belongs to John McDonnell

The Shadow Chancellor has emerged as a frontrunner should another Labour leadership election happen. 

“It would be John.” Ken Livingstone, one of Jeremy Corbyn’s most vocal allies in the media, has said publicly what many are saying privately: if something does happen to Corbyn, or should he choose to step down, place your bets on John McDonnell. Livingstone, speaking to Russia Today, said that if Corbyn were "pushed under a bus", John McDonnell, the shadow chancellor, would be the preferred candidate to replace him.

Even among the Labour leader’s allies, speculation is rife as to if the Islington North MP will lead the party into the 2020 election. Corbyn would be 71 in 2020 – the oldest candidate for Prime Minister since Clement Attlee lost the 1955 election aged 72.

While Corbyn is said to be enjoying the role at present, he still resents the intrusion of much of the press and dislikes many of the duties of the party leader. McDonnell, however, has impressed even some critics with his increasingly polished TV performances and has wowed a few sceptical donors. One big donor, who was thinking of pulling their money, confided that a one-on-one chat with the shadow chancellor had left them feeling much happier than a similar chat with Ed Miliband.

The issue of the succession is widely discussed on the left. For many, having waited decades to achieve a position of power, pinning their hopes on the health of one man would be unforgivably foolish. One historically-minded trade union official points out that Hugh Gaitskell, at 56, and John Smith, at 55, were 10 and 11 years younger than Corbyn when they died. In 1994, the right was ready and had two natural successors in the shape of Tony Blair and Gordon Brown in place. In 1963, the right was unprepared and lost the leadership to Harold Wilson, from the party's centre. "If something happens, or he just decides to call it a day, [we have to make sure] it will be '94 not '63," they observed.

While McDonnell is just two years younger than Corbyn, his closest ally in politics and a close personal friend, he is seen by some as considerably more vigorous. His increasingly frequent outings on television have seen him emerge as one of the most adept media performers from the Labour left, and he has won internal plaudits for his recent tussles with George Osborne over the tax bill.

The left’s hopes of securing a non-Corbyn candidate on the ballot have been boosted in recent weeks. The parliamentary Labour party’s successful attempt to boot Steve Rotheram off the party’s ruling NEC, while superficially a victory for the party’s Corbynsceptics, revealed that the numbers are still there for a candidate of the left to make the ballot. 30 MPs voted to keep Rotheram in place, with many MPs from the left of the party, including McDonnell, Corbyn, Diane Abbott and John Trickett, abstaining.

The ballot threshold has risen due to a little-noticed rule change, agreed over the summer, to give members of the European Parliament equal rights with members of the Westminster Parliament. However, Labour’s MEPs are more leftwing, on the whole, than the party in Westminster . In addition, party members vote on the order that Labour MEPs appear on the party list, increasing (or decreasing) their chances of being re-elected, making them more likely to be susceptible to an organised campaign to secure a place for a leftwinger on the ballot.

That makes it – in the views of many key players – incredibly likely that the necessary 51 nominations to secure a place on the ballot are well within reach for the left, particularly if by-election selections in Ogmore, where the sitting MP, is standing down to run for the Welsh Assembly, and Sheffield Brightside, where Harry Harpham has died, return candidates from the party’s left.

McDonnell’s rivals on the left of the party are believed to have fallen short for one reason or another. Clive Lewis, who many party activists believe could provide Corbynism without the historical baggage of the man himself, is unlikely to be able to secure the nominations necessary to make the ballot.

Any left candidate’s route to the ballot paper runs through the 2015 intake, who are on the whole more leftwing than their predecessors. But Lewis has alienated many of his potential allies, with his antics in the 2015 intake’s WhatsApp group a sore point for many. “He has brought too much politics into it,” complained one MP who is also on the left of the party. (The group is usually used for blowing off steam and arranging social events.)

Lisa Nandy, who is from the soft left rather than the left of the party, is widely believed to be in the running also, despite her ruling out any leadership ambitions in a recent interview with the New Statesman.However, she would represent a break from the Corbynite approach, albeit a more leftwing one than Dan Jarvis or Hilary Benn.

Local party chairs in no doubt that the shadow chancellor is profiling should another leadership election arise. One constituency chair noted to the New Statesman that: “you could tell who was going for it [last time], because they were desperate to speak [at events]”. Tom Watson, Caroline Flint, Chuka Umunna, Yvette Cooper, Andy Burnham and Liz Kendall all visited local parties across the country in preparation for their election bids in 2015.

Now, speaking to local party activists, four names are mentioned more than any other: Dan Jarvis, currently on the backbenches, but in whom the hopes – and the donations – of many who are disillusioned by the current leadership are invested, Gloria De Piero, who is touring the country as part of the party’s voter registration drive, her close ally Jon Ashworth, and John McDonnell.

Another close ally of Corbyn and McDonnell, who worked closely on the leadership election, is in no doubt that the shadow chancellor is gearing up for a run should the need arise.  “You remember when that nice Mr Watson went touring the country? Well, pay attention to John’s movements.”

As for his chances of success, McDonnell may well be even more popular among members than Corbyn himself. He is regularly at or near the top of LabourList's shadow cabinet rankings, and is frequently praised by members. Should he be able to secure the nominations to get on the ballot, an even bigger victory than that secured by Corbyn in September is not out of the question.

Stephen Bush is editor of the Staggers, the New Statesman’s political blog. He usually writes about politics.