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

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How the Lib Dems learned to love all-women shortlists

Yes, the sitting Lib Dem MPs are mostly white, middle-aged middle class men. But the party's not taking any chances. 

I can’t tell you who’ll be the Lib Dem candidate in Southport on 8 June, but I do know one thing about them. As they’re replacing a sitting Lib Dem (John Pugh is retiring) - they’ll be female.

The same is true in many of our top 20 target seats, including places like Lewes (Kelly-Marie Blundell), Yeovil (Daisy Benson), Thornbury and Yate (Clare Young), and Sutton and Cheam (Amna Ahmad). There was air punching in Lib Dem offices all over the country on Tuesday when it was announced Jo Swinson was standing again in East Dunbartonshire.

And while every current Lib Dem constituency MP will get showered with love and attention in the campaign, one will get rather more attention than most - it’s no coincidence that Tim Farron’s first stop of the campaign was in Richmond Park, standing side by side with Sarah Olney.

How so?

Because the party membership took a long look at itself after the 2015 election - and a rather longer look at the eight white, middle-aged middle class men (sorry chaps) who now formed the Parliamentary party and said - "we’ve really got to sort this out".

And so after decades of prevarication, we put a policy in place to deliberately increase the diversity of candidates.

Quietly, over the last two years, the Liberal Democrats have been putting candidates into place in key target constituencies . There were more than 300 in total before this week’s general election call, and many of them have been there for a year or more. And they’ve been selected under new procedures adopted at Lib Dem Spring Conference in 2016, designed to deliberately promote the diversity of candidates in winnable seats

This includes mandating all-women shortlists when selecting candidates who are replacing sitting MPs, similar rules in our strongest electoral regions. In our top 10 per cent of constituencies, there is a requirement that at least two candidates are shortlisted from underrepresented groups on every list. We became the first party to reserve spaces on the shortlists of winnable seats for underrepresented candidates including women, BAME, LGBT+ and disabled candidates

It’s not going to be perfect - the hugely welcome return of Lib Dem grandees like Vince Cable, Ed Davey and Julian Huppert to their old stomping grounds will strengthen the party but not our gender imbalance. But excluding those former MPs coming back to the fray, every top 20 target constituency bar one has to date selected a female candidate.

Equality (together with liberty and community) is one of the three key values framed in the preamble to the Lib Dem constitution. It’s a relief that after this election, the Liberal Democratic party in the Commons will reflect that aspiration rather better than it has done in the past.

Richard Morris blogs at A View From Ham Common, which was named Best New Blog at the 2011 Lib Dem Conference

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