Drink and snack manufacturers used to be vilified for making a profit out of making us fat. With the new Health and Social Care Act starting to bite, we can look at this differently. Because of the reincarnation of the National Health Service as a path to private profit, obesity can now be reclassified as a marvellous opportunity to kick-start the economy.
Those who are overweight and obese will help generate annual revenues of £10bn by 2050, according to Public Health England. Surely this makes it even more important that we understand the causes of obesity.
On 14 April, researchers gathered in Cambridge to go over what we know. The truth is not much. The bottom line is that obesity seems to be becoming programmed into human biology in the developed world. Profit-hungry health providers should be punching the air.
Cambridge University’s Stephen O’Rahilly, who gave the opening keynote speech at the meeting, calls obesity a “heritable neuro-behavioural disorder” that is “highly sensitive to environmental conditions”. As much as 70 per cent of the difference between individual levels of fatness can be attributed to heritable factors but the rapid rise in obesity and diabetes over the past couple of decades shows that it’s not all genetic. There are ways to make people fulfil their potential for fatness.
Much of it has to do with failures in the signals between the brain and the gut – the messages that tell us when we are full and how much energy we feel we have and need. We don’t know a lot about what causes the failures but the bacteria living in your gut might be able to help. A study published in March showed how a microbe transplant can help weight loss. Transplant the microbes from the stomach of a mouse that has had a gastric bypass into the stomach of a mouse that hasn’t and the second mouse will begin to lose weight. No one knows exactly why, but some think that the mouse with the bypass has an altered gut flora and the most prevalent bacteria change the signalling from gut to brain.
Some of the metabolic failures seem to get programmed in before birth. It is becoming increasingly clear that a balanced diet is crucial to the unborn child. Research has shown that mothers who eat more fat than they should in pregnancy increase the risk of their offspring having liver and pancreas damage, heightening the chances of diabetes and early-onset obesity.
Maternal nutrition can affect the child’s mind as well as its body. Poor health and nutrition in pregnancy has been linked to anxiety, depression and attention deficit/hyperactivity disorder in the child. Improved nutrition in the run-up to conception could have an enormously beneficial effect on future generations.
It’s not entirely popular, O’Rahilly concedes, to blame genetics and environmental factors for obesity: as a society, we still want to characterise the obese as lazy or lacking self-control. Research even suggests that some obese people may be suffering from a progressive neurological disorder induced by factors in their environment: the brain machinery controlling energy balance is falling apart.
Anyway, viewed from a different perspective, this programmed obesity is wonderful, guaranteeing you a client base for generations. Get mothers overeating during pregnancy and you stand to gain customers as soon as they are born. They might end up in a mental health clinic rather than the obesity clinic but a customer’s a customer, right?