Saturday, September 16, 2006

Could the panic about obesity be making things worse?

Panic: Scare stories about obesity have been coming thick and fast over the last few days. On Friday 25 August, we were told that England would have 13million obese people by 2010 - one million of them children. The government appointed health minister Caroline Flint to co-ordinate action on increasing our activity levels as a result. This week, the British Fertility Society recommended that women with a body mass index (BMI) above 36 should be denied free fertility treatment on the grounds that they were less likely to conceive - although they were only suggesting a national strategy to replace the current hotch-potch of local restrictions that are often even more severe. Thursday saw the release of an `obesity map' of England, with the slimmest areas all being London boroughs, while the areas with the greatest risk of obesity are mostly in the north.

Don't panic: While the grim reports of early death and chronic disease associated with obesity are used to scare us into staying thin, the truth is that while we're getting fatter, we're also living longer. In fact, the government seems to be promoting two contradictory panics at the same time: that life expectancies may fall due to obesity, while the country will be bankrupted by pensioners living too long.

The relationship between obesity and ill-health is much more complicated than the simplistic fat=unhealthy story we are typically given. In fact, being `overweight' is associated with lower mortality than `ideal' weight - and being `overweight' is certainly healthier than being underweight. BMIs above 30 are not necessarily unhealthy either. The key seems to be activity - fat but active people have similar or better health prospects than thin but sedentary people. In any event, obesity is only relatively important as a health risk in younger people. Since young adults don't get sick very often, this relative increase in risk still represents a low absolute risk. As people get older, the effect of age far outweighs the effect of weight.

Not only is the concern about obesity overstated, the anxiety about our weight has all sorts of negative consequences: it screws up our relationship with food; it creates a nation of hyperchondriacs fretting every time they step on a scale; it promotes misery about our appearance. Worse, by encouraging dieting, which in turn leads to most people yo-yoing in weight, it may actually increase the risk of ill-health: people who lose weight and regain it have a greater risk of mortality than those who never tried to lose weight.

Incredibly, because two-thirds of us are categorised as overweight or obese, the panic about obesity manages to demonise the majority of the population. We have created a carnival of self-loathing that surely outweighs any possible benefit from being thinner. As the American commentator Paul Campos shrewdly notes about the `war on fat': `In the end nothing could be easier than to win this war: all we need to do is stop fighting it.'


Landmark Obesity Report: Kids Need To Move, Move, Move

Yesterday the Institute of Medicine (IOM) released a "progress report" on fighting childhood obesity in America, and the news wires are burning up. Most impressive about the new report is that, despite being commissioned by the let's-fight-obesity-like-tobacco crowd at the Robert Wood Johnson Foundation, it places strong emphasis on the role of physical activity in promoting good health.

In particular, the IOM committee took the Bush administration to task for killing the funding of the federal VERB program, which "claimed it led to a 30 percent increase in exercise among the pre-teenagers it reached," the Associated Press reported this morning. Considering the various scientific findings indicating that caloric intake among the young has not increased in the last several years, while physical activity has dropped like a stone, this might have been one of those rare government initiatives that did more good than harm.

Recommendations like those made by the IOM's committee fly in the face of the more paternalistic demands made by the would-be fat-taxers at the World Health Organization (WHO). The panel's praise for the physical activity promotion campaign directly contradicts the claim made by WHO's Robert Beaglehole, who was quoted yesterday: "Let's be very clear -- the answer to this epidemic is not going to come from physical activity."

Naturally, the self-appointed "food police" at the Center for Science in the Public Interest (CSPI) took the occasion of the report to go nuclear. Margo Wootan, CSPI's chief cupcake crusher, said "the current national response is like putting a Band-Aid on a brain tumor ... We need a whole shift in thinking about how often to eat, what to eat and how much to eat."

As a report in USA TODAY indicates, however, the Big Brother so adored by CSPI isn't likely the man for the job. Instead, it looks like Father, and, even more so, Mother:

Obesity begins at home.

That's the conclusion of nutrition experts who are sorting through a parade of studies released this summer that shows children in all age groups in the USA are gaining too much weight - even babies. And those experts are laying the lion's share of the responsibility on parents, many of whom also are heavy ...

Children say they depend on their parents for the ABCs of good health: 71% say they get information about how to be healthy from their mothers, according to a survey of 1,487 children, ages 8 to 18, conducted for the America on the Move Foundation. And Dad is the resource for 43% of the children.



Jamie Oliver, the public face of Sainsbury's, has been slapped down by the supermarket's boss for his attack on the standards of packed lunches offered by parents. The chef and food guru, who has achieved huge success in improving school meals, is angry his work is being undone by parents who provide "junk" packed lunches. He let rip last week, saying those adults who put crisps, chocolate and sugary fizzy drinks into packed lunches are "idiots", coupled with a host of colourful expletives....

However, the food industry claims there is no such thing as bad food and that it is wrong to demonise products high in fat, sugar and salt. Mr King said: "While I agree with Jamie's drive to get children eating healthily, his attack is neither correct nor the best way to achieve a change. "I ate crisps when I was young and drank fizzy drinks. My children do the same and they should be allowed to enjoy them. "There is no such thing as bad food - just bad diets." He added: "Dictating to people - on unleashing an expletive-filled tirade - is not the way to get engagement."

The comments, in a piece written by Mr King in the Guardian, represent a very public dressing down. They suggest that the relationship is strained and put a question mark over whether the annual contract with Oliver will be renewed. Last year, Mr King ordered a full review of Sainsbury's advertising. This included the possibility of dropping Mr Oliver.



Just some problems with the "Obesity" war:

1). It tries to impose behavior change on everybody -- when most of those targeted are not obese and hence have no reason to change their behaviour. It is a form of punishing the innocent and the guilty alike. (It is also typical of Leftist thinking: Scorning the individual and capable of dealing with large groups only).

2). The longevity research all leads to the conclusion that it is people of MIDDLING weight who live longest -- not slim people. So the "epidemic" of obesity is in fact largely an "epidemic" of living longer.

3). It is total calorie intake that makes you fat -- not where you get your calories. Policies that attack only the source of the calories (e.g. "junk food") without addressing total calorie intake are hence pissing into the wind. People involuntarily deprived of their preferred calorie intake from one source are highly likely to seek and find their calories elsewhere.

4). So-called junk food is perfectly nutritious. A big Mac meal comprises meat, bread, salad and potatoes -- which is a mainstream Western diet. If that is bad then we are all in big trouble.

5). Food warriors demonize salt and fat. But we need a daily salt intake to counter salt-loss through perspiration and the research shows that people on salt-restricted diets die SOONER. And Eskimos eat huge amounts of fat with no apparent ill-effects. And the average home-cooked roast dinner has LOTS of fat. Will we ban roast dinners?

6). The foods restricted are often no more calorific than those permitted -- such as milk and fruit-juice drinks.

7). Tendency to weight is mostly genetic and is therefore not readily susceptible to voluntary behaviour change.


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