WHO'S GOING TO GET FAT ON THE OBESITY BUDGET?

C Susie Orbach 2004

This discovery of a new pill to treat obesity and smoking looks like a
godsend to a government groaning under the weight of the obesity
epidemic. By mucking about with the brain receptors that give cannabis
smokers the munchies, the appetite and desire of those who eat and smoke
too much is meant to be curbed.

Perfect, right? Far from it. Rimonabant, the newest in a long list of
drugs trailed by the pharmaceutical companies that are supposed to deal
with the obesity have been found to be ineffective in all respects
except for transferring NHS monies to the ledgers of the pharmaceutical
companies.

It's not only the NHS that's been out of pocket. Millions are spent by
individuals seeking 'cures' for adiposity. In the States, the figures
from 1990 were a $60 billion spend on diet and diet related products.
That rivals the combined health, welfare and social security budget for
the same period. And the extraordinary thing about this vast amount of
money going to the diet industry is that many individuals who are far
from obese, have come to believe that they must constantly diet.

It isn't that we don't have a serious obesity epidemic. We do. And the government is absolutely right to be concerned.

The launch of a consultation exercise is welcome. Obesity can be a killer as well as a source of anguish and pain to the individuals who are caught inside of it. Working out the ways to deal with those who are currently obese and how to prevent future obesity is crucial.

But we also need some caution. Obesity is a political category with some
intriguing players. We demonise overweight so automatically that we, the
public, the researchers, the government, the eating disorders industry,
the food standards agency, the food activists don't question our
responses to it. Obesity researchers have become adept at writing
abstracts for their papers which draw highly questionable conclusions
about the negative health consequences of overweight which are not
supported by the data in the paper itself. Studies that show no
difference between the health risks of overweight and normal weight
populations are consistently ignored or under reported.

Consider the curious fact that in part, the growth of obesity is has to do with a recent reclassification of the size at which we are deemed fat. The body mass index (BMI) has been revised downwards. Overnight, 39 million Americans - plumpish but not at risk - woke up to find themselves defined as overweight.

Paul Campos, author of the forthcoming The Obesity Myth points out that the new BMI puts Brad Pitt and Mel Gibson as "overweight," while Russell Crowe and George Clooney are now obese.

Who profits by this panic about obesity? Let's be sure that those
invited to solve the problem are not part of creating the problem in the
first place. A population defined as overweight when they are not,
becomes distrustful of its own eating and vulnerable to industries which
profit from their distress.

Take the diet industry for one. It thrives on two notions: first that we could all lose a little weight and second, that all diets fail.

Dieters lose weight, but they can't keep it off. Our bodies have an in-built set point which regulates how our metabolism works to keep us at a personal size that is uniquely right for us (a size undermined by the omnipresent singular images of thinness we see thousands of times a week). Size isn't as simple as calories in and calories out. The metabolism of the repetitive dieter slows down as her food intake decreases and it may not speed up when there is plenty. Repetitive dieting then makes fat hard to shift. No wonder then that 97% of diets fail. If dieting worked you'd only have to do it once. And that would hurt the diet companies.
The government wants us to take personal responsibility for our health
but with 80% of women dieting at any time, here is an instance of
personal responsibility creating the opposite of what we require.

Diet companies are the sharp end of a food industry that targets
consumers to buy more. When we buy low-fat food in which the intrinsic
fat of the product has been removed, we may know that the food has been
enhanced with chemical flavourers and all manner of salts and synthetic
sugars to make it palatable. But we may not have stopped to consider
that the skimmed off fat isn't thrown away. It's sold back to us as a
treat, an indulgence, a little something we deserve or can be naughty
about. In the panic over obesity, argue for plonking a fat tax on these
foods as though that would be a hindrance to their consumption. Imagine
ice cream or crisps bearing an extra tax. Could anything be more
alluring?

There is undoubtedly an argument for reducing the salt, corn syrup and
sugar that has been added to foods to prolong their shelf life and
augment their flavour. Industry cooperation here is beginning because of
the fear of tobacco style law suits Campaigns for slow food, for
breaking the stranglehold the supermarket chains exercise on producers
by supporting local sourcing, reintroducing cooking on site in schools,
encouraging children to enjoy fruits and vegetables are influencing
government policy.

But whatever initiatives the government makes are likely to be thwarted
by the increasingly dominant thin aesthetic which is so invasive that it
affects almost all women and their eating. Even those who have just had
babies who feel - post Liz Hurley - impelled to return to their
pre-pregnancy bodies before they've even finished nursing. Newborns
imbibe, along with mother's milk, a jittery ambience around food and
grow into children unsure of their own appetites. Banning advertising of
junk food to children is worth a try, but it won't be enough. We
urgently need programmes to enable new mothers to feel confident about
their own appetites.

We've got an eating disordered population passing
on the conditions for obesity. This is not a genetic or biological
phenomena but a psychological and social one.

The situation is serious. It requires assessments of how disparate
phenomena - a thin aesthetic, a culture of dieting, adulterated food,
the sedentary life - relate to the obesity epidemic. It may also require
interventions in places which will put the government in conflict with
big industries.

There are some wonderful examples of good practice: the successful
Glasgow schools meals initiative where children want (yes want!) to eat
fruit and veg because of the way it has been presented; the work with
the beauty industry to expand our notions of beauty; the move towards
comprehensible food labelling.

We need to make sure that we don't undermine these efforts by succumbing
to the latest pill hype or sending NHS contracts to slimming companies.
Thoughtful balanced initiatives that cut against the alarmist thrust
that obesity is around the corner for everyone of us and our children is
a place to start. Hysteria move government budgets but let's make sure
they are going to the right places.

Susie Orbach, the psychotherapist is author of 4 books on eating and is
convenor of AnyBody http://www.any-body.org/

Comments

[Cyn]

Yeah, I have trouble wading through Suzie's stuff--I think I've only read Fat, etc. This article comes from a list-serve for professionals in health research, nutrition, teaching, & counseling. The group, which includes some high-profile names in this area, is health-oriented without being inherantly anti-fat.

[Vanessa]

She wrote 'Fat is a Feminist Issue' right? The concept was a neat idea, but the book was toss, I thought.

[lakkris]

i find that same statistical mucky mucky with Baseball. Add more games and change how they gather statistics then you cannot compare Babe Ruth to Mark McGuire. It's not possible because you compare apples to oranges.

Amazing that people don't realize this kind of maneuvering and posturing.