DDr Hamish Meldrum, head of the British Medical Association, is one of life's boffins. With his salt-and-pepper beard and his sensible shoes, he is known for his thoughtful and circumspect comments on all the matters that fall into his remit. But earlier this month, Dr Meldrum seemed to veer off course. He claimed in an interview that fat people are simply greedy and obesity is caused by over eating. "We are in danger of 'over-medicalising' the problem," he said.
Obesity experts were immediately outraged, and said that Dr Meldrum's remarks were unhelpful and anachronistic, as well as politically incorrect. The 88,000 people who were prescribed with anti-obesity prescriptions for drugs like Xenical and Reductil last year, and the one in four Brits who, according to the World Health Organisation, are obese, no doubt felt similarly affronted.
How, they probably wondered, could Dr Meldrum, a medical man, not understand that their problem is genetic, an illness, a cruel compulsion. How could he fail to understand that what fat people need is medical intervention and drugs, and that if this was a simple matter of eating less then they wouldn't be in this position in the first place? And many would also say, what is wrong with being fat anyway?
However, if you are not one of these people, then let me ask you this. How many of you have watched an obese person chowing down on a double hamburger with double fries and a triple cola and thought "Why don't you get it?" How many of you have stood in a newsagent watching an overweight person forcing their overweight hands into a family-sized bag of Doritos and thought "You shouldn't be eating that."
And how many of you listened to Dr Meldrum and thought "He's absolutely bloody spot on."
Right or wrong, the reason Dr Meldrum caused such controversy is because his words in fact marked the latest victory in a cold war that is taking place on every street corner and within every household in the country. Thanks to Dr Meldrum, the skinnies scored again.
While, publicly we all recognize that people can be divided over deep-seated issues such as religion, politics and money, we are now also separated by another issue: fat.
We barely noticed it as it crept its way into our mind, put its roots down in our brain and expanded its tendrils slowly into our consciousness. Slowly, it began to control our views and guide our judgement towards other people. Now, I'm not entirely sure a thin person can look at a fat person without passing a silent judgement, nor can a fat person look at a thin person without sentiment, be that envy or angry defiance. Each side is busy racking up points against the other and at the moment, the skinnies, lead by the likes of Victoria Beckham, Kate Moss and Nicole Ritchie, are winning.
They are the most beautiful, they are the most successful, they are the in-crowd. There was once a time when being large was a sign of prosperity but that pendulum has now swung in the opposite direction and now, according to the Office of National Statistics, obesity is more common amongst lower classes and those in "routine or semi-routine occupational groups than the managerial and professional groups". The fatties, despite well-respected and successful figureheads such as Beth Ditto and Kelly Osbourne, are fighting a losing battle to be seen, heard and respected.
Perhaps this is not surprising, given the strength of recent scientific research on the matter, which only seems to fuel the social divide. Take the report published earlier this year in the Journal of Evolution and Human Behaviour. It concluded that fat people actually have the ability to make thin people ill.
The researchers said that thin people instinctively dislike fat people because their immune system associates fat with infection and sends out a signal of disgust. It is, they say, no different than what happens to our bodies when nausea is triggered on encountering a bad smell.
The study points out that "antipathy towards obese people is a powerful and pervasive prejudice" but suggests that far from being irrational, this could be rooted in a clever Darwinian desire to protect against signs of disease.
Another recent study, carried out at the University of California, showed that obesity spreads within social networks and that people with fat friends are 50 per cent more likely to be overweight than those who hang out with skinny people.
These things considered, its difficult not to wonder if one day the fat and the thin will live as two separate tribes, or perhaps, eventually, species.
Peter Marsh, the co-director of the Oxford based Social Issues Research Centre has just completed a report on "Belonging" in 21st century Britain; he agrees that fat and thin is enough to drive the population into distinct groups.
"We consider ourselves individuals, but it is our membership of particular groups that is most important in constructing a sense of identity" he says. "Without doubt, there is escalating polarization between fat and thin and we suspect that will continue for some time. Couple that with a general sense in Britain that thin equals beautiful and healthy, and what you have is a growing sense that thin is 'in' and fat is very much 'out.'
"This means that members of the thin group grow in power, with better access to jobs and a voice that is more likely to be heard, while fat people feel like an unpopular minority and are without doubt stigmatized. They feel increasingly inadequate, insecure and neurotic, pinning all their hopes on fad diets. Which is a depressing thought given that in the long term, research has proven that those who spend their lives on diets actually end up larger than those who don't diet."
This segregation is, without doubt, growing more extreme, and in some cases more bizarre, by the day. In America, trendsetters such as the website Style.com and The New York Times have named "the bony parts", namely legs and ' the clavicle, as the "new erogenous zones". Really? Even skinnies should now be asking themselves whether it's really possible that the sight of a razor-edged collar bone can make men weak at the knees in the same way as an image of Scarlett Johanson's cleavage?
But no, their stampede continues regardless, and their propaganda grows stronger by the day. The book Skinny Bitch, of which Victoria Beckham is a fan, has become a bestseller and every serious-minded skinny has a copy. It promotes a vegan lifestyle of fruit, vegetables and whole grains and is billed as a "no-nonsense, tough-love guide for savvy girls who want to stop eating crap and start looking fabulous."
The quiet town of Buckingham has also morphed into a skinny mecca. Scientists there are busy working on a baby formula with the power to programme babies' metabolisms to prevent them from ever getting fat. No doubt, if successful, it will make them all billionaires. The drug will influence levels of the hormone leptin, which is thought to act on the hypothalamus which influences food intake and energy expenditure in the long term. If the hypothalamus can be programmed to guarantee your baby girl will still be able to slip into her 26-inch waist jeans even after having three children, thanks to a quick injection shortly after birth, then why not.
And the goalposts of what is thin have been firmly moved too. Once, a size 10 was good enough. Now, unless you've been hiding in a cave in the Outer Hebrides, you will be more than aware that a size zero is the new ideal. In LA, women are apparently achieving this by taking a veterinary medication called clenbuterol. Normally used to treat asthma in horses, it causes rapid weight loss in humans.
I was offered the job of reporter on a recent Channel 4 documentary which would have involved me effectively starving myself and over-exercising for 10 weeks to see if I could achieve a size zero. I was told I'd also need to eat cotton wool, make myself sick, purge on laxatives and live on a diet of only lemonade and cayenne pepper.
I turned the job down on the grounds of a desire to preserve my sanity, but I was left wondering if the programme's producer might be secretly longing to take on the role herself. She talked to me as if the entire female population of the world were worshipping at the altar of size-zero women.
Everyone, I thought, save for the mothers of two size-zero models, 21-year-old Brazilian Ana Carolina Reston and Uruguayan model Luisel Ramos, who recently died of the results of their starvation diets, and the parents of the legions of girls with eating disorders who refuse to eat in the hope of one day looking as thin as Paris Hilton.
Thin may be in, but it is impossible to avoid the fact eating disorders across all ages, from children to middle-aged women, are on the rise. Online, pro anorexic groups, where girls boast of choosing an anorexic lifestyle and post "thinspiration" pictures of skinny celebrities, are thriving.
One clinic in Scotland recently reported a four-fold increase in women in their 30s, 40s and 50s being admitted with anorexia and bulimia. Surely something has gone wrong when middle-aged women subject themselves to tortuous gym routines and starvation diets when a decade ago they would have been more concerned with getting the children to pony club on time. But then, 10 years ago, they didn't have to wake up to see the likes of Madonna, fast approaching 50, prancing around in a high-cut leotard and putting everyone else her age to shame.
Dr Helena Fox is an eating-disorder specialist and consultant psychiatrist at the Capio Nightingale psychiatric hospital in London, and runs a clinic that is permanently full. She believes that current super-thin standards will only lead more women to knock at her door.
"Although there are many factors that lead to eating disorders, the bottom line is that my patients simply believe that if they are going to be successful, considered attractive and be able to do things like get married and find a husband, they have to be skinny," says Dr Fox. "They say things like 'Yesterday was a good day.' When I ask them what this means, it turns out they mean they only ate three lettuce leaves. In today's world, that has become an achievement."
Thankfully, a backlash has begun against the skinny army, but what it will achieve is not yet known. In America, we are now seeing the rise of so-called "fat acceptance groups", such as NAAFA (the National Association to Advance Fat Acceptance) which empower obese people to live more fulfilling lives. Groups meet to offer support and advice to each other just as Alcoholics and Narcotics Anonymous do.
The likes of Beth Ditto and Tyra Banks are attempting to do their bit too. Banks, after being pictured in a less than flattering swimsuit last December, told those that criticized her to "kiss my fat ass" and started a campaign called So What! which aimed at encouraging women to be positive about their bodies. Beth Ditto is rumoured to be bringing out her own plus-size clothes line.
Following in their wake is American comedian and actress Mo'nique, a size 18, who bills herself as a "fat woman talking about being a fat woman." Her book, Skinny Women Are Evil, is about raising the plus-size army to fight back against the skinnies, and quickly became a best seller.
"I wish I didn't have to write the book, but I did because big women are subjected to ridicule simply because we're blessed with a few extra pounds," she says. "I've enjoyed a life-long affair with every roll, every curve and every pound, and because I've always loved me, I've never felt the need to apologise.
"Skinny women are the most intolerant, competitive, judgemental, shallow, sharp-tongued creatures to walk the face of the earth, and just because we like to eat doesn't meant there shouldn't be room in the spotlight for us to shine too."
A backlash is evident on British shores as well, although without quite the same veracity. Nonetheless, issues like model health are being tackled. Although the Interim Report of the Model Health Inquiry, for instance, stopped short of enforcing rigorous measures to weigh models or test their BMI, it did recommend models aged under 16 be banned from runways and also suggested designers should be trained to help models with eating disorders, and that all models should receive education about healthy eating.
And a new Channel 4 series, despite being dubiously named Cook Yourself Thin, is about ditching diet books and learning to cook from scratch. It is fronted by a Claudia Schiffer's ex chef Sophie Michell, who despite cooking for a supermodel is herself a rounded size 12.
"We've lost all sense of middle ground when it comes to weight," says Sophie, who has been critised for being too plump to be qualified to talk about weight loss. "I did a demonstration with some girls recently and they literally backed away from the counter when I got out the olive oil. Why is it that it's no longer enough to be just healthy?"
But it is difficult to be entirely convinced of the rectitude of this backlash. Tyra Banks, for example, undid her good work when she lost two stone this summer, suggesting that despite her bravado, she had taken the criticism to heart.
And take the very public case of Anne Diamond, the British television presenter. She spent years being overweight and a role model for bigger women. Then she had a gastric band fitted. "Being overweight affected every day of my life," says Diamond. "It isn't easy starting the day with a smile when all you can do is pull on a pair of size 22 stretch black trousers and a T-shirt that could shelter a dozen earthquake victims. You feel wretched. It shouldn't, but fat demeans you, even in your own eyes."
Perhaps, no matter how proud they appear and what they say, the fat can't help but wish they were thin.
As with any war, the only real solution lies in coming together and developing a mutual respect for the other's position. This would seem especially poignant given the thoughts of Dr Adrienne Key, a specialist at the Priory Clinic.
She points out that both extremely fat and super thin are part of the same psychologically disrupted attitude to food that is endemic in Western consumer societies. Third World cultures, she says, do not suffer from a wish to be a size zero, nor do they experience obesity. Fat people and thin people, she says, are fighting the same battle.
This knowledge however, is unlikely to spur either side to lay down arms, let alone call a truce. No, this is a battle that for the immediate future at least, is here to stay. *
Fiona Wright: So I'm skinny, get over it
I've been slim all my life. I've never dieted, I rarely go to the gym and I'm a size eight. Even having two children in quick succession has made no difference to my weight. In fact, I'm thinner now than I was before. Do you hate me? I spend my life being chastised by my friends. "You don't eat enough," they cry. "You're too thin, your legs will snap."
I've never really minded though, because I know the secret code. People who criticise me for being slim are jealous. "Skinny cow" translates roughly as "I want to be slim like you." Adults rarely mock fat people, because no one likes kicking someone when they're down.
Most people think I must have good genes or I'm just lucky. The bottom line is, I just don't eat that much. I don't consciously diet, but I eat healthy food in moderate portions. I don't obsess about it. To be honest, I don't really think about it. And there's the rub. Fat people do think about food – a great deal. They know that they can lose weight by eating less, but they choose not to. And let's be clear here, it is a choice. Over-eating is a vice. It makes people feel better, temporarily. If you're eating because you're unhappy or bored, unless that changes, you won't stop eating.
I'm not suggesting that I lead this flawless life, but I don't rely on food to bolster my feelings. Because whether we like it or not, looks count, and looking fit, slim and healthy is about taking responsibility for yourself. If you're very fat, whether it's true or not, people think you have no will-power and no self-respect. They think you're not good at your job, not good spouse material, not well-paid and not successful. I know I'm going to get hate mail for this, but after doing a quick poll in the office, no one disagreed with me. Apart from anything else, being fat is not good for your health. Lovely, clever Dawn French and Fern Britton can protest all they like about being happy with their size, but they are more likely to die earlier than thin people. And that really is the bottom line.
Ursula Hirschkorn: Fat and proud
Anyone would think that being able to squeeze your skinny haunches into a size zero was some sort of Nobel Prize-worthy achievement, the way we laud those few women who manage it.
Posh Spice, Nicole Richie – what's their talent apart from an ability to say no to food? Who cares when their bony behinds have dozens of picture spreads devoted to them?
But what good is a seriously skinny body, if no one gets to enjoy it, least of all yourself? I've been a size six (a US size 2), and I was miserable as sin, caught like a hamster in a constant cycle of fitness and fasting, just so I could keep track of every bone in my ribcage.
After years of starving myself to keep slim, I realised I was on the wrong side of the battle against fat, and that I should give in and let my inner big girl out to play.
I'd brainwashed myself that when it came to diet, dainty was best, picking salad over steak, espresso over ice cream, but who was I kidding? If cottage cheese really was tastier than a luxuriously creamy korma, we'd all be size zero and it'd be no big deal.
The new, super-sized me can enjoy a meal out with friends without salivating over their every mouthful as I toy with a salad leaf; I can sleep in, instead of setting the alarm for 6am for daily trips to the gym; and I can grow out of my clothes and into my curves.
Give me the choice between size zero, or 2-0, and I'll race you to the plus-size rail. It's not that I have anything against the skinnies (after all, it's nothing a few cream cakes can't cure), it's just being fat is so much more fun.
The role models
1. Kate Moss: Veteran waif and supermodel.
2. Rachel Zoe: Anorexic-looking stylist to the stars "credited" with starting the size-zero movement.
3. Angelina Jolie: Skinnier with every new child.
4. Victoria Beckham: Number one "thinspiration" role model on pro-anorexia websites (which promote anorexia as a lifestyle choice).
5. Mischa Barton: Admits she'd be "frightened" of having the voluptuous figure of her former 'The OC' co-star Rachel Bilson.
6. Nicole Ritchie: Actress and singer said, pre-pregnancy, to weigh just six stone.
7. Kate Bosworth: Once a glowing surf chick, now one of the " lollipop head brigade".
Books: 'Skinny Bitch' by Rory Freedman and Kim Barnouin, 'How the Rich Get Thin' by Dr Jana Klauer, 'That Extra Half Inch' by Victoria Beckham.
Television: 'You are What You Eat' presented by ferociously sinewy Gillian McKeith
Holidays: The Mayr Clinic in Austria, for a fortnight of colonic irrigation, stale bread and starvation.
Food and drink: Luscious Organic, Kensington, one of Britain's only macrobiotic restaurants; Skinny Water – bottled water fortified with L-Carnitine and Chromium, said to aid weight loss.
Beat, the UK eating disorders charity, estimates there are 1.15 million people in Britain with eating disorders. According to the Department of Health, some 15 per cent of cases of anorexia result in death, caused mainly by suicide, and complications due to starvation. Being underweight raises risk of osteoporosis and brittle bones, heart attack, kidney failure and infertility.
'Size zero' is a equivalent to UK size 4 and a 22in waist.
The role models
1. Beth Ditto: Hefty rock singer and friend of Kate Moss who says she's never tried a Slim Fast in her life.
2. Lily Allen: Won legions of fans when she posted a video of herself crying on MySpace, saying she felt "a bit chubby".
3. Coleen McLoughlin: Wayne Rooney's fiancee proves an average girl with an average body can make millions.
4. Fern Britton: Self-confident size-16 TV presenter.
5. Kelly Osbourne: The singer and fashion designer who never outgrew her puppy fat.
6. Dawn French: Large-and -proud comedienne who is convinced she will shortly die (not,ironically, it seems from health-related problems)
7. Tyra Banks: once a supermodel, now proclaiming "Kiss my fat ass" on behalf of all plus-sized women.
Music: Mika's 'Big Girl (You are Beautiful)', Mutya Buena's 'Real Girl' and 'Ugly' by The Sugababes.
Books: 'Skinny Women are Evil', by Mo'Nique, 'Fat Chicks Rule!' by Lara Frater, 'Fat is a Feminist Issue' by Susie Orbach.
Films: 'Hairspray' (2007), in which "pleasantly plump" Tracy Turnblad proves weight is no obstacle to fame.
Art: Jenny Saville's oil paintings of curvaceous nudes.
A BMI (body mass index) of over 30 is referred to as obese, over 35 is known as morbid obesity, and over 40 indicates extreme obesity. Obesity is responsible for more than 9,000 premature deaths per year in England and increases risk of chronic diseases such as heart disease, stroke, type 2 diabetes and some cancers. A report by the World Health Organisation also suggests that health is compromised when waist measurement exceeds 94cm (37in) for men or 80cm (32in) for women. .Reuse content