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Dominic Lawson: Don't believe obesity figures – they're spun for a purpose

Friday, 29 August 2008

You can run, but you can't hide: a wave of contagious obesity is, apparently, sweeping the country from top to (ever-expanding) bottom. Yesterday's Guardian declared that "Obesity epidemic spreads to new areas in the south", while simultaneously pointing out that "the worst obesity hotspot is Shetland". Meanwhile the Financial Times warned, rather in the style of a Meteorological Office alert, of "a belt of obesity stretching across Wales, the north Midlands and northern England".

Yes, it's still August, and even the more unsensationalist newspapers are prepared to swallow whole the sort of statistical surveys which would normally end up impaled on the news editor's spike. For both of these stories - and many others, along exactly the same lines – are a regurgitation of a report from an organisation called Dr Foster Research. What some of these supposedly terrifying reports fail to tell us is who paid for this research. It was funded by Roche, the pharmaceutical company which developed the anti-obesity drug Xenical.

This does not in itself discredit the survey – but it's still useful to know what its ultimate purpose might be. A year ago, for example, Dr Foster issued a report which complained that "around 3 per cent of Primary Care Organisations do not fund the use of drug therapy for obesity, despite the recommendations of organisations such as the National Institute for Clinical Excellence." With a crafty eye for the prevailing political wind, this press release from 'Dr Foster' was headlined "New audit reveals inequality in NHS services to tackle obesity across the UK."

That particular "audit" was funded by Abbott Laboratories, developers of the anti-obesity drug Reductil; it was obviously not designed to address the question of whether the 3 per cent of PCOs which chose not to prescribe pharmaceutical treatments for obesity had decided that there were more urgent or deserving causes to be treated by means of their drugs budget, or perhaps simply took the view that these slimming drugs had side effects which could outweigh the benefits.

Dr Foster's latest "audit of obesity" has at least attracted some criticism, following its initially uncritical reproduction by the press and broadcasters. The MSP for Shetland, Tavish Scott, said that it was "absolutely ridiculous to suggest that Shetland is an obesity hotspot". NHS Shetland declared that Dr Foster's audit was based on "flawed research". Well, they would say that: but there does seem to be something fishy in a report which has Glasgow well down the "obesity league" with a figure of 6.6 per cent of the local population, while Shetland comes out worst in the entire country, at 15.5 per cent.

I do have a doctor friend, a great worrier about obesity, who claims that the further north he travels in the United Kingdom, the wider people's bottoms seem to be – especially among the female population, he insists – but even so I can't help feeling that the people of our most northerly outpost do not merit being stigmatised as the tubbiest in the land. And even if they were indeed so well-layered, they have a particular requirement for such internal lagging which provides much needed warmth for the inhabitants of a cold and remote spot; they therefore deserve our understanding, rather than our criticism.

More pertinently for us all, there is nothing wrong, or even unhealthy, in being obese, at least as defined by the official measurement known as the Body Mass Index. Admittedly, I speak as a man of average height who weighs 15 stones; but on current BMI definitions George Clooney and Russell Crowe are clinically "obese" while Brad Pitt and Mel Gibson are "overweight". Meanwhile another doctor friend of mine points out that many of his anorexic patients would be classified as very healthy according to most conventional measurements, such as blood pressure; but clearly their attitude to food is anything but healthy.

Do not expect such arguments to weigh heavily with the political class. Both the Government and the official Opposition are engaged in a battle over which of them can appear most productively concerned about "the obesity epidemic". The Conservatives have found it a rewarding way of scoring easy points off a punch-drunk Labour administration. A few weeks ago, David Cameron declared that the Government had failed to stress personal responsibility for obesity: we should stop talking about it as something that just happens to people, he said: they needed to pull their socks up – specifically, to eat less and exercise more. This week, however, the Conservatives seem simultaneously to be taking the completely different tack that it is all part of a growing inequality between the various social classes which it accuses the Government of failing to address.

There is, in fact, almost no difference in the rate of so-called "obesity" between people of different income levels. It is possibly true that truly morbid obesity is now more common among the poorer, when once it was the exclusive privilege of the most affluent – Queen Victoria and her son Edward VII both boasted figures which did not deviate much from the spherical. This modern trend, which differentiates the developed world from less fortunate nations, is not a result of increasing relative poverty in the UK, as so many insist: instead it demonstrates that, at least in terms of food purchasing power, we have, after the US, the richest poor people in the world.

In any case, what are we supposed to do for those who choose to eat vastly more calories than they burn up through work or exercise? When the Government imposed Jamie Oliver's "school dinners revolution" on the state education system, it backfired almost comically, as increasing numbers of pupils abandoned the newly "healthy" school canteen, while their anxious mothers pushed Big Macs at them through the school railings. Anyone who has attempted to persuade their own unwilling child to eat an unwanted salad or vegetable will be instinctively sceptical about the state's ability to succeed in enforcing dietary correctness.

Even with all the panic partially promoted by the manufacturers of slimming pills, we are at least a long way from emulating the law recently imposed in Japan: this requires all adult citizens to have their waists measured by order of the state, and if they repeatedly exceed the allowable limit – 33.5 inches for men and 35.4 inches for women – they are subjected to "health re-education" and their employers become liable to financial penalties.

An overweight nation might indeed be aesthetically less attractive than, say, the Nubian tribes whose physical perfection so transfixed the late Leni Riefenstahl; but we should still treasure the freedom to grow into shapes which reflect our own pleasures, rather than the requirements of conventional wisdom or the box-ticking desire of officialdom for a lower national average waistline.

d.lawson@independent.co.uk

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Comments

59 Comments

The is the so called 'obesity paradox' where research keeps on not proving that being heavier is bad for your health. This is the biggest indication that research into this topic is fueled by prejudice more than anything else. For more info on the 'obesity paradox' go to www.junkfoodscience.blogspot.com

Posted by m gordon | 02.09.08, 18:46 GMT

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Quite right - eat all you like and the state will pay for the consequences. Fatties die young, and often a miserable death.

Posted by Adam | 30.08.08, 23:09 GMT

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Compare a photo of football supporters from the 60's and the present day as I recently did. The contrast is scary.
The sixty's lads look far healthier and more alert. I am amazed when walking round town and seeing young men with thick necks and flab everywhere. There will always be a variety of figures thank god. But we cannot delude ourselves that being portly should be the norm. Enjoy sensible eating, and watch out for the main culprit sugary soft drinks.

Posted by Harry Owen | 29.08.08, 22:16 GMT

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twfloraldesign at gmail.com email me for a good time:)

Posted by bitch | 29.08.08, 19:05 GMT

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Surely you mean waddle Dominic ? 9 out of 10 cats suffer broken bones when trodden on by fat owners because they are too fat to move its PC gone mad !

Posted by Fat Cats for justice | 29.08.08, 18:31 GMT

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The NHS should not be judgmental abut people's weight or lifestyles - why? Because these are often predetermined via genetics or personalities formed in early life. Perhaps people who drive should not get free healthcare? Or people with too many kids? Or people who play sport? Or people who are black/Asian therefore more likely to get heart disease and diabetes because of their heritage? All wrong and stupid, but much loved by the pompous and the sanctimonious.

And remember, just because people are overweight - even obese - that does not necessarily mean they eat unhealthily or live unhealthy lifestyles. There are plenty of slim people who live off fast food and whose cholesterol is high. Winston Churchill was healthy - he ate well. Many slim people do not - and many sport people are very unhealthy and die fairly young.

Lots of stones flying aroung this glass house today...

Posted by Winston | 29.08.08, 18:02 GMT

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"there is nothing wrong, or even unhealthy, in being obese"
- really? You mention that you are 5 stone overweight. Didn't your school teach you metric measures? If you're of average build and height, then you are 50% heavier than you should be. Maybe all the fat is in your head, because if you can't see that there is a serious problem, you must be in denial.
I recently visited the UK on holiday. Compared with when I left 10 years previously, many people were so obese that they resembled farm animals.

Posted by Clive | 29.08.08, 17:53 GMT

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KATH - I appreciate the reasonable tone of your rebuke. My comment was not aimed at the medical tier of the NHS (i.e, the useful poeple) - more the propaganda wing. My attack was fuelled by personal experience; hence the vehemence. If you had been, rightly or wrongly, ejected from every pub in the country largely because of the spin and lies told by a certain organization you might also feel aggrieved. If that same organization had, through negligence, almost killed your partner then you might also feel anger on top. I'm perfectly slim and healthy by the way.

Posted by Adrian Smith | 29.08.08, 17:52 GMT

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Andrea,
you're absolutely right. I guess being poor isn't a complete barrier to being fit - it just exacerbates the problems of lack of education and availability of cheap ready meals.

Posted by Ian | 29.08.08, 17:25 GMT

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Adrian, it may not be our purpose in life but we certainly ought to make it our business to at least work with the NHS if we expect it to pick up the pieces when things go wrong for us. Big fat bullying mouths? Try overstretched, overworked and underfunded.

I am in no way a Cameronian but is it really unfair to ask people to at least attempt to help themselves rather than drain resources from the NHS?

People complain about the nanny culture in this country but they have been babeified by the welfare state (of which I am a supporter). In Italy there is not NHS which perhaps accounts for why they care alot more care of themselves, they are thin and yet still manage to eat very well.

Posted by Kath | 29.08.08, 17:24 GMT

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