Is overeating an illness? Is being a bit fat and a bit lazy a clinical condition? Is even posing such questions an admission of craven defeat in our ongoing battle of the bulge? No. No. Yes. But. A big but. For (whisper it) big butts.
Anyone already offended ought to keep reading. This is probably about you. And me and most other people “carrying a few extra pounds”, as the modern euphemism has it.
A group (maybe the collective term is an outbreak?) of doctors has written to the British Medical Journal suggesting that obesity be classified as a disease. I know, I know, but stay with me. It’s nonsense, of course. Yet I think I can discern the method in their madness; this is a bold exercise in rebranding par excellence.
Our medical experts know full well that obesity is not really a disease — anyone with half a brain can see obesity is self-inflicted. Too many calories, too little exercise, all smothered with a large dollop of defensiveness (just listen to me shriek in outrage in the Zara changing room ...).
Love your curves if you like, ladies. Big can indeed be beautiful. However, it can also be a pathway to Type 2 diabetes, cardiovascular issues, stroke and heart attack.
Binge eating is, if anything, a mental health issue — but if people hate being told they are fat, they won’t appreciate being told it’s all in the mind.
If we as a society are to make any progress in fighting the flab we have to engage with the world as it is, rather than how we would wish it to be.
That means treading softly, because we tread on emotions. For the record: I am a bit fat. I have been chubby and slim and very slim for a long time and really quite hefty.
Being slim was the best because it freed up my brain, which would otherwise be fogged either with visions of dancing Curly Wurlys or disgust at my intemperate Curly Wurly consumption. So I can say with some authority that people who are fat know they are fat.
Nevertheless they tend to get cross when it is pointed out, because they feel judged. Whether or not that judgement is justified is immaterial; people who feel humiliated are more likely to reach for a snack than a pair of trainers.
If we are to tackle this growing public health crisis, then we need to call time on the blame game.
‘No magic bullet’
Recently on BBC Woman’s Hour our outgoing chief medical officer, Prof Dame Sally Davies, spoke about obesity as a slow-burning issue, the full consequences of which have not yet materialised.
“There is no magic bullet,” she said. “We need small actions to reduce calories in an environment where it’s easy to be healthy.”
Instead of “fat-shaming”, she added that the emphasis should be on increased risks of cancer and reduced fertility along with a raft other (actual) diseases.
So there we have it. Reshape our environment. Burn the crisps. Squirrel away the confectionery behind shutters along with cigarettes.
Drastic, I know, but it’s a variation of what we all do when we are trying to get fit, not fat. My family knows that chocolate digestives and Penguin biscuits in the cupboard signal Mummy is on a diet because I’m not tempted by either.
Out of sight, out of reach, if not mind. Maybe such a move is redolent of a Nanny State — but nannies are wise, and the safest pair of tough-love hands imaginable.
Just ask Nanny McPhee or Jacob Rees-Mogg. Better still, ask his nanny.
Because we need to have a serious and, if at all possible, dispassionate discussion about our collective weight gain, which disproportionately affects the poor and disadvantaged.
Figures from the NHS in 2018 showed that 29 per cent of adults and 20 per cent of Year 6 children were classed as obese. Half of all British people will be obese by 2045, more than double the global forecast of 22 per cent. The cost to the NHS is already pounds 10 billion annually. Eventually, it will be brought to its knees by the weight of patients.
Take a look at Sixties school photos and you will see young people of different shapes and sizes, most of them on the skinny side because that was typical.
Fast-forward to the average prom in 2019 and it’s a very different picture. Instead of social media encouraging the perfectly ordinary, it has bifurcated into self-satisfied teeny tiny superwaifs flaunting hip bones versus the bullish body positivity movement dressing up what doctors would diagnose as morbid obesity.
I’m certain I’ll be vilified for my heresy.
But as I see it, body positivity is just another symptom of defensiveness masquerading as bold assertiveness. And it has to stop.
I do realise that not everyone is meant to be a skinny Minnie — a degree of diversity is normal. Love your curves if you like, ladies. Big can indeed be beautiful. However, it can also be a pathway to Type 2 diabetes, cardiovascular issues, stroke and heart attack.
And whether it’s Cancer Research or the BMJ or even not-so-little-old-me speaking this truth, it should not be interpreted as a hate crime. You may not want to hear it, but they have a responsibility to say it.
School uniforms are now manufactured in 5XL. Five years ago one council started digging supersized graves to accommodate supersized bodies.
There’s a shortage of transplant organs because the donors’ weight renders them unusable. The facts and figures are unavoidable; it’s time to shelve the stigma and talk as a society.
Losing weight and, crucially, keeping it off is hard because once you shed the pounds, your body automatically releases a hormone called ghrelin, which stimulates your appetite.
It’s a mechanism that evolved to make us bounce back from famine — and now sabotages our valiant 5:2 diet attempts.
If rebranding obesity as a disease allows overweight people to seek support, get practical help and receive the same encouragement that we give to smokers trying to quit, that can only be a good thing.
— Judith Woods is a noted columnist who writes on health care.
