Obesity, Made in England (2018)
Foreword
Alice Wiseman, Gateshead Director of Public Health
The rise of the obesity epidemic...made in England
Welcome to my third annual report as Director of Public Health for Gateshead.
This year's report, "Obesity; Made in England' focuses on the issue society has in maintaining a healthy weight. The report describes the challenge of obesity today, a challenge, that we are struggling to tackle effectively.
Weight is a very personal issue. It seems so easy, it's just a case of energy balance...isn't it?
Knowing and making the right choices? Eating well and exercising more.....right?
Those of us that have struggled to maintain a healthy weight will be acutely aware of how judged you can feel. Young people have told us that being overweight is a key trigger for bullying. The stigma faced by people who are overweight is significant and as such I feel it's important to address this explicitly before I start.
We are bombarded by media headlines which, often place the blame firmly at the door of individuals. The news media regularly takes a victim-blaming approach, attributing weight problems to poor choices and laziness. For example, an article in the Daily Mail illustrates the theme 'Too little exercise', and reads, "get half an hour's walking exercise a day. That's all you need to do" (MacRae, 2009, p. 11). The pounds 1-a-day slimming pill. Daily Mail, p. 11. This article, like many others, also promotes the message that combating obesity is simple, which serves to reinforce a belief that obesity is totally controllable by individuals.
Headlines in the past few years have blamed people experiencing obesity for rising fuel prices, global warming and causing weight gain in their friends. A label used in numerous newspaper articles is "fatty" or "fatties" (Ferrier 2009, p. 37). A number of headlines also play on words to present obesity in a derogatory or humorous manner. News stories are particularly influential and insidious given that their content is readily available through various sources and is rarely challenged (Heuer et al, 2011). To date the majority of research examining obesity in the media has focused on entertainment media, including television and magazine portrayals (Greenberg et al, 2003 and Latner et al, 2007).
In response to this, as might be expected, obese people are often stigmatized; for example, Greenberg et al (2003) reported that obese television characters had fewer romantic relationships and friendship interactions and were less likely than non-obese characters to have positive interactions with others.
Since 1946, every generation has been heavier than the previous one.
The way we live, work, travel, play, shop and eat has been transformed greatly in recent decades.
Put simply, the fundamental cause of obesity and overweight is an energy imbalance between calories consumed and calories expended. Globally, there has been:
- An increase in the availability and intake of energy densefoods that are high in fat.
- A decrease in physical activity due to the increasing sedentary nature of our lives (for example; work, play and transport).
Whilst I accept that personal responsibility appears to play a crucial part in weight gain our human biology is constantly being overwhelmed by the effects of today's 'obesogenic' environment. This is a term used to describe how we live in an environment that encourages weight gain and obesity through an abundance of energy dense food, clever marketing that disproportionately focuses on the promotion of energy dense options, motorised transport and sedentary lifestyles.
We know that both the physical and psychological drivers as human beings mean that the vast majority of us are predisposed to gaining weight. Given all the external pressures, it is not surprising that for the majority of people in the UK, body mass index (BMI) is now above that considered to be in the 'healthy' range. We evolved in a world of relative food scarcity, very different food production methods and hard physical work - obesity is one of the penalties of our modern world.
"People in the UK today don't have less willpower and are not more gluttonous than previous generations. Nor is their biology significantly different to that of their forefathers. Society, however, has radically altered over the past five decades, with major changes in work patterns, transport, food production and food sales" (Butland 2007).
In this report I will describe how societal changes over recent decades have exacerbated our risk of obesity. I will also set out the unacceptable inequalities faced by some communities alongside some of the opportunities we have to address this through enabling communities to take their own action. Some progress has been made, however beneath the surface, huge disparities in health remain and as the proportion of working families living in poverty rises, this is only likely to get worse.
I intend to set out the case for a whole system approach that places greater emphasis on action to address the wider environmental and societal issues that contribute to increasing obesity levels. We need to work together to create the conditions for healthy weight.
The obesity epidemic is not inevitable. We, as society have created many of the problems that have created the obesity epidemic and therefore, we, are also the people who have the power to solve it.