Kieron Smith, Boy by James Kellman describes life in Glasgow in the 1960s as seen by a child from ages four to almost thirteen. Nothing is presented other than Kieron’s thoughts, so what we are told directly is what he finds interesting and what he thinks about it. Indirectly, the novel describes a number of social and other situations that were starting to change, including this: “There was a fat boy in our street. People called him fatso.” At the time, obesity was unusual enough to draw attention. Yet now more than a third of Scottish 12-year-olds are considered to be overweight, a fifth to be obese and over one in ten severely obese. The statistics for adults are even worse, with almost two-thirds of men and more than half of women.
The situation is better in the other OECD countries, apart from the United States, but overweight is a concern almost everywhere. Obesity is one of the few cases where the popular perception that things were better in the old days is supported by a range of objective evidence. The facts also suggest that people are right in blaming the problem on changes in lifestyle and diet. Kellman’s hero is outside as much as possible, and is usually involved in highly physical pastimes like football, climbing or running. He hardly ever has any pocket money and can rarely afford to buy snacks or a soda. Indeed, another boy is remarkable because he can buy chips once a week on the way home from a youth group.
That doesn’t mean his diet was particularly healthy, but hours of physical activity and no income to buy junk food compensated for all the carbohydrates. Diets for lower socio-economic groups have remained just as poor, or have got worse in some respects, at the same time the amount of exercise has declined.
The result is that overweight and obesity rates have been increasing relentlessly worldwide, Obesity-related problems, such as diabetes, now account for 2% to 6% of health care costs in most countries. Even lower-income countries are affected, with some of them actually having problems of obesity and under nutrition simultaneously.
The causes and consequences of obesity and how to tackle it are analysed in Fit not Fat: Obesity and the Economics of Prevention. The book asks how to trigger meaningful changes in obesity trends. The short answer is by wide-ranging prevention strategies addressing multiple determinants of health. The reality is that every step of the process is conditioned not just by public health concerns, but by history, culture, the economic situation, political factors, social inertia and enthusiasm, and the particularities of the groups targeted.
Authors Franco Sassi and Michele Cecchini of the OECD’s Health Division also contributed to a series of articles on obesity in The Lancet, the latest of which are published today. The Lancet’s conclusions are similar to the OECD’s: the changes needed are likely to require many sustained interventions at several levels, and national governments should take the lead.
That includes tougher action – including taxing junk food – but the food industry will resist such changes. Speaking to the BBC about the reports, Terry Jones, of the UK Food and Drink Federation, said “The Lancet fails to recognise the lengths to which the UK food and drink industry has gone to help improve the health of the nation, particularly in relation to rising obesity levels.”
Professor Boyd Swinburn (author of a paper on what’s driving the obesity epidemic), doesn’t agree. In fact he compares the tactics of the food industry – in terms of getting people addicted to their products and in blocking attempts to discourage consumption – to those of tobacco firms in previous decades.
Health is one of the topics included in the OECD Better Life Index. The Index allows you to put different weights on each of the topics, and therefore to decide for yourself what contributes most to well-being.
You can create your own index on the BLI site and share it on social media and other platforms.