Making Obesity History means changing our relationship with food
DANI GARAVELLI

IMAGINE another Live Aid a few years from now. There are the stark images of malnourished children flitting across a giant screen aimed at shaming world leaders into action. In between the ageing Madonna's cussing and Bono's whining, there's the usual polemic about how governments are continuing to fail vast sections of society - and, of course, there's Bob Geldof, describing the manifold health problems associated with poor diet, and urging everyone to take to the streets in protest. Except, this time, the emotive footage is not of starving children, it's of morbidly obese ones. And the health problems in question are not rickets or beriberi, but heart disease and diabetes.

A far-fetched scenario? Well, perhaps. But with obesity now rivalling starvation as a global issue, it is not unreasonable to suggest the world is sorely in need of a Make Obesity History campaign.

It was Professor Barry Popkin from the University of Carolina who put the problem into perspective. Last week he told the Institute of Agricultural Economics that there were now one billion obese people in the world, compared with 800 million hungry ones.

Without underplaying the importance of tackling starvation in the developing world, he pointed out that obesity carries its own death toll and has serious economic implications in terms of productivity and healthcare. Nor is it an issue confined to the West. Indeed, the country with the fastest rise in its obesity figures is China, where people are shifting from cereal to animal-based diets, and the car is ousting the bicycle as the principal means of transport.

Of course, Scotland knows all about obesity, with figures running at twice the UK average. Almost 57% of women and 64% of men here have an excessive Body Mass Index, with more than a third of under-12s considered overweight, and almost a fifth obese.

Like most countries, Scotland is trying to tackle the problem by improving school dinners and hammering home the healthy eating message in public information campaigns. But - despite mounting concern worldwide - there is little evidence of coherent international strategies to combat the problem. Similarly, while a handful of mavericks have made an impact - most notably Morgan Spurlock, whose film Super Size Me has been credited for McDonald's decision to introduce a 'healthier' menu - and we are, on one level, obsessed by nutrition (think free radicals and macrobiotic diets), the problem has not mobilised the population in the way that issues such as Third World debt and climate change have.

And it is easy to see why: while pictures of the starving evoke emotions of both pity and guilt - with those who are suffering very obviously the victims of external forces - images of the obese are more likely to provoke contempt and a sense that their plight is self-inflicted (although in most cases this will be a gross over-simplification).

Although the factors fuelling starvation are complex - with natural disasters, wars, corrupt governments, poor farming practices and unfair trading all playing a part - they are easier to grasp than those behind the obesity epidemic.

For a start, obesity affects people from all ethnicities and social backgrounds, from wealthy white businessmen to the disenfranchised black residents evacuated from a sodden New Orleans. It may be linked to greed, a product of a consumerist society where every craving has to be satisfied, but it is just as often a product of poverty and food insecurity. Nutritionists have found that those on lower incomes will always choose food that maximises calorific intake, and that those whose incomes fluctuate will overeat when food is available, as if stocking up for hard times.

Like starvation, obesity is fuelled by commercial imperatives, with the sale of cheap, high-fat, salty foods reaping huge profits for multinational companies. But unlike starvation, obesity has a deep psychological component that is difficult to analyse. Most of us use food for purposes other than nutrition: to stave off boredom, to provide comfort, as an expression of love or, if we suffer from low self-esteem, as a way to punish ourselves and others. This is often extended to the way we feed our children, using 'treats' to cajole and control. We love food and we hate it; we binge and we diet; we perceive it as both a treat and a threat.

The fact that our relationship with food is so perverse means that some anti-obesity measures will only ever have limited impact. Forcing retailers to print more detailed nutritional labels is positive, but will only have an impact on those committed to making healthier lifestyle choices. Raising taxes on fatty foods - like raising taxes on cigarettes and alcohol - may penalise the less well-off without changing their bad habits.

More likely to pay off would be the demystification of nutrition and cookery. Articles on free radicals, antioxidants and high and low GI counts may be offputting rather than helpful to many people, while all the 'Good Food For Kids'-type books, with their recipes for exotic smoothies and pumpkin muffins, are of little use to you if you have never owned a food processor or a cake tin. Instead, the message should be reinforced that simple dishes such as grilled fish, wholemeal rice and carrots can be just as healthy as fancier fare.

The banning of television adverts promoting junk food pre-watershed - a measure being called for by the British Medical Association and the Food Standards Agency - would have an even bigger impact, reducing 'pester power', although it would require political backbone, as it would cost television channels an estimated £141m a year. And, of course, local authorities should improve access to sports facilities, promoting physical activities of all kinds.

Hand in hand with support should go penalties for parents of obese children who persistently ignore advice from dieticians. Does this seem harsh? It isn't meant to. But overfeeding is as pernicious and socially unacceptable as any other kind of neglect, and should be treated as such.

Most importantly of all, however, we need more research into the psychology of food, and how to foster a healthier relationship with what we put in our mouths. Because until the majority of us learn to divorce our food consumption from our emotional wellbeing, all the government initiatives in the world won't eradicate obesity.

Diet and Weight Loss

Last updated: 19-Aug-06 00:46 BST