Opinion -The obesity epidemic: A problem of our own making

It is widely recognised that the world – not just developed countries like New Zealand – has a problem with obesity, i.e. being overweight!  The proportion of people that are technically obese is quite extraordinary and growing.  The part of the problem that s particularly disturbing is that we have a problem with obesity in children, not just adults.

Why does it matter? It matters for two reasons, one of which is personal to the individuals and the other of which is financial and affects us all, standard or over-weight!

The personal issue is that obesity leads to a whole host of health problems which includes excess pressure on the joints, reduced mobility, the increased chance of an early death and the increased incidence of diseases like Type 2 diabetes which is eventually a killer.

The wider concerns are that it increases all kinds of community costs the most obvious example being the cost of running the health system.  But there are also relatively incidental costs like having to make airplane seats larger to accommodate larger people, and to burn more fuel to get them to their destination.
There is a clear biological rationale for what is happening.  The human body basically evolved back in out cave man/women days when we had to hunt and gather food, foods like fat and sugar were particularly valued because they gave us scarce energy, and humans were programmed to over-eat when they could to better provide for those days and weeks when food was scarce.  Biologically nothing has change, that is still the way we are programmed to behave.  But of course our circumstances have changed.  Particularly in developed countries food is now plentiful and many foods are loaded with sugar and far because they make the foods taste good.

So do we just “go with the flow” or try to do something about it?

I certainly belong to the group of people who think we should be doing something about it and most health professionals are in the same camp because they have to deal with the end results.

A possible but fairly brutal approach is to see this as a  generational problem, and to basically just let it play out.  This amounts to pretty much writing off a large part of current generations of children particularly and hoping that the next generation will have learnt the lesson. I can’t see that happening – for cost reasons alone.

Obesity is not always voluntary and for those people the option of surgery should be kept open.  The most famous example was David Lange.  The problem with this option is that there will always be limited public funds and those who benefits will be mainly those who can afford private surgery.

An option is to ban certain foods that have a high energy value per gm. and that would include many fast foods and energy drinks.  The problem with bans of that sort is that that there are too many options available – people will find it relatively easy to get around the ban, And you can bet it will be unpopular.

Better education is always as option but experience suggests that it is not very effective in isolation, particularly in the short term.  But education should be a component in any, longer term strategy.

Another option is to provide financial and other incentives not to be obese.  However, these need to be generally targeted not targeted at individuals who may have a reason be to be obese.  A tax on sugary drinks has been suggested and I would support that.  Manufactures are reasonable innovative about these things and will soon found ways to keep flavour characteristics but reduce the calorie (energy) load.  The objection is “why target sugary drinks?” and the answer is that it is the easiest place to start,   But if it is to be effective it needs to be extended to cover other forms of sugar – how about sugar itself??  Or if you really want to push the system try taxing alcohol which is a significant contributor to obesity for significant drinkers.

There is a whole conversation to be had around the issue of taxation.

The difficult target is what I called “embedded sugar” – sugar that is present in almost all processed foods but hidden amongst other ingredients.  Labelling protocols have been suggested to draw out this information and I would support that.  But it needs to be made simple and direct.  Complicated symbols are not as good as simple, direct information.

In the end though it comes down to personal commitments and responsibility.  Parents need to be conscious of what their children are eating and help then make good choices.  Adukts need to be good examples or role models which means having good eating habits themselves.  This will present special challenges when there are cultural traditions to grapple with but that is what it will take.  Doing this does not mean introducing drastic regimes.  Good eating habits still allow for special treats to be a part of the diet, but they need to be a part not the everyday basic.

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This is another of Bas Walker’s posts on GrownUps.  Please look out for his articles, containing his Beachside Ponderings.