Facing the facts on fat

The obesity crisis won't be solved if policymakers continue to focus on individual choices while ignoring the bigger picture. By Anke Klitzing.

The British government’s announcement of a new obesity ‘strategy’ in mid-October was yet another example of the tendency in public policy circles to individualise socioeconomic problems. As chef Jamie Oliver put it following the announcement: “Simply telling people what they already know – that they need to eat less and move more – is a complete cop-out.” 

Ireland, in common with much of Europe, is facing a serious battle with bulging waistlines. The World Health Organisation found in 2010 that 61.9% of the Irish population is overweight, and 25.2% obese (in the UK, it’s 64.2% and 26.9% respectively). Obesity is a major factor in a range of chronic diseases such as cardio-vascular diseases, hypertension and diabetes. And chronic diseases are a burden on the economy as well as the health system, as productivity suffers. The Report of the National Taskforce on Obesity, published in 2005, attributed 2,400 premature deaths per year to obesity in Ireland, “at an estimated cost, in economic terms, of €4bn to the State.”

With numbers like this, the situation is rightly called an epidemic and a public health crisis, and therefore requires a public response. The British government’s strategy has included calls for encouragement towards exercise; other countries such as Denmark and Hungary are proposing a ‘fat tax’ or sugar tax respectively. But as Trevor White writes in the Irish Times: “Ireland should follow suit, but that seems highly unlikely. A national taskforce on obesity was established in 2005. Six years later, less than a fifth of its 93 recommendations have been implemented. A national nutrition policy has been ‘forthcoming’ or ‘about to be published’ every few months since November 2005.”

To blame an untameable appetite for chips and chocolate for the growing rates of obesity is simplistic. The availability and accessibility of healthy, nutritious food are crucial factors, and not always given. The Irish Healthy Food for All initiative reports that up to 15% of the Irish population is unable to maintain an adequate and nutritious diet that is low in fats, salt and sugar but high in fibre, vitamins, minerals and other micro-nutrients. And they are unable to do so because of the cost – a family with two children on welfare benefits would have to spend over 50% of their income on healthy foods (a detailed 2004 study by a group of researchers at NUI Galway calculates the cost of healthy food for a single mother with one child on welfare benefits at 80% of weekly income), especially since many families living in disadvantaged areas have to rely for the majority of their shopping in local convenience stores, where prices are even higher and choice lower than in the larger chain supermarkets. The latter, however, are usually located outside of town centres, and public transport options are often inadequate. Public policy should look to public transport and retail planning to change the dynamics that perpetuate unhealthy eating habits.

Information about healthy eating is also often sketchy. Many people receive the majority of their information from a variety of scattered sources, the most popular being television. This leaves them with fragmented, often contradictory knowledge. The information is also liable to be tainted with commercial motivations, and mixed up with or at least sandwiched by ever more sophisticated marketing by the food industry. Coherent information about health and eating is an important factor in helping families make the right decisions about their eating habits. This needs to begin in school, coupled with a marked emphasis on providing fresh, healthy, nutritious food during school lunches.

However, a fat tax, information campaigns and a national cycle lane initiative (proposed as part of the British strategy) are only reactive measures and ignore the great underlying dynamics of our food system.  As Trevor White puts it, “blaming the victim is just an excuse to let industry off the hook." Our food system is set up according to the logic of agro-industrial production, with a few major players dwarfing the scene. Industrial production requires industrial distribution and eventually, also consumption in industrial dimensions, which find their limits in the size and capabilities of the human body. Unless the body itself takes on industrial proportions. Agro-industrial food production is a manifestation of neoliberal economics, uncompromisingly geared towards perpetual growth, without the consideration of natural limits. Apart from damage to humans in the form of obesity, agro-industrial food production has caused massive damage to the environment. The EU Environmental Impact of Products (EIPRO) study of 2005 finds that “food and drink cause 20 to 30% of the various environmental impacts of private consumption.” Run-offs from factory farms poison rivers and the seas, and acres of original rain forests are slashed and burned to create more grazing land for vast cattle herds.  Our food is cheap and can stay cheap because these damages are not calculated into the cost of food, and neither is the cost of the public health crisis.

What is necessary to counteract obesity is a much greater public response, across sectors and government departments. What is necessary is a National Strategy for Real Food. Dietary advice and policy measures that demonise one particular substance (for example fat), or hail another as a miracle redeemer, miss the point. Fat, and also salt, are not unhealthy substances per se. Artisan cheeses, fresh butter, smoked salmon or a side of bacon are not “bad” foods as such, despite their fat content; quite the contrary – they provide essential nutrients, apart from being tasty and a pleasure to eat. And the effects of a tax on fat, for example, would be easily circumvented by the big food industry – by further processing their foods to replace the fat with a different substance manipulated into providing a similar taste and consistency, and by offsetting the increased prices through further cutting costs somewhere along the line of the production process.

Marion Nestle, professor of Nutrition, Food Studies and Public Health at New York University writes in response to the Danish fat tax: “Leaving aside the usual criticisms, such as the impact on poorer people, I have a different reason for being troubled by tax interventions. They aim to change individual behaviour, but do little to change the behaviour of corporations that make and market unhealthful products, spending vast fortunes to make them available, desirable and socially acceptable.”

A fat tax would be a blunt tool to judge foods by, and hurt the wrong people, such as the small producers of actual food. It is crucial to acknowledge the service that small artisan producers and distributors of food are providing to the community in the context of the debate on obesity.  Small-scale farmers, shepherds, fishermen, beekeepers and gardeners are stewards of the land and waters, maintaining a healthy coexistence with nature, looking after the landscape and preserving biodiversity. Small-scale food processors and traders (such as cheese makers, fish smokers, butchers, bakers and chefs) not only provide us with good food, but are vital in maintaining a lively local economy and vibrant town centres. Not to even mention the preservation and continuation of skills and knowledge related to their crafts. A food system based on fresh, real foods, provided by skilled craftsmen and available in the centre of the community would be an actual step towards curing the ills that plague our public health. And while the price-per-kilo may be higher than that of the foods offered by the big industry, the external benefits to the individual, local economy and the community would be a real bargain.

The 2005 Report of the National Taskforce on Obesity states clearly: “A population shift must be facilitated, to enable individuals to have more discretion and control in what and how much they eat, at an accessible price…the social change strategy is to give people meaningful choice.” Change is possible, three times a day.

Image top: Ben.Harper.