Obesity? Round up the usual suspects
You know the form: government sells off school playing fields, children get fat, government must be seen to do something but poor old Matt Hancock is preoccupied with Covid, so he rounds up usual suspects, namely junk food and advertising. He shows no interest in analysing the real causes of the growth of obesity nationwide, starting in childhood, continuing through life and culminating in premature death. This paper concludes with some proposals for serious research after addressing some of the fallacies in Hancock’s current approach.
We have been here before. In 2003, the Food Standards Agency (FSA) used a study by the Centre for Social Marketing to attribute childhood obesity to advertising. The research was deeply flawed. Some authors have claimed that the number of TV ads watched resulted in, or at least was correlated with, childhood obesity. They deduced the number of ads from time watching TV without distinguishing the BBC from commercial channels. They overlooked the reality that the number of ads seen correlates with the percentage of time children spend watching TV. Couch potatoes get fat. Amazing. Gaming rather than playing with friends outdoors will have the same result.
There is no doubt that the growth in obesity is a problem. The Nuffield Trust reported an increase from 15% in 1993 to 28% in 2018. Addressing only calorie intake whilst ignoring calorie usage, through exercise and other means, gives a distorted picture. My golf club used to host schools. Playing golf gave the children fresh air, exercise and an introduction to a healthy lifetime. But the teachers could not cope with the risk assessment form-filling and the activity ended. Of course golf is a dangerous game. One of our members, this very week, dropped dead on the course; he was only 93.
The government’s latest proposal to ban junk (or unhealthy) food is based on two OFCOM studies and on a 2006 paper by the same team that conducted the FSA study, this time for the World Health Organisation [2] Professor Hastings’ team, now called the Institute for Social Marketing, exhibits the same biases and flawed logic as their 2003 study. The OFCOM studies deal with the time children spend looking at TV and technological gadgetry, but mentions neither advertising nor junk food.
Hancock’s main justification is public support: “Further advertising restrictions are widely supported by the public, with polling from 2019 showing that 72% of public support a 9pm watershed on junk food adverts during popular family TV shows and that 70% support a 9pm watershed online.” But that probably only reflects the long-running propaganda campaign against junk foods rather than scientific analysis. We would all rather blame others for our waist management problems than ourselves. Hancock also says it is now top of his agenda because obesity is responsible for disproportionate Covid deaths. He seems to have forgotten we will all be vaccinated in a few months time.
The government defines unhealthy food as foods and drinks which are high in fat, salt and/or sugar. From an obesity perspective, they mean fat and sugar. Excess weight is caused by too many calories in compared to calories usage. It is not just exercise; Edwardian houses had no central heating which allowed most people to eat and drink more than we do but stay slim.
In fact, “junk” or “unhealthy” foods are merely those of which government disapproves. Cornflakes and sugar are both healthy but when manufacturers combine them for our convenience, they suddenly become unhealthy. Calories are calories; it is ridiculous to suggest that a hamburger lovingly prepared by Mum is healthy whereas one with identical ingredients prepared by the evil Mr McDonald is unhealthy. Fruit juices (healthy) and coca cola (unhealthy) had about the same levels of sugar when comparisons were made in 2014 and more now that government has pushed down sugar levels in fizzy drinks.
The government focuses, reasonably enough, on digital advertising as online is disproportionately watched by younger people. Its shocking statistic that food and drink digital advertising rose by 450% between 2010 and 2017 is not quite so shocking when one takes into account the squeeze the government put on non-digital advertising for these categories, which caused advertisers to transfer, and the increase in the whole online advertising market by 275% over the same period. The comparison may not be exact as the government provides no source for its statistic.
To return to the central issue, obesity is a serious problem which needs serious research, not Hancock’s facile parade of the usual suspects. For a start, obesity needs to be understood and addressed as a social problem. For example, a Scottish study showed that “65% [of children from less affluent families were] more likely to be overweight as judged by BMI. However, these children weighed the same as more affluent children of the same age, but were 1.26 cm shorter.” Why is it that the proportion of overweight children aged 10-11 has changed very little in the 13 years to 2019 (+6%), meaning that the problem is developing thereafter? From the same report, the most deprived children are more than twice as likely (27% vs 13%) to be obese. Why is this and what can be done about it?
A cohort of teenagers should be studied over ten years to understand the behavioural, genetic and social differences between those who do and do not control their weight. Why do some obese people lose weight in response to prompts and others do not? What kind of prompts work and which do not?
Such research should be commissioned from accredited scientists, not “social marketers” with axes to grind.
[1] Tim Ambler, (2004), "Do we really want to be ruled by fatheads?", Young Consumers, Vol. 5 Iss 2 pp. 25 - 28
[2] Hastings G et al. (2006). The Extent, Nature and Effects of Food Promotion to Children: A Review of the Evidence. Geneva, World Health Organization.