Back in the 60s being fat was not an issue – only 1% of men and 2% of women in England were classed as obese, and it was non-existent in children. Compare this with today’s 25.2% of men and 27.7% of women, along with 9% of children obese by the age of 15.*
Dr Ian Douglas, from the London School of Hygiene and Tropical Medicine, says: ‘Obesity is one of the biggest health problems of our generation.
‘Rates of cardiovascular disease, although slowly declining, are still alarmingly high while Type 2 diabetes is on the rise, affecting 3.5 million people in Britain. Finding effective ways to tackle the obesity crisis is therefore a key public health strategy.’
But what is obesity? You are classed as clinically obese if your Body Mass Index (BMI) is over 30 (under 25 is considered healthy) and it is worked out by dividing your weight in kilograms by the square of your height in metres (you can find calculators to do this online).
Being obese is not being a bit bigger than you would like – around one in every 11 deaths in the UK is now linked to carrying excess fat, that is 50% more than the rate in France. Experts have also warned that the number of fatalities due to obesity may soon, for the first time, exceed those caused by smoking.
The rise in obesity has been debated by experts and the media. There are lots of theories about what is causing so many people to become fat, but whatever the opinions, one thing is agreed: a solution is needed, soon.
ALL TOO MUCH
Back in the evolutionary past you would have lucked out if you were blessed with certain genes that slowed metabolism and boosted your appetite, the so-called ‘thrifty gene’. You would have had less energy, a bit of a downer when it came to finding food, but more useful when food was scarce. This is because the energy would have been stored efficiently as fat reserves and that would basically have helped you survive.
It is only in the past 100 years that such a huge variety and quantity of food has been readily available. So those people who have inherited this ‘thrifty gene’ from their ancestors are now piling on the lbs because there is no scarce food period, ever. And that is a problem.
CHEWING THE FAT
Dieticians say the same number of calories are consumed, on average, as 60 years ago. Wartime rationing allowed about 3,000 calories a day for men compared to today’s Department of Health recommendation of 2,500 for men and 2,000 for women. It is the type of food that is consumed that is making us put on weight. There is much more fat in most diets today, much of it saturated.
In the 1940s, Britons derived 32% of their calories from fat – not far off the 33% recommended by UK Government guidelines; today a whopping 40% of your diet is fat. And at nearly 500g a week, twice as much sugar is consumed than it used to be. There is also the increasing reliance on processed and fast foods that have become a large part of many people’s diets.
Corn syrup is another reason cited as contributing to the obesity crisis, used as a flavouring and cheap preservative. Nutritionists say it is hard to metabolise this form of sugar as it doesn’t trigger the production of hormones that help regulate appetite and fat storage. So we want more, store more, and get bigger and bigger.
Alcohol, full of empty calories, is also more widely consumed now than it was 60 years ago.
THE LIFESTYLE FACTOR
Lifestyles are also a factor in the obesity problem. Many people grab high-fat, high-sugar snacks on the go as that’s what quick and available. And even apparently ‘healthy’ foods, such as breakfast cereals and yogurts, are often not as healthy for you as you may think, many containing hidden sugars.
Portion sizes have grown in line with our waistlines. British retailers have been selling food in bigger packages, with the average supermarket pizza increasing from 200g to more than 250g in the last two decades alone, and individual chicken pies increasing from 160g to 240g. This trend towards larger portions is considered to be a major factor in the obesity epidemic.
WHAT IS BEING DONE?
The government is stepping in, taking the food industry to task. ‘Over the past 30 years the industry has been unfettered and has put whatever it likes into food, unmonitored by the government,’ says Tam. ‘Now the government is bringing in a Child Obesity Framework, which is tasking the industry with ‘reformulation’ where they are obliged, albeit voluntarily, to change the ingredients in food so there is less sugar and fat content.
‘This is a concerted effort by government, although people are ultimately responsible as to what they put in their mouth; it is very hard to resist the barrage of eat this, drink that messages that the industry puts out.’ The framework will be launched this month.
ALL SIT DOWN
It’s not just a case of what is being eaten; we are not moving enough to burn off the extra fat and calories we are consuming. Back in the Fifties, a woman burned more than 1,000 calories a day doing everyday activities, walking, cycling, and doing housework, compared with an average of 556 today.
Couple that with many people having sedentary jobs, sitting at a desk for much of the day, hopping in a car to get home, sitting in front of a screen all evening – it is not surprising that many people are piling on the lbs. Over the years this lack of day to day activity equals gradual weight gain. Studies have also found sitting for long periods of time increases the risk of Type 2 diabetes, some types of cancer, and premature death.**
THE BIG SOLUTIONS
In the last 12 years, eight different genes have been discovered that can contribute to obesity leading to new treatment options for affected patients. ‘There is a huge amount of literature pointing to the fact that genetic background is quite considerable, with some people saying it is 70% responsible for obesity,’ says Tam Fry, National Obesity Forum spokesman. ‘Knowing the genetic make-up of an individual is key but finding it is very expensive now; hopefully that will come down. But what we don’t want is people saying that “it’s in my genes and therefore there’s nothing I can do.” If people make that excuse we are going to get nowhere.’
Of course diet is key to stopping obesity. ‘Diets should be based on plants and fresh food. And people are advised to eat as little processed food as you can possibly get away with,’ he advises. ‘Be concerned about the amount of red meat and sugar in your diet, as large amounts of both of those can cause problems.
‘As a nation we are currently consuming double the amount of sugar than is recommended, and we should all cut down because it is useless nutritionally and full of calories.’
‘I am fully behind the idea of the sugar tax when it comes to fizzy drinks, beloved by both children and adults. But taxing food stuffs is a different kettle of fish, because so many people rely on food which is moderately or quite high in sugar just to live, and to tax that would be wrong; it would disadvantage the poor. Sugar tax on drinks yes, as high as you like, but for food stuffs – I would not be an advocate for that.’
Eating slowly and not rushing your meals allows the messages from your gut to your brain to kick in, telling you how full you are. This takes at least 20 minutes: by which time you could have stuffed a huge amount of food into your stomach without noticing.
‘If you rush meals and wolf it down you may not feel full, even though you are,’ says Tam. ‘Sit down to a meal around the table with the family and talk to each other so it’s relaxed. One of the reasons obesity is such a problem is because people are eating on the go: snacking should be avoided. Stick to three meals a day and have proper breakfast. If you feel the need for a morning snack choose something like a banana, then have a light lunch. And your third meal should not be too late as you do not have time to work it off before you go to bed.’
DR CHRISTIAN SAYS
‘Part of the problem of obesity is that nature has designed us to get fat wherever possible. I think the solution lies in four main areas: legislation against companies putting too much sugar in products, education of our children, advertising with hard hitting adverts and operations to help those already obese.’
THE SURGICAL SOLUTIONS
A large scale study found that obesity surgery helps reduce the risk of developing serious health conditions such as heart attacks and Type 2 diabetes, as well as improving existing conditions. ‘While effective prevention is clearly needed, our findings show that as well as helping patients substantially lose weight, bariatric surgery improves serious obesity-related illnesses as well as reducing the risk of developing them,’ says lead author of the study, Dr Ian Douglas. And Dr Christian Jessen is also an advocate of surgery. ‘Bariatric surgery for those beyond the point of no return is money saving for the NHS and the operations are life saving. It’s a no-brainer,’ he says.
Gastric band: A band is placed around the stomach dividing it into two, so it takes less food to make the person feel full. Most people will lose 50% of their excess weight within two years.
Gastric bypass: The stomach is divided into two, and the upper section of the stomach is connected directly to a section of the small intestine, bypassing the rest of the stomach and bowel. Most people will lose 70% of their excess weight within two years.
Bilo-pancreatic diversion: Similar to a gastric bypass, except a larger section of the small intestine is bypassed. Has the best results in terms of weight loss (average excess weight
loss is 80% within two years of surgery).
Sleeve gastrectomy: Surgically reduces the size of the stomach by three-quarters. Generally used to treat people who are too obese to have other types of surgery. Most people will lose 20% of their excess weight within 12 months of surgery. Further bariatric surgery may then take place.
Intra-gastric balloon: A silicone balloon is placed down the throat and inflated in the stomach so it takes less food to feel full. Most people will lose around a third of their excess weight within 12 months. It is a temporary measure as it must be removed after six months.