With a new report finding that Britons vastly underreport the number of calories they eat per day, concerns about the national 'obesity epidemic' have again raised their head. Official surveys prior to this have always seen the average person disclosing that they eat around 2000 calories per day, so it is naturally a shock to public health bodies and policy makers so concerned with the state of the British waistline to discover the real figure is closer to 3000 calories.
Obesity is undoubtedly "big" business. Our overconsumption earns huge profits that oil the wheels of the increasingly engorged food industry. Retailers and advertisers peddle food manufacturers' products in ways that commodify our physiological drives and play on our emotional vulnerabilities in order to maximise the chance that our bodies become receptacles for their goods. Extreme lengths will be gone to - from making misleading health claims promising physical wellness to promoting food products in terms of the emotional benefits and happiness they guarantee. More worryingly, extreme risks are willing to be taken. Just as producers across the globe are often exploited for corporate gain, so too are our physical and emotional wellbeing gambled in the pursuit of profit.
Far-reaching negative health outcomes and significant public health risk have been clearly demonstrated in academic research as a result of the promotion of calorie-dense, nutrient-poor foods, especially when directed at more susceptible groups such as children and adolescents. The price tag of the impact of obesity on our health for the NHS is a fat £6.1bn annually, and for the wider economy, a hefty £27bn. This isn't to mention the unestablished role of the food industry in relation to people experiencing problems with eating, the rise in clinical eating disorders and the recent acceptance of Binge Eating Disorder as a diagnostic illness. Add to this the fact that prevalence remains high, and is predicted to increase steadily from two thirds to 70% population being classified as obese by 2034, nobody can deny that a response is needed.
The latest suggestion from the Royal Society of Public Health (RSPH) is for 'exercise equivalents' to be displayed on food packaging. These will show the number of minutes of activities such as jogging, swimming and cycling that are needed in order to burn off the calorie content of the product. This is something that RSPH CEO Shirley Cramer believes will make 'the calories contained within food and drink more relatable to people's everyday lives, while also gently reminding consumers of the need to maintain active lifestyles and a healthy weight'.
But changing problematic behaviours isn't always a simple task, and the idea that what we eat is simply a matter of individual free will based on the information at hand is one that deeply troubles me. Facing a life-threatening struggle with both anorexia and bulimia over a period of a decade taught me that the choices we make about what we put into our bodies are not free choices in their entirety, but choices heavily shaped by our physiology and, just as importantly, our wider environment. The responsibility for weight, shape and health is all too often placed firmly at the door of the individual, as though our decision-making processes and behaviour exist at a purely cognitive level where knowing something is bad for you will mean that you won't do it. Yet failing to recognize that what we come to eat is not also determined by factors such as education and upbringing, the availability and cost of various foodstuffs, and our responses to relentless advertising campaigns is short-sighted, however much we might like to feel as though we are the ones in control of our choices.
The reality of human experience is that, for one reason or another, we are all-to-often drawn to behaving in ways that we know are unhelpful. In the example of my eating disorder, as a medical student at the time I knew exactly what I was doing to my body, all of the risks I was taking and the likely implications for my health of starving myself or repeatedly binge eating and vomiting. Yet I still went ahead with my damaging behaviours, frustrating those around me (including healthcare professionals) as to why, as an intelligent person armed with the facts, I found it so hard to do the overwhelmingly logical thing.
The RSPH admits that 'although nutritional information provided on food and drink packaging has improved it is evident that it isn't working as well as it could to support the public in making healthy choice'. Let's hope they can also admit that being informed only takes us so far, and that our motives for eating aren't always straightforward. My own food-related behaviours clearly weren't a healthy choice, but they conferred other benefits in terms of emotional release, distraction from distress or boredom, regulating my mood and more - not dissimilar to the factors at play in some of the eating habits that result in obesity. Being negatively incentivised never helped, and the punitive notion of food needing to be 'earned' through activity leaves me feeling very concerned.
Exercise equivalents are actually misleading in failing to convey how the Basal Metabolic Rate (BMR) of an average adult requires them to consume in the region of 1500-1600Kcal per day irrespective of their physical activity level, just to maintain their weight. Eating an average 2000Kcal of food per day does not mean we need to compensate by exercising the equivalent amount out of our system - in fact for most people that amount of energy would be consumed in the course of a normally active day which didn't include a session of a specific type of exercise. Our bodies consume calories just by doing nothing, and by normal activities which we might not class as exercise. Of course being active is to be promoted, but we already have enough guilt surrounding food and eating without adding 'gentle reminders' that give an incomplete picture of how the metabolism works.
Yet it is the consumers, in underreporting their calorie intake, who have been described in the national press as 'potentially misleading policy makers'. Surely policy makers recognise the importance of addressing misleading advertising campaigns as well, with their exaggerated claims about 'superfoods' or the 'low-fat' foods that are less upfront about their high sugar content? Surely intervention is also needed to rectify the lack of education about where our food comes from and how it is prepared, and to address the rise of eating disorders amongst young people who increasing report difficulties relating to body image, food and eating? The persistant misinformation about food takes place in many areas of public life.
It's about time we looked beyond our individual eating habits and considered the wider social and cultural drivers of the ways we consume, and stop placing responsibility and blame for obesity or ill health solely with the individual. Like much else, obesity is a collective issue that needs a comprehensive response, and if we want dietary choices to be in the hands of an empowered and responsible consumer, then maybe this requires policy makers to be brave enough to disempower a food industry which appears to put profit first, whatever the cost.
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