TCS Daily

Money Where the Mouth Is

By Roger Bate - May 15, 2003 12:00 AM

An epidemic is sweeping the world. It is not the nasty Chinese pneumonia, the Ebola virus or even AIDS, but obesity. According to Professor Philip James, chairman of the International Obesity Task Force (IOTF), an organization backed by the World Health Organization, "1.7bn people are obese around the world." Hundreds of millions suffer from debilitating illnesses and over 2.5 million people die every year because of their weight problem, says the United Nations.

The facts are plain: 3,500 calories of food equal one pound in weight. So eating 100 calories a day (half a cookie) more than we burn leads to nearly a pound of weight gain per month. On average Americans put on about 30 calories a day (Europeans and Asians slightly less), leading to a few pounds a year. And that is why the rate of obesity has slowly but surely increased.

To reverse the trend will require an equally slow and consistent decline brought on by more exercise and better diets. However, activists, whether trial lawyers in the U.S. or consumer groups in Europe, want faster action against one alleged cause - fast food. The activists have already garnered lots of media attention, and may make lots of money from litigation if they humble fast food outlets. But their "success" will not reduce obesity because fast food is not the cause; if anything, statistics point in the other direction. My own initial research shows that the greater the degree of McDonald's restaurant penetration into a European country the fewer fat people there are.

Fat and Fatter

Professor James considers there are numerous risks from being clinically obese (what most people would call overweight), especially cardiovascular disease and diabetes. "It is clear that extreme forms of obesity are rising even faster than the overall epidemic and we are witnessing a real health tragedy," he said.

According to the UN's World Health Report, 300,000 Americans and 320,000 Europeans died last year from obesity-related diseases. Worldwide, the total number of deaths was over 2.5 million, with the UN projecting a doubling to five million by 2020.

This sounds terrible and possibly alarmist, and there are critics of the numbers. The prestigious New England Journal of Medicine is skeptical of the U.S. projection, claiming it was "derived from weak or incomplete data." Furthermore, according to many nutritional experts, definitions of "overweight" and "obese" mean that stocky, very healthy, heavy-boned people (football players for example) are considered obese. These people are not unhealthy; weight itself is not the problem, but where fat is deposited that causes the problem. Nevertheless the situation is bad and worsening by a few calories each day.

Reversing the trend will require changes in attitudes toward eating and exercise patterns. But to change attitudes we have to understand why people are getting fatter.

The most obvious reason we are fatter is that we eat more than ever before. Malnutrition has been the main problem through the ages, with only the very wealthy sure of enough food. Consequently humans, when presented with ample food supplies, have always eaten more than required for immediate sustenance. We are genetically programmed to overeat since it is only recently that food has been plentiful and the danger of constant overeating has become a problem.

The way food is prepared and delivered has changed significantly too. Today, far more people eat out at restaurants and buy take-out or fast food than ever before. The ease of this type of food delivery and its relatively low cost means that it is far easier than ever before to eat too much.

Lastly, more people have sedentary lifestyles than 100 years ago. In Europe and the U.S., official sources show that less than five percent of the workforce has what can be described as energy intensive jobs. Compare that with the 35 percent of people who had energy-sapping jobs in farming and heavy industry in 1900, and the 50 percent who had those jobs in 1800. Also, homes are far warmer than 100 years ago; shivering burns a lot of calories. It is true that more people exercise now than ever before, but not enough to counteract their more sedentary lifestyles and arrest the upward obesity problem.

Finally, Western children have a less strenuous existence now than before (almost no one under 16 works), and are cosseted and protected far more too. According to Kent University sociologist Frank Furedi, there is widespread concern about child abuse, which has scared most parents into driving their children to school, rather than making them walk, and not allowing them out because of the perceived increase in danger from strangers and road traffic. Furthermore, litigation-driven safety legislation in schools (at least in the U.K. and the U.S.) has lowered the number of energy-intensive activities that kids can partake in. Televised entertainment also has had an impact on exercise, for all ages, but most especially children.

How to Reverse These Trends?

Exercise (especially easy fat-burning activities like walking) is a great way to reduce obesity, and schools and employers should encourage it. Exercise also strengthens muscles, including the heart. Encouraging a balanced diet is essential so that obese people don't just cut out certain types of food, or different health problems can arise. Restricting the amount of high-fat fast food is also sensible. Moderating fast food intake to a few times a week for children, and no more than one meal a day for adults would help. And asking restaurants and fast food outlets to make available the calorie content of their food would be good too (some, like McDonald's, already do this).

Getting obese people to litigate these companies because their food may have high fat content is unlikely to help, although it might bring much money to some obese people and their lawyers. McDonald's is currently being sued in a US court in part because of its "contribution to obesity." Trial lawyers like John Banzhaf, a veteran of anti-tobacco litigation, have been preparing the ground work for this and other cases and are hoping that "big fast food" becomes the new "big tobacco." Even the IOTF, in its book Obesity in Europe, tries to connect the fast food industry with big tobacco, stating: "Marketing evidence is overwhelming that young children are often targeted in a manner akin to the tobacco trade's targeting of older children."

My own basic analysis of McDonald's restaurant penetration into European countries shows a negative correlation with IOTF obesity data. In other words, the more McDonald's restaurants per 10,000 people, the fewer people are overweight. Simple statistical analysis shows that the over 6,500 McDonald's restaurants in Europe are associated with 4 percent fewer overweight women and 2 percent fewer overweight men than if they did not exist. My analysis is preliminary and in any case proves nothing, but it is indicative that fast food has little to do with overall obesity rates. If fast food were the main cause of weight gain, we would expect to see the UK and France, with high fast food penetration, being the most obese. Yet it is Greece that has the most obese population, with over 70 percent of adults clinically overweight, while the country has few McDonald's restaurants.

The IOTF claims that because many of the influences on obesity are cultural and environmental, "it is no longer acceptable to blame the individual for their obesity." I couldn't disagree more; ultimately the responsibility lies with the individual. No one is ignorant of the fact that if you eat a lot you can get fat. Human catabolic and anabolic processes have been well understood for centuries. Blaming fast food outlets or schools for lack of variation in diet is not helpful. Producers, retailers, restaurants and schools have a lot of responsibility in ensuring our food is safe, and some in providing us with information about food ingredients and calorie content, but ultimately the responsibility lies with each one of us, and with parents for their children.

The IOTF, by trying to blame society, and trial lawyers by trying to blame fast food corporations, are providing excuses to the many overweight people that "it's not their fault." Apart from the small percentage of people who have genuine metabolic problems, it is the individual's fault. Without accepting that responsibility, no one will get any better. Furthermore, the IOTF and others want to make it a societal problem so that they can gain generous government support to study society's problem and encourage legislation that makes litigation, and hence financial gain, easier.

Roger Bate is a TCS columnist.

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