Saturday, December 24, 2005

The Fat Of The Land - Future Shocks - Part 8

You do not have to look very far into the news reports these days without finding out about the "time bomb" that is the obesity problem that is facing this country. Statistics are bandied about with wanton abandon including: that obesity costs £7.4 billion to the NHS, that diabetes will rise by 54% over the next few years whilst heart disease will rise by 20%, whilst 20% is also the number of Scottish children who are now in the obese category. People talk about 'fat-tax' and that the 'fatties' should get off their backsides and stop eating so much as if people are on some form of voluntary self-destruction course.

A worrying report has emerged recently about the East Suffolk Primary Healthcare Trust who in an effort to save money have been denying 10 clinically obese patients the hip and knee replacement operations that they require. The patients have been told that they must first lose weight before they will receive their surgery. There is no information as to what steps the trust may have taken to assist the 10 patients to lose weight.

This is another example of the thin end of the wedge, since it assumes that it is acceptable to deny people surgery if they deviate from a required norm. This started with the call for smokers to be denied treatment for any smoking related illness unless they gave up. The same interestingly has not been true of drinking and the late George Best, despite medical problems caused by chronic alcoholism, was still the recipient of a new liver and given the best medical care money could buy in the Cromwell hospital in West London, it didn't stop the alcohol eventually doing for him in the end.

The denial of treatment to people for any reason is alarming, it is even more so when no connection is made with the fact that modern life is increasingly consumption based in all forms. I do not know the hippocratic oath in its entirety but I do not recall any part of it including the caveats that doctors need only treat certain types of people if they can prove that any ailment is not somehow self-inflicted.

Notice that such a move not to treat certain types of people will always start with groups who do not have a great deal of sympathy, it is acceptable to be anti-fat and the ill-informed assumption that fat people just shouldn't eat so much is seldom rebutted. I am fat myself, I freely admit it, I am no longer in the dangerously obese section, a section which is surprisingly easy to fall into, you might assume that I was the size of a house but no, well, small cavaran perhaps! My weight problem could be caused by a variety of factors but in my case lethargy is partially if not mainly to blame. However studies have shown that our diet directly affects our energy levels and this means that there can be something of a vicious circle- eat shit food (which is often cheap and readily available), have no energy or inclination to then do any exercise. Is it our fault, well, yes it is but the trap is easy to fall into and difficult to get out of just as it is with any addictive lifestyle and our prediliction for fast food does nothing to alleviate this, quite the contrary.

Intrinsically I agree with a fat tax but it is only fair if obesity is treated properly as an addiction and dealt with the same as any addiction should be, think of fatty foods as heroin. OK, that sounds bizarre but you wouldn't say that other people who are not heroin addicts could dabble in a bit of smack from time to time so why should it be the same with fast food of no nutritional value. Of course this cannot happen using bans and legislation it has to be considerably more proactive. A tax needs to be levvied on foods that are high particularly in saturated fat. Some of the revenue from this needs to be channeled into subsidies for certain foods which are beneficial alternatives because if you make the healthy option affordable and the fatty option less so then you automatically entice towards good food rather than the current trend for poor food. For example most people will these days buy vegetable oil for their cooking because it is cheap, furthermore one of the worst proponents in fast food outlets is hydrogenated vegetable oil which is packed with saturated fat. If extra virgin olive oil were even only double the price you would have a far greater number of people using it instead, it is considerably tastier for food as well as it being far less high in saturated fats and higher in polyunsaturates. Likewise if companies had financial incentives to reduce the amount of high-salt, high-sugar processed foods in favour of fresher lower calorie, lower-carbohydrate options it might change their business plans somewhat.

The same can be said of exercise. It is all very well for the middle classes to have the options of gym membership at £25-£50 per month but that is an exorbidant amount of money for the majority of people in this country, whilst you may at the same time point out that a great many would spend the same amount on Sky TV and the National Lottery these are all part of the social sleeping drugs of the working classes. If exercise is to be made part of the modern routine it has to be engendered at a young age and that means both in school and at home. For this to happen there must be the facilities for all sorts of varieties of activity, after all playing football is not everyone's cup of tea. At the moment we are woefully short of facilities and in recent times that trend has worsened considerably with the state school playing fields being sold off left, right and centre. Youth clubs are often non-existent in deprived inner-city areas whilst under-funded and manned by volunteers in the marginally more cohesive suburbs and rural communities.

You cannot demonise one section of the population when it is clear that societal constructs mean that this section is on the increase beyond any reasonable control. However it is unsurprising that obesity is very much a social class issue, the lower income brackets, ie people without access to good quality fresh food or often the time to cook properly are most vulnerable to fast food and low quality, cheap ingredients. Our throwaway culture has led to throwaway attitude to food, most families barely if ever sit down to a proper meal together, contrast this with Italy where a family meal tends to be an event and savoured with antipasti, wine, main course, pudding etc. etc. There are undoubtedly fat Italians but the meditteranean diet is far lower in fat and cholesterol and hence the rates of obesity and the corresponding heart disease, high blood pressure, diabetes rates etc. are appreciably lower.

The school run in my day used to involve walking or getting the bus, only a handful of people at my primary school were picked up in the car the rest of us didn't even contemplate it and neither did our parents. Nowadays it is de rigeur for little Johnny or Sharon as well as little Portia or Toby to be carted in en voiture be it a 4x4 off road vehicle or MPV. The roads around schools are gridlocked at 9am whilst the pavements remain empty. External activities take planning and cost money whilst watching the TV or buying the kids a Playstation 2 are considered low maintenance activities. "Anything for a quiet life." Can we really be surprised that our children are accustomed to a sedentary lifestyle when it is us that have taught it to them by everything they see around them at home and in school. Of course active children are less maleable and can be a handful, that's because they are children, it's what they do, the pushing of boundaries against their parents is designed to test limits on people who are not supposed to knock seven shades of shite out of them before they get into the real world.

So the question is, do we as a society wish to continue to sit back and watch our children die whilst the fast-food companies reap huge profits or start to change things fundamentally and accept finally that the freedom to choose is a hollow one when you don't actually have any genuine choices.

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