By Rachael Shabetai
Obesity has hit the headlines recently, with the government announcing its plans to tackle the so-called ‘obesity crisis’.
Johnson has said these plans have been designed to protect ourselves against COVID-19. Disappointingly, this conversation has been about personal, not state, responsibility, littered with classic and inaccurate clichés about obesity and its impact on the health system.
The government has announced the introduction of calorie-signposting on menus, the removal of adverts of certain foods before the watershed, and no more deals on unhealthy snacks. Not only is this going to make late night library sessions less enjoyable, there is a more sinister message at play here.
What COVID-19 has revealed about UK public health
These policies place the onus of weight loss on individuals themselves, rather than acknowledging what public health officials have known for years — that obesity is linked with poverty, lack of education and lack of resources.
These guidelines arose after research was published from Public Health England, showing excess weight placed people at greater risk of hospital admission and ICU care. However, a closer look at this report reveals much more uncomfortable truths.
Public Health England concluded that people living in more deprived areas had higher rates of infection and greater mortality of COVID-19. In the most deprived areas, mortality rates were more than double the least deprived areas.
Damningly, the report states ‘this is greater than the inequality seen in mortality rates in previous years, indicating greater inequality in death rates from COVID-19’. If you are from a less affluent background, your predicted life expectancy can decrease by over 20 years — with this gap widening due to coronavirus. The report also highlighted the disproportionate effect COVID-19 has had on the BAME community, with people of Bangladeshi ethnicity having a death risk of double that of their White British counterparts.
And what does this have to do with obesity?
Yet, despite this report bringing into focus the unfair impact of COVID-19 in the UK, the response the government has taken is on an individual’s responsibility to lose weight. Not the institutionalised racism within the health service disproportionately affecting BAME communities, or the clear inequalities within our society that literally cut years off your life-expectancy depending on what postcode you are born into.
Our weight status is not solely dependent on our personal choicesHealth Equalities Group
The fact that during this pandemic the use of food banks has increased by 177% from this time last year — and it took footballer Marcus Rashford stepping in to guarantee children free school meals over summer — throws into harsh light just how much Boris Johnson and his government care about what’s on our plates. Let’s not even start on the fact they’re subsidising McDonald’s.
The government’s blatant fatphobia
Instead, this all too familiar trope of ‘fat = unhealthy’ has been used; framed in aid of helping the NHS. Matt Hancock, the Health Secretary, wrote in the Daily Telegraph about the new policies, that “If everyone who is overweight lost five pounds it could save the NHS over £100m over the next five years.” Once again, the responsibility has been shifted to the individual.
This should come as no surprise after the pandemic, where it was made clear in England that the approach towards COVID-19 is one of personal responsibility. After all, this was the government who locked down weeks after other European countries – advising us all to socially distance, but not legislating any enforcement.
Furthermore, the cost of obesity Hancock references has been catastrophised. In 2017, the net costs of obesity were estimated as £2.47 billion pounds in 2016/17 — only 2.3% of the NHS budget. The same think-tank theorised that death from obesity saved the public purse – due to less money claimed in state-funded care and unpaid pensions.
Obesity will not collapse the NHS
So let’s get one thing straight; obesity is not the money-draining cause of NHS collapse. And it is outrageous for Matt Hancock to argue it is the overweight and obese population’s responsibility to look after a system that cares for all of us — regardless of how much we drink, how many children we have or how much we weigh. Especially as his government has systematically dismantled and defunded this same system.
Boris Johnston may attribute his weight gain to laziness, but it is abhorrent to not acknowledge the social determinants to health, and insinuate this laziness applies to the rest of the country. This should have been an ideal opportunity to consider the link between poverty, obesity and COVID-19. Eight Public Health directors from the North-West of England have signed an open letter arguing “our weight status is not solely dependent on our personal choices. There are many other significant factors that determine one’s weight – including where we live, how much money we earn, who we socialise with, what marketing we are exposed to, our family history and many more factors.”
The fatal toll of austerity
The problem arises when tackling obesity is regarded as a personal problem, as it allows the government to get away with not acknowledging the consequences of their cuts. This involves combating austerity: meaning people don’t have to rely on food banks and have the time and equipment for healthy eating and exercising.
Through government-funded programmes — free, nutritious meals in schools, free fitness programmes, accessible clinics on healthy living and managing illness, this can be achieved. It cannot be achieved by creating a culture of calorie counting and fat-shaming, which could fuel and exacerbate eating disorders. It cannot be achieved by removing ‘buy one, get one free’ advertising – which is a tax on those from lower socioeconomic backgrounds. And it certainly cannot be achieved by placing the responsibility of weight loss onto the individual.
Healthy living should not only be accessible to the privileged few, and it is equally the time to stop fat-shaming and pretending that health services don’t exist to provide for all us.