Monday, December 14, 2015

Obesity isn’t the half of it: fat or thin, our eating is disordered

Sally Davies, the UK’s chief medical officer, is right to highlight women’s health issues. Her report, published at the end of last week, is comprehensive and thoughtful but her implicit claim, that obesity poses a threat to the nation comparable to terrorism, is concerning (she wants it to be elevated to the level of a “national risk”). This generated headlines but closed down the complex thinking that’s desperately needed.

What is obesity? Is it one thing? No. It is an arbitrary number on a scale which counts people with a BMI of over 30 as obese. Bundled together in Davies’ figures are the “overweight” who, according to the US National Centre for Health Statistics, are not necessarily unhealthy. Health and weight are not the same. There is health at different sizes.

Obesity endangers health of women and babies, warns UK's chief medical officer
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Is obesity a result of overeating? Yes, maybe, and no. There’s science and then there is the agenda of the various health, fitness and diet businesses mixed up in this. Sometimes fatness is the result of inadvertent repetitive dieting which can upset our metabolism. Sometimes it’s a result of eating the non-food foods that industry peddles. These drench our tastebuds with fat, salt and sugar combinations that overstimulate without giving a sense of satisfaction – other than reaching the end of the packet. Sometimes it is because these same non-food foods take a too-quick journey through our body without being properly digested.

Sometimes, as epigeneticists are discovering, it is to do with changes that occurred two generations ago, when food was very scarce. Sometimes, as Tim Spector of King’s College London, proposes, it is to do with changes caused by early and frequent antibiotic use which alter the flora in our gut.

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