鈥淲E鈥橵E just gotten too darn fat,鈥� US health secretary Tommy Thompson said last week. 鈥淥verweight and obesity are literally killing us.鈥� His remarks followed publication of figures in The Journal of the American Medical Association showing that a staggering 64 per cent of the US population is now clinically overweight or obese.
The figures reveal that obesity is close to overtaking tobacco as the leading cause of death in the US. In 2000 it killed 400,000 Americans, a third more than in 1990, and just 35,000 short of deaths linked to smoking. That mountain of flab helps to trigger a host of diseases from type 2 diabetes and high blood pressure to heart disease. The total bill for obesity-related problems in 2000 alone has been put at $117 billion.
This not a purely American problem: the same trend blights many other countries. So how have we arrived at this state? The sad answer is that none of those involved 鈥� not governments, nor the food industry, nor consumers 鈥� has taken their responsibilities seriously.
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Take food companies. Their mission is still to sell more, even though it is obvious we need less. Can companies really justify adding the equivalent of 10 teaspoons of sugar to a single-serving can of soft drink? They need a new business model based not on 鈥渕ore鈥� but on 鈥渉ealthier鈥�, yet they seem to be shy of moving.
The US government does not seem to be pushing. Last week, following release of the obesity figures, the National Institutes of Health and the Food and Drug Administration issued strategies for tackling the problem. The NIH has a respectable programme of research, but the FDA is largely limiting itself to 鈥渆valuating鈥� and 鈥渃onsidering鈥� different food labelling schemes, and 鈥渆ncouraging鈥� food companies to adopt them. The limpness of these measures has attracted scathing, cynical criticism from consumer groups.
To complicate matters, a few weeks before Thompson announced the FDA鈥檚 plans, one of his special assistants issued a 28-page missive criticising the World Health Organization鈥檚 Global Strategy on Diet, Physical Activity and Health. The WHO calls for reductions in fat, salt and sugar in foods and advocates fresh fruit, nuts and more exercise. It is all common-sense stuff, recommending healthier food rather than more of it. The FDA鈥檚 response calls into question whether the US administration has any strategy on obesity at all.
But we consumers cannot plead ignorance. It may be true that we are up against our own physiology, which evolved to store away fat for times of famine, but this is a poor excuse. Nutritionists have been saying for years that we need to learn restraint in the land of plenty. We should be voting with our wallets for healthier food.
If consumers do not act now, they face a grim future. Last week, The New England Journal of Medicine reported that the number of stomach bypass operations for severely obese Americans soared from 16,000 annually in the early 1990s to a staggering 103,000 last year. Of course, drugs might make such drastic action unnecessary. At the annual meeting of the American College of Cardiology in New Orleans last week, delegates heard about a drug called rimonabant that suppresses appetite by blocking a neuroreceptor (see 鈥淏ye-bye munchies鈥�). But even rimonabant is a year from the market.
Preventing obesity is much simpler than treating it, so establishing healthy patterns of eating early in life is paramount. It needs to happen now: childhood obesity has trebled in the US since the 1970s, and 15 per cent of adolescents are overweight or obese.
One obvious priority is getting bums off seats, dragging children outside for exercise away from TVs and computers. On diet, the American Academy of Pediatrics has called for soft-drink vending machines in schools to sell just milk or water, or be phased out. And what about programmes to guarantee healthy breakfasts and other meals at school?
For all these things to happen, there is one essential ingredient: parent power. Whether the cause is safer local playgrounds or better food labelling, motivated parents have the political muscle to make it happen. They may have been brought up to be pathological eaters, but there is no need for their children to suffer the same fate.