Insecurity, Inequality and Obesity in Affluent Societies,
edited by Avner Offer, Rachel Pechey and Stanley Ulijaszek, Oxford University Press/British Academy, 220pp, £50 (hardback)
I have struggled with an uncontrollable appetite for potato crisps for as long as I can remember. The legacy in my arteries of that unholy trinity of salt, fat and sugar, married to a sharp burst of flavour, may well eventually kill me.
Recently, at a garden party in Prague, a bag of what an American reveller called ‘chips’ was passed around: paprika-flavoured exotica rarely encountered in these northern isles. Twilight had long passed but the evening remained soothingly warm. The murmur of impenetrable Czech lilted. As soon as the crisps fell into my clutches I got carried away, retreating to a dark corner to devour the remainder of the bag. I began munching them in generous bunches, allowing a pleasing crunch between my molars that released luscious oil, the mulched potato sticking to my gums and whispering sweet nothings to my palate.
I finished the packet in urgent handfuls, rationalising as I went along: I am on holiday; I need more salt in the heat; it would soak up the alcohol; I do not need to worry about my weight. As I ate, dopamines spilled forth like the convectional rain that eventually arrived that sultry night. I was in the grip of what David A. Kessler terms Conditioned Hypereating. Medievals knew it as Gluttony. I was a slave to my passion but also to an industry that sets out to trigger that response.
Unique conditions prevail in the Western world where food calories are so cheap and accessible that most of the population struggles to keep their waistline in check. The pall of obesity has spread with the advance of global capitalism like squawking seagulls following a heavily laden trawler to shore.
Yet not everyone, nor every society for that matter, is prone to it. A new collection of essays links rampant obesity to the stressful lives of populations living in capitalist economies.
The editor of the collection, Avner Offer, asserts: ‘Among affluent societies, the highest prevalence of obesity is to be found in countries most strongly committed to market-liberal policy norms.’ He argues: ‘if stress generates obesity, then welfare states protect against stress, and are likely to have lower states of obesity.’
He says: ‘it is appropriate to think of the rise of obesity as an eruption, and to look for another eruption to explain it.’ He identifies this as the emergence of the New Right in the 1970s, and the market-liberal regimes that subsequently carried out their economic and social programmes in the main English-speaking countries and elsewhere. Thus: ‘the economic benefits of flexible and open market liberalism, such as they are, may be offset by costs to personal welfare and public health, which are rarely taken into account.’ He cites the example of the UK, where the prevalence of obesity among adults has almost tripled since 1980. He suggests an obesogenic environment was largely in place by the 1970s: car use and television watching were well established, and food was already cheap and plentiful.
Increased stress levels, especially fuelled by insecure employment, affect dietary choices: ‘Physiologically, stress leads individuals to prefer fatty and sweet foods, and frequently to consume more calories, exacerbating weight gain, especially in the form of risky abdominal fat.’ The idea of a link between insecurity, stress and obesity is supported by the ‘social gradient’ of obesity: it is most prevalent among those at the bottom of the social scale.
Offer refers to a study on mice which suggests that weight gain from a high-fat, high sugar diet is exacerbated by intense, chronic stress. Illuminatingly, in the month after 9/11 sales of snack foods increased by more than twelve percent across the United States as paranoia, verging on mass hysteria, swept through the country. Further, a recent cross-sectional study of German adults found a higher risk of obesity among over-indebted individuals. Overall: ‘among rich nations, the USA and Great Britain have experienced the greatest income inequality since 1980 and the greatest increase in the prevalence of obesity.’
Another author, Peter Whybrow, connects these responses to our early evolution. He argues that stress causes the lizard core of our brains to release dopamine, a hormone connected to pleasure, after consuming fatty and sweet foods.
He paints a familiar picture: ‘In the presence of continuous psychosocial shocks, a complex work environment, repeated deadlines, a difficult marriage – the alarm bells are continuously ringing and the stress response is continuously in play. In consequence, the body is maintained in a high state of psychological arousal, where the vulnerability to chronic illness is increased, with obesity as no exception.’
He also connects its prevalence to poor sleep patterns: ‘Over the same period that Americans have been stealing from their sleep bank, the incidence of obesity in the USA has doubled.’
A note of caution is struck in the article written by John Komlos and Marek Brabec who argue it makes ‘little sense’ to say the epidemic appeared rather suddenly in the 1980s. They argue that the roots ‘reach further back in time than common wisdom suggests’, claiming these were ‘embedded in the social fabric’. They contend that ‘the most obviously persistent among these were the major labour-saving changes of the twentieth century – chiefly the industrial processing of food, and with it the spread of fast food outlets and the associated culture of consumption, the introduction of radio and television broadcasting, the increasing participation of women in the workforce and the IT revolution – which taken together virtually defined US society in the twentieth century’.
Joseph A. Schumpter characterised capitalism as a dynamic system of ‘Creative Destruction’, and
a process of industrial mutation … that incessantly revolutionises the economic structures from within, incessantly destroying the old, incessantly creating a new one … Not only are the processes of production and distribution of economic output constantly revolutionised, but all other domains of life are also continuously transformed. Villages die as cities grow, family cohesion crumbles as individuals become more independent of traditional ties, and old ideas and values are delegitimised by developing science and new ideas that are more consistent with evolving social structures.
Capitalism is a dynamic system that has brought incredible technological breakthroughs and industrial efficiencies, but the decline of older sources of community and culture have left many ‘lonely, bored, anxious and passive’ per Erich Fromm. In these circumstances a dysfunctional relationship with food has emerged with obesity among a range of pathological conditions.
This only tells a part of the tale, however. It is also important to assess the cultural contribution. Obesity is most prevalent in Anglo-Saxon societies without developed gastronomic traditions similar to those seen in continental Europe. Moreover, the culture of eating is haphazard and unregulated. Consumption is not confined to meal times. Grazing through the day is commonplace. In these circumstances the monster of obesity thrives.
Eating habits in Anglo-Saxon societies tend to be hierarchical. The diets of rich and poor diverge to a much greater extent than is the case in continental Europe. Local dishes are rarely prized with elites tending to favour exotic, external models. Today upper classes often gravitate either towards traditional health foods based on whole grains, nuts and vegetables, or faddish weight-loss diets like those advocated by Dukan and
Atkins. Both modes of consumption share one thing in common: they cost a good deal of money, especially the latter.
A wholefood diet should be cheaper: brown bread was once the food of the poor who could not afford refined white bread, which was seen as a luxury – a situation that has been reversed. Now the Chorleywood Bread Process delivers white bread of strikingly poor nutritional quality at very low cost. Perverse government subsidies in Europe and the United States keep nutritionally empty ingredients, especially those used in fast food, at artificially low prices.
Alas, wholefoods have become whole-wallet-foods. Drewnowski states that in the United States:
the price disparity between ‘empty calories’ and healthier food options continues to grow. Whereas fat and sweets cost only thirty percent more than they did twenty years ago, the cost of fresh produce has more than doubled.
The trend in Britain is likely to have been similar.
Both high fructose corn syrup and beef are kept at artificially low prices, despite their deleterious effect on human health. It is ironic that where the state (and the European Community) has attempted to curb the effect of capitalism it has devoted subsidies to food the consumption of which over a prolonged period will damage the health of consumers. This pushes up health costs, reduces labour productivity and triggers depression. What’s more the whole system is utterly unsustainable.
How to Address It?
The challenge of solving the obesity problem is testing the capacities of policy-makers around the world. Thus far the results have been unimpressive. I have previously argued that the whole model of Western medicine should be altered to bring disease prevention to the fore. Health, rather than pathology, should become the speciality of the doctor, especially the general practitioner. This would involve more community- based health programmes that would see doctors engaging with schools
and other organisations to raise nutritional awareness in subtle ways. Food is all-important to health: as Hippocrates said ‘let food be thy medicine and medicine be thy food’.
Advertising of objectively unhealthy products should be banned and a special tax should be introduced for refined sugar. The consumption of meat, especially red meat, should be discouraged, with subsidies to farmers removed. The powerful effect of advertising should be trained against unhealthy food just as it has been against tobacco.
Further, a serious evaluation should be made of British agriculture to increase the production of healthy, sustainable foods. Far too much grain is cultivated for livestock production. Healthy food for human beings should be the objective.
Obesity can be addressed but governments need to wake up to the causes – not only economic insecurity but the types of food that are cheaply available. Addressing eating habits must begin in schools. All students should be taught how to cook and grow fruit and vegetables. Owing to the celebrity chef phenomenon, food is already embedded in popular culture, so it should be easy to instil a sense of pride in cookery and horticulture.
Arguably, the large supermarket chains are beyond redemption as these, along with the diabolic purveyors of fast food, have been the agents of obesity. Individuals and government agencies should look for alternative models of consumption such as cooperatives. The People’s Supermarket in Bloomsbury, London is an excellent example of a community taking ownership of its food and the idea is spreading. If the current government’s notion of the ‘Big Society’ is to stand for anything it should mean state support for such initiatives or at least making life difficult for the large supermarkets that monopolise food supply and show little in the way of corporate responsibility.
The challenge of alleviating stress in a complex capitalist society is significant but we should not give up hope. Any one of us can succumb to the allure of crisps, cakes and burgers, but equally we can resist them. Perhaps a younger generation armed with knowledge from the free internet will create a powerful movement against the Western lifestyle. Sometimes change arrives with unexpected speed. The indicators for obesity appear bleak but each one of us has the capacity to resist temptation.