Socialist Health Association Promoting Health through Socialism

Understanding obesity in a changing food environment

Professor Andrew Hill
Academic Unit of Psychiatry, Leeds University Medical School

An obesity epidemic? - epidemic is not the right word. Obesity is not objectively defined. A small change in the criteria produces a large change in the incidence

  Men Women
1980 6% 8%
1993 13% 16%
1995 15% 18%
1997 17% 20%
1999 19% 21%
2004 23% 24%

(Health Survey for England)

A toxic or obesogenic environment

Obesity as a normal response to an abnormal environment
side-effect of technology & prosperity reflects natural human preferences

(eg easy, convenient, fast, low effort, value for money)

In conjunction with variability in tendency to weight gain
e.g. thrifty genes

Modern environment/biology mismatches

Stimulating eating Reducing activity
strong signals to eat weak activity signal
weak signals to stop strong signals to stop
rewarding inactivity is rewarding
no viable alternatives inactivity is a viable alternative
eating well is high status inactivity is high status
increased availability reduced availability

Current approach to obesity:

Lifestyle, choice, individual responsibility

Fails to acknowledge:

This supposed reduction in consumption could be contrasted to:

10 year increases (Mintel, 2004):
32% food market
80% fast food sales
86% takeaway foods
12% per capita food supply, 5 yrs (US)

Changing food environment
Decreased
Increased
real cost of food opportunity cost of cooking
cost of energy-dense foods food eaten away from home
local food availability food promotion
family dining portion sizes
  food variety

External influences on food intake

Key Messages