Inequality is fattening
People will get thinner only when they have things that are worth staying
thin for - self-esteem, social status and jobs
http://www.guardian.co.uk/comment/story/0,3604,1226522,00.html
Polly Toynbee
Friday May 28, 2004
The Guardian <http://www.guardian.co.uk>
This obesity debate is full of humbug and denial. Fat is a class issue, but
few like to admit that most of the seriously obese are poor. This is not
about the nanny state telling Boris Johnson to keep off the claret in his
club. It's about people like us telling people down there in the underclass
to eat up their greens. Health professionals say "we" must take more
exercise and stop eating fast food, but mostly they really mean "them".
It's an old story - trace it back to the poor laws. The middle classes like
to worry about the morals, health and drag on public expenditure of the
poor. Horrendous projections for what obesity will cost the NHS naturally
worry taxpayers forking out to fill hospital beds with poor fat folk.
True, many of us middle classes are overweight, but most of the dangerously
obese - the 22% with a body-mass index in the red zone - are to be found
carless on council estates and not in the leafy suburbs where kids are
driven to school in supertanker 4x4s. It is poor children at most risk of
swelling up like balloons, in danger of losing limbs and eyesight to
diabetes as they grow up. It's wrong to talk about "fat cats" when the
privileged are usually thin and sleek with bodies well-exercised by gyms and
personal trainers on diets of radicchio and sparkling water.
Kinder experts look for sympathetic reasons why the poor are fat and
unhealthy. Fresh fruit and vegetables are so expensive, they say. There is
no transport to get from estates to the good food shops. Poor women are too
hard-pressed to have time to cook proper family meals, so they snack. It's
hard for poor children to exercise in dangerous concrete jungles, with no
cars to take them to ballet and judo lessons. Or maybe, sadly, these people
just don't know what's good for them.
All these may be contributory factors. The uneducated may not read small
print on deliberately incomprehensible food labels to detect the difference
between kJ and kcal. Unlike neurotic middle-class mothers, they may not
follow every scare about tartrazine and GM or dream up hypochondriacal
allergies for lack of anything else to worry about in what is, remember, the
safest and healthiest time ever.
So why are the poor getting dangerously fat? They are mainly a little better
off and food has got cheaper. They are not ignorant. Every woman alive has
spent her life obsessing over body size, perusing every diet in magazines
and daytime TV shows. Never has there been more information about what food
is fattening and what is not. Public health advice is puny beside this great
surfeit of diet and fitness info.
What's more, these messages are vigorously reinforced by every fashion and
celeb page telling us thin is beautiful, fat is horrible. Tabloids spend
fortunes on paparazzi snaps of some celeb on the beach who has "let herself
go". Star-cellulite-in-bikini is worth as much as star-in-illicit-love-nest.
Fergie fat or thin is regular fare. No child needs to be told fat is bad
when right from nursery school it's the fat kids that get tormented for
being slow, ugly and undesirable - often reinforced by teachers who see them
as losers, too. From Charlie and the Chocolate Factory to Harry Potter,
heroes are skinny and lithe, while nasty children are fat porkers. Who
doesn't want to look more like Posh than Roseanne?
So what's gone wrong? Most of us wrestle with food, torn between denial and
desire, between fridge and gym, eating and regretting. It is very hard and
girth grows by the decade. Most people I know live in a Bridget Jones cycle
of boom and bust with the weighing scales. But mostly the middle class stays
the right side of dangerously obese. In the highest echelons, those
superthin lettuce-eaters Tom Wolfe calls the social x-rays know that
thinness radiates high status, as surely as bound feet did in old China.
"You can't be too rich or too thin," said Dorothy Parker.
But fat means poor and out of control. People who feel they have no control
over their own lives give up. What's there to struggle and make sacrifices
for? No job, no prospects, no point. A little of what you fancy compensates
for life's big disappointments. So drinking and smoking and eating the wrong
things become small treats in desolate lives. Being out of control becomes a
mindset ever harder to climb out of. No job becomes no status, no hope and,
rapidly, unemployable semi-despair, whatever the job market out there.
Poor children at school know their low status from the day they walk in. The
little girl with perfect kit, sparkly trainers and lovely lunchbox is always
admired over the shabby kid who never went to ballet and only had a packet
of Wotsits for breakfast. The rest of us have very good social incentives
not to give in to temptation - and even then often fail - but those who have
nothing easily give up.
The traditional middle-class reaction is to teach poor mothers how to become
better managers; a family can eat healthily on very little, they opine. See
how low-paid vicars bring up their broods on a pittance. Though when I
recently tried living on the minimum wage, even without children, I found I
couldn't manage, counting every penny and eating nothing but lentils, rice,
potatoes, pasta, cabbage and oranges. It's a miserable, life-denying way to
eat, but that's not the point. Even with more money, the poor would probably
eat themselves into an early grave if there was not much else to live for.
Why defer gratification if there isn't going to be any compensating
gratification?
It is inequality and disrespect that makes people fat: obesity took off 25
years ago, up 400% in the years when inequality has exploded. People will
only get thinner when they are included in things that are worth staying
thin for. Offer self-esteem, respect, jobs or some social status and the
pounds would start to fall away.
The inequality/obesity link is mirrored internationally. America has by far
the most unequal society and by far the fattest. Britain and Australia come
next. Europe is better and the Scandinavian countries best of all. No doubt
there are also social policy reasons for this: the best social democracies
pick up family problems earliest and offer most support, putting people back
on their feet, preventing social exclusion. But the narrower the status and
income gap between high and low, the narrower the waistbands.
Of course, we need tough labelling laws and a ban on advertising junk to
children in schools and on TV. It's a disgrace that there are virtually no
safe cycle lanes in cities. Every school needs great dance, aerobics, sport
and fun in after-school clubs. It's shocking the government is so craven
about controlling the excesses of the food and drinks industry. But let's
not fool ourselves: only a genuine drive towards a society that doesn't
leave out a quarter of its citizens will send the bathroom scales tipping in
the right direction.
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Ursula Snyder, PhD
Editor/Program Director, Medscape Ob/Gyn & Women's Health
www.medscape.com/womenshealth
Section Editor, Ob/Gyn & Women's Health, Medscape General Medicine
www.medscape.com/mgmhome
T: +1 902 868 1892 F: +1 902 346 2048 (CANADA)
Email: [log in to unmask]
Medscape/WebMD
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New York, NY 10001
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